Treating Blepharitis

Eyelid Hygiene:

  • Twice each day, in the morning and in the evening, you should apply warmth* to your closed eyes for 10-20 minutes to loosen/soften the oils in the glands of your eyelids (meibomian glands).
  • This should be followed immediately by washing your eyelids, either at the sink or in the shower.  You should close your eyes and use gentle soap and water to “shampoo” your eyelashes/eyelids for a full minute per eye.** You can simply use your face soap, bar soap or an eyelid towelette (i.e. Optase -Dr. Muller's favorite, Ocusoft, other).
  • In person, Dr. Muller and her staff will teach you how to perform "eyelid hygiene" optimally, including massaging the oil secreting glands in your eyelids. Eyelid Hygiene

*Warmth is best applied to your closed eyelids using gel packs or a heat mask such as an Optase or Bruder which can be heated in a microwave, or a Wizard Research Laboratories Electric Heated Dry Eye Mask (Dr. Muller's favorite). Washcloths do not work well.

** Note: a minute will feel like a very long time with your eyes closed.

 

EYELID CLEANSING IS ANALOGOUS TO BRUSHING YOUR TEETH

Most of us know that brushing our teeth prevents the accumulation of plaque, and the development of cavities and gum disease. Another part of your daily hygiene should be taking the time to clean your eyelids and eyelashes. Cleaning your eyelids removes debris that can build up over time causing obstruction and loss of your meibomian glands, known as meibomian gland dysfunction (MGD). Prevention of MGD using early detection and intervention is essential to the long-term health and comfort of your eyes.

Preservative Free Artificial Tears:

One drop instilled proactively into each eye 4-8 times each day.

Some artificial tear options include preservative free: OCuSOFT Retaine MGD, NanoTears MXP Forte, NanoTears TF, Systane Ultra, TheraTears, Refresh Optive Advanced, Soothe, GenTeal Lubricant Eye Drops for Mild to Moderate Dry Eye.

Omega-3 fatty acid supplements, in addition to a diet rich in Omega-3s:

Omega-3 supplements should be purified and from re-esterified triglyceride EPA and DHA. Please note that 3000 mg/day are recommended.

https://prnomegahealth.com/products/dry-eye-omega-benefits/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975557//

Prescription Medications:

Depending upon the severity of your meibomian gland dysfunction the following medications may be prescribed by Dr. Muller:

  • Antibiotic ointment at bedtime
  • Azasite drops massaged into the base of your eyelashes at bedtime
  • Antibiotics by mouth (doxycycline, tetracycline, minocycline, etc.)
  • Restasis, Cequa, and/or Xiidra
  • Mild steroid drops such as Alrex . Inveltys, Flarex, FML, or Lotemax
  • Other

Mechanical Treatments

Blepharoexfoliation: Golf Club Spud exfoliation

A numbing drop is placed in each eye prior to treatment. Using a handheld instrument known as a golf club spud, Dr. Muller painlessly cleans and exfoliates your eyelids removing keratin, debris and the biofilm* plugging, or blocking, the openings of your meibomian glands. 

This procedure treats meibomian gland dysfunction, blepharitis and ocular rosacea, enhances the health of your eyes, eyelids and meibomian glands, and helps with dry eye symptoms.

After the procedure, you are instructed as to how to maintain the benefits. The procedure is typically repeated at intervals which vary based upon each person’s individual needs.

MicroBlepharoexfoliation (MBE) using BlephEx:

BlephEx™ is a comfortable in-office procedure performed by Dr. Muller using a revolutionary new patented medical device which employs a high speed rotating micro-sponge to deep clean and exfoliate your eyelids and eyelashes, removing dandruff, scurf, debris and the biofilm* plugging, or blocking, the openings of your Meibomian glands. 

This procedure treats meibomian gland dysfunction, blepharitis and ocular rosacea, enhances the health of your eyes, eyelids and meibomian glands, and helps with dry eye symptoms.

A numbing drop is placed in each eye prior to treatment. The procedure lasts about 6 -8 minutes, is comfortable and soothing. Most patients simply report a tickling sensation.

After the procedure, you are instructed as to how to maintain the benefits. The procedure is typically repeated at intervals which vary based upon each person’s individual needs.

iLux:

iLux is a handheld medical device which gently and comfortably heats your eyelids to a safe, therapeutic temperature which softens the contents of your meibomian glands. Once the contents are softened, manual pressure is applied to your eyelids to evacuate the contents of your glands. iLux treatments can be customized to optimize your results by applying more compressions combined with a longer heating time in the areas where you need it most.

This procedure treats meibomian gland dysfunction, blepharitis and ocular rosacea, enhances the health of your eyes, eyelids and meibomian glands, and helps with dry eye symptoms.

Not all LipiFlow Treatments are Created Equal: Dr. Muller’s Unique Approach

The results achieved by Dr. Muller’s patients from LipiFlow treatments performed in her office have proven significantly more effective and longer lasting when compared with the results from LipiFlow procedures performed elsewhere. 

This is due to Dr. Muller’s thoughtful and intensive methodology which consists of  a unique pre-LipiFlow treatment process, coupled with her exclusive, proprietary post-LipiFlow treatment protocol. 

Dr. Muller participates in each LipiFlow procedure performed in her office (the procedure is not simply performed by a technician). 

It is these distinct differences which combine to ensure that Dr. Muller’s patients receive the most effective and longest lasting results from their LipiFlow treatment.

LipiFlow:

LipiFlow is the “gold standard” for treating meibomian gland dysfunction, blepharitis, ocular rosacea and dry eye. This is because LipiFlow is the most effective way to unclog and evacuate your meibomian glands. LipiFlow is an FDA-cleared electronic medical device that removes meibomian gland blockages and restores gland function. Through advances in the application of Vectored Thermal Pulsation (VTP) technology, the LipiFlow treatment utilizes a patented algorithm of heat applied comfortably to your eyelids, followed by massage, to remove the obstructions and evacuate the contents of your glands. This deep cleaning allows the meibomian glands to resume proper oil production and flow, once again contributing the oil layer to your tear film. The entire treatment takes approximately 12 minutes, is comfortable and is extremely effective.

 

*A biofilm is a slimy, sticky film of bacteria that coats the surface of the eyelids. A biofilm is composed of a well-hydrated matrix of bacteria and their glycocalyx, a sugary coating that allows cells to adhere to and communicate with each other. The eyelid margin—with its moisture, nutrients and warmth—is the perfect environment to cultivate a thriving bacterial biofilm.