Three Steps to Relief

Triple-stage process eliminates dry eye symptoms.

Eileen Hoffman, 55, had bad eyes since her youth. Because she wore glasses most of her life, she maintained her vision with annual exams by an eye doctor. At one appointment, the Jamaica native couldn’t achieve clear vision, and her doctor offered a possible explanation that sounded serious.

Eileen Hoffman is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

Eileen Hoffman

“At my eye exams, my glasses prescription kept going up each year,” Eileen recounts. “One year, no matter what prescription we tried, it wasn’t improving my vision. My doctor also tried a few different approaches, including using a series of soft contact lenses. When that didn’t help, he suggested I might have a condition called keratoconus. He told me I needed to see a specialist.”

Keratoconus is a disorder of the cornea, the transparent layer that forms the front part of the eye. With keratoconus, the cornea thins out and bulges forward. It cannot maintain its round shape and instead becomes shaped like a cone. Treatments for keratoconus include special contact lenses, corneal inserts and, in severe cases, corneal transplants.

Eileen began looking for a cornea specialist. She was given the name of Clifford L. Salinger, MD, founder of The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens. Dr. Salinger, she was told, was one of the top cornea specialists in the area. She was disappointed, however, to discover that Dr. Salinger was not on her company’s insurance plan.

“I’m the fixed assets coordinator at the Palm Beach County Sheriff’s Office, so I’m in a position of influence at my agency,” Eileen describes. “I had them negotiate to get Dr. Salinger on our insurance. They did and Dr. Salinger became my cornea specialist in 2000. He confirmed the keratoconus, and I eventually had corneal transplants in both eyes.

“After the surgery, I began suffering with severe dry eye disease. My eyes were irritated, and because of the corneal transplants, they became painful. My eyes were itchy, and I had blurred vision. I was also having difficulty with sensitivity to light. I’m an avid reader and news watcher, and my dry eye symptoms made doing those things uncomfortable.”

Dr. Salinger explained to Eileen that the oil glands in her eyelids had become clogged with debris. They weren’t releasing enough of the oils necessary to keep a good, consistent tear film on her eyes’ surfaces, which keeps the eyes moist. The lack of a consistent tear film was causing Eileen’s eyes to be dry and irritated.

The Surgery Factor

One of the causes of Eileen’s dry eye symptoms may have been the surgery. Dr. Salinger notes that many factors contribute to dry eye disease, including previous eye surgeries such as cataract surgery and LASIK®. Surgery does this by interrupting the corneal nerves. This plays an important role in the development of dry eye disease.

“Any surgery, even perfect surgery, can upset the delicate balance of the eye’s tear layer,” Dr. Salinger explains. “As a result, the tear layer is more unstable and has the potential to evaporate more quickly, which leads to dry eye symptoms.

“And Eileen obviously had a history of eye surgery. She had the corneal transplants in both eyes – first in her right eye in 2004 and then in her left eye in 2006 – and those surgeries, along with her age and perimenopausal status, all contributed to her dry eye issues.”

Initially, Dr. Salinger treated Eileen’s dry eye symptoms with a regimen that included preservative-free, over-the-counter, sterile artificial tears; hot compresses; lid cleansings; vitamin supplements specifically for dry eye and anti-inflammatory eye drops to reduce the inflammation that contributes to the evaporation of tears.

“That treatment improved her symptoms some, but only incrementally,”
Dr. Salinger states. “She was still having difficulty wearing her contacts, and continued to have discomfort, itching and irritation. We finally recommended treatment with the LipiFlow® and went ahead and performed it in April 2018.”

The LipiFlow Thermal Pulsation System from TearScience® combines the controlled application of therapeutic heat with a gentle, pulsating massage. These two functions work to liquefy then remove clogging debris from the glands in the eyelids, enabling them to function efficiently.

“LipiFlow is a revolutionary breakthrough for treating chronic dry eye disease,” Dr. Salinger asserts. “It relieves dry eye symptoms by removing blockages of the eyelid’s oil glands. Opening and clearing the blocked glands enhances the natural production of the oils needed to restore a healthier tear layer on the surface of the eye.”

