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Monday 28 January 2013

The goggles that soothe dry eyes in 12 minutes


A new 12-minute treatment in the doctor’s office could help relieve the problem of chronically dry eyes. 
The procedure uses special goggles to gently warm and squeeze tiny glands in the eyelids, which help to keep the eye lubricated.
Dry eye affects around three million Britons — it’s sometimes caused by a lack of tear fluid, which is needed to moisten and clean the front of the eye when we blink. This can worsen with age.



The new device, the LipiFlow system, works by warming and compressing the eyelids to clear the meibomian glands and improve flow

It can also affect people who wear contact lenses; this is because the lens reduces the amount of oxygen reaching the eye surface.
But in around 65 per cent of cases dry eye is caused by a lack of protective oil in the tear fluid. 
This clear oil, known as meibum, prevents the watery tear film evaporating. 
The oil itself is produced in the 30-40 tiny meibomian glands in the eyelids. 
But in patients with evaporative dry eye, as it is known, the meibum becomes thick and buttery, clogging the glands. 
Without the protective oil, the tear film evaporates, leaving the eye feeling dry, gritty and sore. In extreme cases, this dryness can cause permanent damage to the front of the eye, leading to scarring or infection of the cornea (the clear front window of the eye).


Patients can use eye drops to lubricate the eye, or warm compresses to try to melt the meibum and clear the glands. 
They can also clean around the eyelids (not the eye), carefully using a cotton bud and baby shampoo to remove the fatty plug. 
There has also been some evidence to suggest that a diet rich in omega-3 fatty acids (found in oily fish) may help.
The new device, the LipiFlow system, which was launched in the U.S. around six months ago, works by warming and compressing the eyelids to clear the meibomian glands and improve flow. 
It consists of a soft plastic cup that sits over the eyeball, under the eyelids. 
The back of this cup has a small heated plate on it that presses against the eyelids. 



Dry eyes can affect people who wear contact lenses; this is because the lens reduces the amount of oxygen reaching the eye surface


A second cup then sits over the eyelids. The inner cup starts to heat up, melting the fat in the meibominan glands. 
The outer cup has two tiny paddles that gently put pressure on the eyelids every two minutes, which helps to squeeze out the abnormal thickened secretions from the gland.
The device is heated to 42c for 12 minutes and studies suggest that once the glands have been cleared, they start to produce normal fluid.
A study of 139 patients, published in the journal Cornea, showed that after four weeks patients who had been treated with the device had more healthy secretions from their glands when compared with patients who used a warm compress. 
Patients who’ve had just one treatment often experience significant improvement, claims Imran Rahman, a consultant ophthalmologist at 20-20 Vision in Manchester who has started using the LipiFlow system.
However, the treatment — at £595 per eye — is not cheap. 
But it could be considered for difficult cases, says Professor Bernard Chang, consultant ophthalmologist at Leeds Teaching Hospitals NHS Trust. 
‘Warm compresses can help unblock the glands and improve dry eye — and this device acts in a similar, but more sophisticated, way. 
'The device could be useful in hard-to-treat cases.’ 

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