A recent study by Lemp, Michael et al. revealed that after evaluating a group of patients that definitely had dry eye, 86% had meibomian gland dysfunction that was contributing to their dry eye problems. The abstract for this interesting dry eye study can be found HERE.
It’s conclusion is very important as historically we have been treating dry eyes by trying to replace the water component of the tear film. In most cases this is not going to be effective because in the presence of meibomian gland dysfunction, just replacing the water component will either drain away or evaporate again. Potentially traditional eye drops will be ineffective in over 50% of cases.
It stands to reason that treating meibomian gland dysfunction will become standard practice in due course. At The Eye Practice we will soon install the state of the art instrument for meibomian gland dysfunction, called LipiView and LipiFlow. Traditionally we have used warm compresses to treat meibomian gland dysfunction. This is quite inefficient in transferring heat to the meibomian glands. The Lipifow is a brilliant innovation. Not only does it transfer heat effectively, it also massages the meibomian glands once the solidified oil in the glands have been melted so that they start to flow again and hence coat the tear film and therefore suppress the evaporation that leads to all the drama that dry eye creates.
There are eye drops that have been released as well called Systane Balance by Alcon. These finally attend to meibomian gland dysfunction. There are two problems with these:
They only mask the problem and do not attend to the underlying blocked meibomian glands. At least they replace the deficient meibomian oil.
Currently these drops only come with preservatives. Ideally they will release unpreserved ampules, which we at The Eye Practice have a preference for – who wants preservatives in their eyes?