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    In-office MGD treatments may provide relief but lack formal studies

    Patients must play a role in MGD care; surgeons need a systematic treatment approach


    Overview of in-office treatments

    These challenges have led to several in-office treatments for blepharitis that Dr. Davidson outlined.

    One such device that helps with making the diagnosis is an interferometer (LipiView, TearScience) that takes precise measurements of tear film thickness, takes dynamic meibomian imaging, and allows the user to quantify lipid level of tear film.

    “This is helpful for analytical patients because you can show them a number,” Dr. Davidson said.

    The treatment arm of LipiView is Lipiflow, which applies heat to the inner eyelids. The device liquefies meibomian gland contents and facilitates the release of secretion from the meibomian glands. The treatment lasts about 12 minutes.

    A couple of studies have analyzed Lipiflow results, including one with 40 eyes in 20 patients that found that meibomian gland secretion scores increased at 1 month and lasted for 3 years.

    The same study found that tear breakup time increased from baseline to 1 month but was not that different compared with baseline at 3 years, Dr. Davidson said.

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