The Importance of Ocular Hygiene

Dry eye is a very common problem in my practice. Patients usually come through my door with a different complaint, but it turns out that they suffer from an ocular surface problem, meibomian gland dysfunction, or evaporative tear disease. I could identify some form of this condition in almost all of my patients.

Some have a very mild form of OSD and are asymptomatic, and in others it is more advanced, but I believe in all patients it needs to be treated at a young age, so that they do not think that they got the condition overnight, as many currently do – it happens over many years, in a similar way to tooth decay. It is important that clinicians assess lid health regularly.

Patients who come to me with dry eye mostly use over-the-counter artificial tear drops. There are some good prescription eye-drop options available, but usually drops alone don’t solve the problem entirely. Patients have the option of applying a warm compress to their eyes at home – in the form of a warm wet towel or a microwaved heat mask – but this is time consuming.

We also know that heat is not necessarily effective in those conditions: it is important to maintain the temperature for a specific time to make sure the meibum is melted.

For these reasons, I was quite keen to try the TearCare device from Sight Sciences. I have used it over the past few months, participating in clinical research trials, as well as offering it to patients in my private practice. It is a great tool for managing the evaporative form of dry eye, which involves meibomian gland dysfunction, and I’ve been suggesting it to patients as a first-line treatment.

Patients really appreciate the fact that they are not required to apply prescription medication every day, and they tend to see a very quick improvement. I make it clear that using TearCare is not a cure, but a continuous process. Just like taking care of our teeth throughout our lives and going to the dentist twice a year – it is equally important for my dry eye patients to take care of their ocular hygiene.

The device is really easy to use, both for the physician, and for the patient. It allows me to target the glands, and if I can see that one gland is more plugged than the other, I can manually target it with extracting forceps.

I am usually the first person telling my patients about ocular surface disease, or dry eye, even though so many of them would have benefitted from being treated earlier. I feel that it is now vitally important to raise public awareness of this issue. There are many great technologies available to treat this condition – and new ones will continue being developed – but very few patients know about meibomian gland and dry eye treatments, and I would really like this to change.