Startling Results

“LipiFlow can be performed in different ways,” Dr. Salinger informs. “Many doctors perform LipiFlow only. We perform a three-step process that includes treatment with the LipiFlow. Step one in the process is a very thorough deep cleaning of the eyelids. Step two is treatment with the LipiFlow itself.

“The third step is an expression of the oil glands by the doctor immediately after the LipiFlow while the gland material is still warm and relatively viscous. This step is done to remove any clogging material the LipiFlow may have left behind.”

During the actual LipiFlow procedure, an eyepiece contacts the outer eyelid and contains a soft, flexible bladder that intermittently inflates to provide controlled pressure and massage. Heat is applied to the inner surface of the lid because of its proximity to the glands.

“We believe that by doing step one and step three in combination with the LipiFlow, individuals get more benefit sooner than they would if we didn’t do all three steps,” Dr. Salinger observes. “The benefits also last significantly longer when the three-step process is used.

“We’ve had patients who’ve have had the “LipiFlow-only” treatment performed elsewhere come to us for the three-step procedure. They tell us at their one- or two-month follow-up visit that they’re doing much better than they did after having the LipiFlow without the eyelid cleansing and oil gland expression.”

The results are startling. Dr. Salinger reports that 90 percent of people experience measurable improvement after one LipiFlow treatment at The Dry Eye Spa and V.I.P. Laser Eye Center. About half of those patients notice improvement within one month. For the other half, it may take two to three months. For a very small percentage, it may take longer.

“The treatment was actually very comfortable,” Eileen comments. “During the first part of the LipiFlow procedure, the cleansing part, I was in heaven. The second part was great, too. The manual expression part I didn’t like as much, but I got through it with no problem.”

Dr. Salinger stresses that after patients achieve symptom relief with LipiFlow, it’s important that they continue with their routine dry eye treatment regimen. This is critical for maintaining the benefits of the LipiFlow treatment process.Eileen Hoffman is treated for dry eye disease with the LipiFlow® system by Dr. Clifford Salinger at The Dry Eye Spa® & V.I.P Laser Eye Center in Palm Beach Gardens.

“If patients want to keep the oils from their eyelid glands flowing, they have to continue addressing their dry eye condition,” Dr. Salinger confirms. “Maintaining their routine treatments will keep them on a healthier track.”

The Best Decision

Once Eileen had the LipiFlow procedure, her vision improved appreciably, and her symptoms of irritation, itching and sensitivity to light disappeared. She can now read and watch the news in comfort. She’s thrilled with the outcome of her treatment.

“The LipiFlow was the best thing I ever did,” Eileen raves. “Since I had it done, I haven’t had any issues with dry eye.

“I told Dr. Salinger that sometimes things are going on in my life, and I forget to do my daily drops and cleansing routine. When that happens, I can go four or five days without suffering any ill effects. I attribute that to the LipiFlow because prior to that, if I skipped my drops or cleansing, I’d get severe irritation and discomfort.”

Eileen began seeing Dr. Salinger for her corneal disorder, but she continued with him afterward for all of her eye health needs. She’s grateful to the doctor and his staff for the care they’ve given her over the years.

“I love The Dry Eye Spa and V.I.P. Laser Eye Center,” she enthuses. “It’s topnotch. And I love Dr. Salinger. I trust him implicitly.

“I think it was a very good decision to get Dr. Salinger on our insurance plan. I’m so happy I was in a position to do so because he has taken care of my eyes ever since with no problem.

“Whenever I talk to someone at work, I recommend Dr. Salinger, but I tell them he’s my doctor,” Eileen adds. “Without me, he wouldn’t be on our insurance plan, so I feel very territorial when it comes to him. Still, I recommend Dr. Salinger and The Dry Eye Spa and V.I.P Laser Eye Center wholeheartedly to anyone who has corneal or dry eye issues.”

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