This manual method of unclogging the meibomian oil gland is called “Debridement – Scaling.”
Clogged meibomian glands are a significant problem in people with chronic dry eye disease. The meibomian glands get inflamed and clog up the pores to prevent lubricants from flowing.
Lid Margin Debridement – Scraping and cleaning meibomian glands is a new simple procedure. It uses a lid paddle to gently scrape along the eyelids to remove the dead epithelial cells and open up the meibomian glands. You can see the fluid flow out immediately.
At one month post-treatment, people reported a significant improvement in dry eye symptoms.
The researchers showed there is an increase in the number of functional meibomian glands. debridement is a promising development in Meibomian Gland Dysfunction (MGD) therapy\
How do meibomian oil glands get clogged?
MGD becomes more common as we age. In cases of moderate to advanced Meibomian Gland Dysfunction, devitalized epithelial cells can accumulate on the lid margin over the meibomian gland orifices. Clogging of orifices is similar to dead skin cells blocking facial pores. Significant accrual of this material can create an almost plaque-like quality to the lid margin that will stain with lissamine green. There should be no surprise that meibomian gland function is sub-optimal in this environment. Eyelid hygiene does very little to address it.
A painless, quick, in-office procedure can remove this debris, which allows for improved gland function and better response to warm compress therapy. The eye is numbed with a drop of topical anesthetic, and the lid margins are ‘exfoliated’ with a spud by gently scraping across the length of the margin. You can often observe glands immediately release their contents as you pass over them, even when months of warm compresses have failed to do the same.
Debridement can treat anterior blepharitis of the lid margin.
How does Debridement -Sscaling work in
dry eye treatment
One of the primary mechanisms driving obstruction of the meibomian glands (MGs) is hyperkeratinization of the eyelid margin and duct orifices. Keratinized material clogs the orifice. The obstructed gland and meibum cannot deliver from the gland to the tear film. Debridement mechanically removes debris and keratinized cells from the eyelid margin. So the meibum can flow into the tear film.
Korb first reported Debridement of the lower eyelid margin line in 2013. He used a spatula and found scaling of the LOM. The lower lid margin provided statistically significant symptom relief and improvement in the meibomian gland function. He concluded that Debridement is effective in the management of MGD and evaporative dry eye. Further studies have since found similar symptomatic improvement.
The introduction of the BlephEx instrument has since offered a controlled, electronic alternative to manual spad scraping. It has become part of the armory of eye doctors involved in dry eye management. In persistent anterior blepharitis, where lid debris from an ever-developing lid surface biofilm inhibits normal MG function, Debridement can help.
How Can Theralife Help?
TheraLife, we recommended the following regimen to treat MGD.
- TheraLife Eye revitalizes tear secretion glands, including meibomian glands. –
- Hot compress- twice a day, 10 minutes each time
- Use Thermal Pulse System to melt the clogging and open the secretion glands. The procedure may need to be repeated every 9-12 months.
- Use Intense Light Pulse (IPL) therapy using laser heat to open the glands.
- Use steroid drops to stop inflammation when the condition becomes severe.
Over time, the meibomian glands accumulate dead epithelial cells (just like dead skin cells) around the eyelid, making it impossible for the natural lubricants to flow out.
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