Hello and welcome to Case of the Day. I’m Dr Croley and today we’re gonna discuss an interesting patient, in a case that we just completed.This lady has severe dry eyes and she’s been on multiple different types of treatment from Restasis, we’ve even performed LipiFlow on her eyes which only gave her minimum relief. She’s had Punctal Plugs, she’s been on a variety of different types of supplements and a variety of treatments. And so today we did a ‘probing’ of all her Meibomian glands and so we’re gonna go over what that is. This is sort of the newer treatment for severe cases of dry eyes, and so we’re gonna discuss a little bit about dry eyes and then what a ‘probing’ does.
So for people who have dry eyes, there’s different types. The most common type is what we call Evaporative Dry Eye due to Meibomian Gland Disease or dysfunction, which is what she has. So your tear film is composed of three layers, basic layers. A bottom mucous layer, then a water layer, and then an oily layer. The oily layer covers over the water layer and protects it from evaporating from the surface of your eye. The oil is also a lubricant. And so with people with Meibomian gland disease, they have a very low level of the lipid layer to their tear film which then allows the tears to evaporate off the surface of their eye. The Meibomian glands are located on the eyelid and they secrete the oil onto the tear film.
So we’re gonna show you a little image here. And so this shows you on the left-hand side of the photograph an image of the Meibomian glands in the lid and in the middle is just a picture. And so when we look at these glands, they’re normal at the top and all the glands are visible. These gradually go down due to chronic inflammation over years of time, these glands start scarring and closing down and getting start-shut where they no longer function. And so what we do is to actually is to go to each opening on the gland where it opens on the edge of the lid, then actually stick a probe down in it to try to break any scarring that’s preventing the oil from getting out in those glands. And so this procedure had a success rate compared to other things of doing very well. And so it’s typically not done in people who have mild dry eyes or Meibomian gland disease but people who have had severe.
So in my particular case, I try most of the things first such as Restasis, LipiFlow treatment which is the only FDA-approved treatment for Meibomian gland disease and we put people on Hydroeye pills, special teardrops, FT oil and hot compresses to try to calm the eyelids down. And even Doxycycline or Tetracycline which is also to keep any inflammation and maybe slow- grade chronic infection down in the lids.
And then now we’ve added this Meibomian Gland Probing to the process and we’re hoping to start having good results with this. Some people who are sort of at their end of their road, that there’s nothing else has worked, and they’re really miserable and unhappy how their eyes feel. And so we’ll give you a report later on how these people start doing with Meibomian gland probing.
So if you have any questions about dry eyes and any of these type of treatments, you can always contact us through the website, I will be happy to try to answer those questions. If not, may God bless you with healthy eyes and great vision.