What is Meibomian Gland Dysfunction related Dry Eye?

The edges of our eyelids have oil glands called Meibomian glands. These function to secrete an oily substance called Meibum which in turn helps prevent tears from evaporating off of the front surface of the eye, thereby keeping the eye moist for a longer period of time.

With Meibomian Gland Dysfunction (MGD), these glands become damaged or clogged and no longer secrete the necessary amount of meibum to coat the tears. This leads to the tears evaporating faster from the eye and in turn dries out ones eyes, leading to Dry Eye Disease. Such damage to the meibomian glands can be brought on by inflammation, certain medications, trauma to the eye (styes or chalazia), make-up toxicity, age, sex, or ethnicity.

Typical treatment options include, preservative-free artificial tears, lid scrubs, heat masks, punctal plugs, prescription medications (such as Maxitrol or Restasis), or lifestyle changes (such as humidifiers). While these treatments can be effective, they require some time to feel the full effect, a more targeted and accelerated treatment option that can be done in-office is to reduce inflammation which in turn re-establishes the health and flow of meibum from these glands. What is Radiofrequency treatment?

A newer advancement in eyecare, Radiofrequency (or RF) uses electromagnetic waves to vibrate the water molecules in ones skin, this movement causes a controlled increase in thermal heat in the surrounding area. RF has a multitude of medical applications such as, in surgeries, pain control, ablation of tumors, tightening of the skin, and dry eye treatment. When used around the eyelids, the skin becomes heated to an appropriate temperature that melts the clogged meibomian glands and frees up way for meibum to flow (1). During its treatment cycles, RF was also found to tighten the skin in the target areas, such as ones eyelids and cheeks. This had the added bonus of rejuvenating the look and feel of the surrounding skin as well as treating ones dry eyes.

What is Optilight IPL (Intense Pulsed Light)? Intense Pulsed Light (or IPL) works by reducing inflammation around the affected areas. Using specific wavelengths of light, it causes the blood vessels around the treated area to constrict; this results in decreased inflammation around the eyes/tears. This reduction in inflammation clears the way for the meibomian glands to resume proper function. The FDA-approved Optilight IPL system, was specifically designed for the eyelids and its surrounding tissues (1). Benefits of IPL and RF IPL is an effective method of treating dry eye. However, with the combination of RF, this effectiveness has been increased significantly. As opposed to just IPL, RF+IPL results in an greater increase in healthy meibum flow by 17 to 33%. RF+IPL has also been shown to rejuvenate meibomian glands by an added 17% when compared to IPL alone. Additionally, the meibum itself was smoother, healthier, and flowed better with the combination as opposed to just IPL alone

(1). Study 1. Chelnis, J., Garcia, C. N., & Hamza, H. (2023). Multi-frequency RF combined with intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction. Clinical Ophthalmology, Volume 17, 3089–3102. https://doi.org/10.2147/opth.s426564

Conclusion The inclusion of RF with the standard IPL treatment is shown to significantly improve the expression of the meibomian glands on both the upper and lower lids. After approximately 4 combination treatments, this results in an overall reduction of meibomian gland dysfunction and an improvement in both dry eye symptoms and, as an added bonus, will tighten the skin for a more youthful look.

Written by Midwestern Optometry Intern, Vinay Naidoo

Dry Eye Treatments Using Light & Heat Therapies