Dry eye syndrome is a common pathology affecting between 5 and 15% of the population with symptoms increasing with age. Conditions of a modern lifestyle, including working on computer screens, driving cars, air conditioning, artificial lights, air pollution, wearing contact lenses etc, make dry eye syndrome a more and more frequent nuisance.
Generally speaking, dry eye conditions are a result of a lacrimal layer issue, either caused by insufficient tears or excessive evaporation. It is recognized that a large majority of cases are caused by the evaporation form, mainly due to an insufficiency of the external lipid layer of the lacrimal film secreted by the meibomian glands.
There are 80 meibomian cells located in the upper and lower eyelids. These cells produce a fat phase, avoiding tear evaporation, adapting the tears to the irregularities of the eye’s surface and a perfectly convex diopter. Lipids are made of polarized fat acids. Their fluidity is ensured by the body temperature. They are non-polarised on the surface, giving the stability of the lacrimal fluid and allowing the lubrication of the palpebral conjunctival plane. The contraction of the Riolan muscle allows the lacrimal film to spread out.
The lacrimal film is made up of 3 layers:
- The mucous layer, in contact with the ocular globe, secreted by the conjunctival mucous cells.
- The aqueous layer, secreted by the lacrimal glands.
- The lipid layer, secreted by the meibomian glands.
Meibomian gland dysfunction:
When the lipid phase, produced by the meibomian cells, are affected, it will lead to excessive evaporation of tears, and unstable lacrimal film and an inflammatory reaction of the conjunctiva. The result is an increase in vision disorders during long periods of short-distance tasks, such as computer work, with a burning feeling of the eyes.
If the process accelerates, the discomfort becomes permanent, creating paradoxal excessive tearing, making contact lens wear impossible.
Anatomical modifications can occur with atrophy of the meibomian gland orifices, with episodical infections, sties, secondary conjunctival infections, chalazion and in more serious cases, apparition of micro-ulcerations of the corneal epithelium.
Treatments currently available are mainly substitutions and are often insufficient to overcome the discomfort felt by patients.
Intense Regulated Pulsed Light (IRPL):
The “E-Eye” is a device that generates a new type of polychromatic pulsed light by producing perfectly calibrated and homogenously sequenced light pulses. The sculpted pulses are delivered under the shape of regulated train pulses. The energy, spectrum and time period are precisely set to stimulate the meibomian glands in order for them to return to their normal function.
- The session treatment only takes a few minutes.
- Patients are comfortably seated on a treatment chair.
- The metal eyewear protection if positioned over the patient’s eyes.
- Then optical gel is applied on the cheekbone and the temporal areas.
- A series of 5 flashes are applied under one eye, starting from the inner canthus (nose) to the temporal area, using the nominal power.
- The same process is then repeated under the other eye.
The stimulation leads to the meibomian glands returning to their normal function in a very short time (a couple of hours) following the treatment.
The full success of treatment depends on the compliance with a specific protocol. The protocol consists of 3 sessions as follows:
- Day 1
- Day 15
- Day 45
- Day 75 (optional)
The efficiency is nearly constant on all forms of meibomian gland dysfunction. On the other hand, it does not improve pathologies linked to aqueous or mucous phase or if there is a secondary infection that would need to be treated first.