![]() We must simultaneously attend to the chronic aspects of their disease by addressing their underlying inflammation and MGD. When that happens, we lose these patients. Patients will feel better quickly following an intervention however, if the results of these acute treatments are not paired with chronic therapy, the effect will not be durable. Thermal therapies such as LipiFlow (Johnson & Johnson Vision), Systane iLux (Alcon), and others also address aspects of dry eye and meibomian gland disease (MGD). This is typically an acute intervention with TearCare (Sight Sciences, Inc) and intense pulsed light (IPL Lumenis), which we use synergistically in our clinic. ![]() ![]() My role is to give patients hope by starting with a treatment that provides immediate results. Frankly, these types of patients have often lost faith that they can be successfully treated, and some have resigned themselves to suffering. In my experience, many patients have been treated dismissively over the years, with little more than artificial tears and warm compresses. I try to establish what the most significant form of their DED is and treat that to achieve noticeable results. Because of the complexity, I break the treatment course down to simple building blocks. They may have underlying medical conditions contributing to their DED and even progress to mechanical dry eye. They often have overlapping forms of the disease, from aqueous tear deficiency to meibomian gland dysfunction and evaporative dry eye to mucin deficiency. Most of the patients with dry eye dis-ease (DED) who I see in our tertiary center have seen multiple eye care professionals without success.
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