Dr Brendan Cronin
MBBS(Hons) DipOphthSci BCom LLB FRANZCO
Director of Education, Queensland Eye Institute
Meibomian gland dysfunction is one of the most common presenting complaints to optometrists and ophthalmologists. There is no common one-size-fits-all treatment plan, and many of our existing treatment advice is ineffective and limited.
Intense pulsed light (IPL) is a new treatment modality that is showing great promise in drastically improving the satisfaction of patients with this irritating and often under-treated condition.
Benefits of IPL
IPL was first used for hair removal in the late 1990s and other applications such as tattoo and pigment removal ensued. The wavelengths of light used are in the visible spectrum between 500 nm and 1200 mm. IPL differs from laser because the light in IPL is neither coherent nor mono-chromatic.
The E>Eye is the first medical IPL device designed for treating meibomian gland dysfunction. Using sequenced light pulses, the device precisely stimulates the meibomian glands.
The benefits of IPL in meibomian gland dysfunction were first documented in patients who were receiving IPL for facial rosacea from dermatology clinics. The improvement in their dry-eye symptoms formed the basis for further research into IPL treatment for dry eye.
The results of a recent clinical trial on the effects of IPL applied to the periocular area for MGD at Auckland University showed a ‘significant improvement’ in the treated eye in both non-invasive tear break up time and lipid layer grade.1
The genesis of the benefits of IPL raises some fascinating questions about the correlation between rosacea and meibomian gland dysfunction and the degree to which these diseases share a similar pathophysiology. This is an area that needs more research to try to elucidate a cause for both conditions.
I started using the E>Eye device in January 2014. It quickly became evident that patients were extremely happy with the results. In particular, the patients with obvious rosacea were describing huge improvements in their ocular comfort and an improvement in their conjunctival injection. For a condition that previously had limited therapeutic options, IPL is an exciting and effective treatment modality for some patients with meibomian gland dysfunction. It adds another treatment option to the armamentarium of the practicing clinician.
Figure 1. Clear meibomian gland secretions after a course of IPL
|Figure 2. Meibomianography showing severely atrophied, shortened and poorly functioning meibomian glands
Figure 3. Meibomianography showing healthy meibomian glands
- Craig JP, Turnbull PR, Chen A. Prospective evaluation of intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD). Presented at the EVER Congress; 2014 Oct 4; Nice, France. Available from: http://www.ever.be/view_abstract.php?abs_id=9209&action=print