How Do We Fix The Oil Problem?

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How do we fix the oil problem?

Before eating good oil, or doing good blinks, or even adopting a lifestyle geared to supporting the oil glands can otherwise be counted on to help - it is important to determine how blocked and dysfunctional the glands have become and what other issues may be contributing to dry eyes. For instance, certain medications and over-the-counter products can inhibit the glands - especially the so-called retinoids often marketed to treat acne and reverse skin aging. This brings us back to a good exam by a dry specialist.

If the glands have become inactive through poor diet and poor blinks, the oils tend to thicken into products that - by degree - look like buttermilk and then butter, lard and finally like candle wax. Once the oil becomes waxy, then this acts like a ”cork in the bottle” blocking the glands from working at all. Just as heat thins oil, or even wax if it gets hot enough - most modern treatments for these obstructions (called obstructive MGD) involve heat. At home, special devices have been developed for this purpose. In-office treatments involve more deeply applied, higher levels of heating than can be safely done at home. Heating is followed by degrees of squeezing or expression, to chase these now liquid waxes out of the glands. The FDA has approved many devices for this purpose, including Lipiflow, iLlux, Sight Science’s TearCare, and most recently Intense Pulsed Light or IPL.

Off-label treatments include devices not yet studied or approved by the FDA for this particular purpose - but are approved by the FDA for other uses. This would include treatments like Radio Frequency or RF. - approved to help reduce fine lines and wrinkles in skin - but also great for melting these waxy oils and aiding in their expression. RF can be used for many surgical applications, including ironing out the loose folds and wrinkles in a membrane (called the conjunctiva) lining the white part of the eye and inner parts of the eyelids (commonly called conjunctivochalasis, conjunctival chalasis or CCH). I’ve helped pioneer RF for these application and have published several studies showing its value. There will be more on these applications in subsequent blog postings - including the use of the thermaShields that I helped develop, which eyeThera (a company I am a part owner of) produces and which I routinely use in my dry eye practice. Now that others have discovered the benefits of using RF for treating dry eye disease, there are increasing numbers of practices offering this novel technology for this off-label application. What’s recommended for you will depend on what your specialist finds, which forms of heated expression and/or smoothing out and reattaching the loose membrane (CCH) they offer and what they feel will be most effective for your case.