Treating MGD

Lid Hygiene:

Apply warmth to your eyelids using a warm washcloth, a Bruder Moist Heat Eye Compress, other, immediately prior to cleaning, or “shampooing”, your eyelids and eyelashes to obtain the most effective cleanse.

After you apply warmth to your eyelids, your eyelid cleansing should be performed for at least one minute with your eyes gently closed. 

Eyelid cleansing can be performed simply using face or bar soap and water, diluted baby shampoo, or products such as OCuSOFT hypochlorous spray and eyelid wipes, or Optase wipes which contain tea tree oil (Dr. Muller’s recommendation).

Lid cleansing should be done a minimum of two times each day, i.e. in the morning and in the evening. 

LID 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 a minute 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. This obstruction and loss of your glands leads to MGD and dry eye. Prevention of MGD using early detection and intervention are essential to the long-term health and comfort of your eyes.

Preservative Free Artificial Tears:

One drop instilled in each eye 4-8 times each day, depending upon need.

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.healio.com/ophthalmology/cornea-external-disease/news/print/ocular-surgery-news/%7B4c7547a8-5f21-480f-a839-46a9a347f4ec%7D/re-esterified-omega-3-supplements-improve-ocular-surface-signs-symptoms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975557/
https://www.nwvision.org/eye-care-services/dry-eye-treatment/omega-3-supplements-for-dry-eyes/

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 your lashes 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 drops drops
  • Other

Mechanical Treatments

Blepharoexfoliation: Golf Club Spud Scaling procedure

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

This procedure treats blepharitis, 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 of the procedure by keeping their eyelids clean. The procedure is typically repeated at intervals which vary based on 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 along with a medical grade eyelid cleanser to deep clean and exfoliate your eyelids and eyelashes, removing dandruff, scurf, debris and the biofilm***** plugging, or blocking, the openings to your Meibomian glands. 

This procedure treats blepharitis, 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 and is soothing. Most patients simply report a tickling sensation.

After the procedure, the patient is instructed on how to maintain the benefits of the procedure by keeping their eyelids clean. The procedure is typically repeated at intervals which vary based on each patient’s individual needs.

In-office treatment provides targeted approach to blepharitis

 

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 unblock, clean out, and evacuate 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 the most.

This procedure treats blepharitis, 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, together with a unique pre-LipiFlow treatment process, coupled with her exclusive post-LipiFlow treatment protocol. 

Dr. Muller is involved in every aspect of 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 ocular rosacea, Meibomian gland dysfunction and dry eye. This is because it is the most effective at unblocking and cleaning out your Meibomian glands. LipiFlow is an FDA-cleared electronic 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 production and flow of oils. The entire treatment takes approximately 12 minutes, is comfortable and is extremely effective.

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

Meibomian Gland Probing:

Meibomian gland probing is a safe and effective technique for treating obstructive meibomian gland dysfunction. The procedure is performed in our office using a compounded surgical grade topical anesthesia applied to the eyelids. 

Probing is performed through the natural gland openings, or orifices, physically unclogging the openings and the ducts of the Meibomian glands. Meibomian gland probing mechanically clears the orifices and the ducts from blockage by thickened meibum, cellular debri, and fixed fibrotic obstructions thus allowing the oils to flow freely again. Having the oils flowing freely again improves the health of the surface of the eyes, and the Meibomian glands, which alleviates eye and eyelid discomfort. 

Dr. Muller typically combines the use of various anti-inflammatory medications and antibiotic drops to optimize your results.

Additionally, Meibomian gland probing has been reported to be associated with regeneration of missing, or atrophied, Meibomian glands. Probing may promote glandular regrowth/regeneration in part by mechanically re- establishing a patent orifice/duct system.