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    Hypochlorous acid eyelid wash reduces bacterial load

    Application did not alter diversity of bacteria recovered but can reduce symptoms related to overgrowth

     

    Response in clinical setting

    Microbiological specimens were taken before treatment and 20 minutes after treatment from both eyelids of 36 patients. Of the 72 specimens collected, 71 were processed. Most of the patients, 22, were women and the average age was 63 years.

    The results were both startling and clinically important, Dr. Epstein said.

    Related: Topical ENaC blocker serves as novel approach to tear film

    A single treatment significantly reduced the overall bacterial population on the eyelid but had little impact on the bacterial species diversity.

    “The effect of bacterial overload on blepharitis and meibomian gland dysfunction has not been appreciated until recently,” Dr. Epstein said. “I had never seen this kind of response before.”

    Recent: New dry eye treatment demonstrates rapid onset symptomatic relief

    Most lid disease is the result of two related-but-distinct pathologies, he explained. As MGD progresses, the character and the amount of oil produced by the glands changes. They produce less meibomian, which becomes thicker and more saturated. This promotes increases in bacteria on the lid leading to overpopulation.

    One pathology is a direct byproduct of bacterial competition as populations overgrow. Bacteria produce a number of inflammatory proteins to combat each other which can inflame host tissue. In the ocular environment, bacteria produce an abundance of enzymes including lipase, which breaks down the lipid layer in the tear film.

    Related: Intense pulsed light shows therapeutic potential for MGD

    As the lipid layer breaks down and mixes with salt in the tears, saponification produces the frothy soapsuds often seen on the lid margin and in tears. These soaps are both irritating and further break down the lipid component that protects and stabilizes the tear film.

    Polar, nonpolar phases

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