Different Devices That Unclog Meibomian Glands
Malfunctioning of the Meibomian glands causes the stability of the tear film to be altered. The quality of the tear film is assessed by the tear film Break-Up Time (BUT) test that is performed using fluorescein and a slit lamp. The time between a complete blink and the appearance of the first dry spot in the tear film on the surface of the cornea should be more than ten seconds to be considered normal. Poor tear film is characterized by shorter BUT. Many attempts have been conducted to improve tear BUT. A 2020 study revealed that eyelid warming steamer is effective in improving tear film stability measured using BUT. Another study conducted in 2021 revealed a significant improvement in tear production (both lacrymal flow and stability of the tear film) for patients with dry eye who have been treated with autologous serum eye drops. Another method for improving tear film stability is through improvement of Meibomian glands functionality and the use of devices that include:
Science’s Lipiflow, also known as thermal pulsation, combines the application of massage with heat to dissolve and squeeze out the content of the Meibomian glands and to get the lipid layer of the tear film to its normal state. Similar to Lipiflow is a device called eyeXpress that uses googles to transmit heat for 15 minutes than the eye doctor squeezes out the content of the Meibomian glands manually. Similar to eyeExpress is a device called TearCare that applies heat to the glands through applicators placed over each eyelid.
A portable device called Systane iLux treats with light-based heat and compression for about ten minutes under the supervision of an eye doctor. The portability of the device allows the eye doctors to transport it from one room to another. Practitioners use Systane iLux in adjunction with BlephEx device that consists of a handpiece that spins a singleuse along the edge of the eyelids removing scurf and debris and exfoliating the eyelids.
There are many devices for home use that are portable and somehow have the same mechanism of combined heat and massage. A personal compact handheld device that can be used at home is called Nulids. It is effective at removing biofilm and scurf clogging Meibomian glands orifices.
Thermoflo is another device that consists of a handpiece attached to a unit that transmits heat through a silver eye pad with ultrasound gel applied to the tarsal conjunctiva for fifteen minutes.
Intense Pulsed Light Therapy (IPL) has been initially FDA approved to treat skin problems and is also employed to treat Meibomian glands through direct application of infrared light to the eyelids reducing inflammation and loosening up clogged Meibomian glands.
ITN TrueTear by Allergan consists of two probes placed inside each nostril and stimulating the nerves inside the nose sending messages to the brain to increase the secretion of tears via lacrimal glands.