A lady in her mid 50's was referred to our clinic from another optometrist in early 2017 for management of her severe dry eye symptoms.
For years this poor woman had been suffering from debilitating symptoms of eye burning, blurred vision and swollen tender eyelids. She had used most eye drops that were commercially available and at times had needed ocular steroids and antibiotics to help her condition. Unfortunately the eye drops only ever helped her for a short period of time: she freely admitted that the constant struggle with her eye condition was having a massive effect on her quality of life. This is the sad reality of dry eye disease, that many people without the condition fail to understand.
Signs of poor quality meibomian gland secretions in MGD dry eye.
On examination I could see that this lady had moderate Meibomian Gland Dysfunction (MGD), a condition where the oil glands in the eyelids become inflammed and function poorly. The oils released from these glands create the protective outer surface of the tear film, preventing evaporation of the main volume of the watery tears. Her MGD was leading to evaporative dry eye, this was why her drops were of limited benefit. Her issue was the quality of her tears, no the quantity.
We are the first practice in the Bay of Plenty to invest in a state-of-the-art technology for treating MGD-related dry eye: Intense Pulsed Light (IPL) Therapy. This painless treatment is designed to decrease inflammation and improve the quality of the secretions from the meibomian glands, thereby improving dry eye symptoms. Importantly the effect lasts. for many patients for at least 6 months or longer. I recommended IPL treatment to this lady and she started her 6 week treatment program that day.
On review after the IPL treatment this patient returned very pleased. Her dry eye symptoms had reduced dramatically and she was only needing to use eye drops occasionally when she remembered. Day to day activities like sitting down to read a book was no longer a struggle. Even her husband commented she seemed like a new person!
The improvement in this lady's corneal health following IPL treatment. The left photo before treatment shows the significant ocular surface damage as seen by a diagnostic dye (speckled area arrow). This damage is all healed following IPL treatment (right).
Clinically I could see that the IPL treatment had improved the quality of the secretions from the meibomian glands so that they flowed easily with gentle pressure. The surfaces of the eye were now devoid of any dry patches and the stability of the tears had increased from drying out within 3 seconds, to being stable for over 15 seconds! This lady gave me a huge hug following our appointment, she was so pleased with the improvement she had achieved from IPL treatment. Importantly at her most recent visit 3 months later she was still experiencing the same relief of her original symtpoms.
Before treatment this patient's eye took only 3 seconds to start drying out as measured by automated tear film analysis. After treatment the tears are completely stable after 15 seconds!
This case shows the potential for modern day treatments such as IPL to improve the underlying cause of dry eye disease and offer lasting relief for our patients.
To find out if your irritated eyes could benefit from IPL treatment arrange a dry eye assessment with our optometrist Mr Alex Petty by contacting the practice.
