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Meibography – another tool in the fight against Dry Eyes


Meibography – another tool in the fight against Dry Eyes


You can’t fix what you can’t see.  Evaporative dry eye, where the tear evaporates too quickly, is the most common cause of dry eyes.  It stems from atrophy of the Meibomian glands (oil glands within our lids), which results in decreased lipid production, a deficient lipid tear layer and consequently increased tear evaporation.  To diagnose and manage this, we need to see the glands, and now we can!  Our meibographer the Meibox uses infrared light to capture high resolution image of the Meibomian glands.  At Dr. Mei-Ling Chan Optometry, we image our patients’ glands routinely to spot cases of Meibomian Glands Dysfunction early and manage the clinical signs and symptoms of dry eyes while they are still mild.  This saves our patients from needless difficulty and expenses in the future, which is inevitable if the disease is allowed to progress and more glands die. 

In addition to Meibomian glands imaging, we also have the ability to check the tear osmolarity.  Tear osmolarity is the concentration of solutes in the tear film.  It increases in dry eye patients.   As tears become concentrated (hyperosmolar), damage begins to occur on the ocular surface.  Untreated, hyperosmolar tear becomes toxic to the corneal epithelium.  As such, tear osmolarity is an important biomarker we use in our clinic in diagnosing and monitoring the efficacy of dry eye treatment.   

The underlying cause of dry eyes is inflammation on the ocular surface.  We have the ability to detect this using the InflammaDry – a rapid, in-office test that detects MMP-9, an inflammatory marker elevated in the tears of patients with dry eyes.  This serves as another valuable diagnostic tool. 

We believe in investing in technology because growing diagnostic capabilities mean more specific identification of underlying causes of dry eye and the ability to tailor treatment accordingly. 

Due to the confluence of demographics, digital device stress, and increased use of prescription medications, the number of cases of dry eye is ever rising.  Dry eyes (or ocular surface disease) not only cause discomfort, but visual disturbances that affect other aspects of our lives such as reading, using the computer and driving.  At Dr. Mei-Ling Chan Optometry, we are committed to dry eye because that means identifying more patients who can benefit from treatment.  Ask us if you have any questions or concerns about dry eyes, we can help.

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