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Unclog Glands That Cause Dry Eye

LipiFlow treatment solves an investigator’s case of the missing tears.


During his 35-year career in law enforcement, Michael Driscoll helped put many dangerous criminals in prison, so he prefers to keep a low profile. “I’m originally from the Boston area, but I’ve lived in Florida for 33 years,” Michael shares. “I worked for and retired from the Florida Department of Law Enforcement, but I’m a private investigator now, so I’m not completely retired.”

As an investigator, Michael relies on his vision to identify individuals and activities of interest in his cases. For more than a decade, Michael’s vision was compromised by symptoms of dry eye disease, a condition associated with a lack of quality tears to lubricate and nourish the eyes. “I’ve suffered with dry eye for at least 12 years, maybe 15,” Michael reveals.

“It became progressively worse over the past few years. I experienced symptoms such as dryness and burning, and also intense tearing. Early on, I didn’t tear up that much. In the last year or two, my eyes teared excessively. “My dry eye never got to the point of being painful. It was just very, very annoying because it wouldn’t go away. I rate the discomfort a five or six on a scale of one to 10. It was very difficult because the symptoms were with me the entire day.” Much to Michael’s dismay, the dry eye treatments recommended by his ophthalmologist were ineffective on his worsening symptoms.

“My doctor prescribed various medications over the years. Some of them worked and some didn’t,” Michael discloses. “Treatments such as hot compresses had always helped, but in the last year or two, nothing helped. Whatever treatments or medications my doctor prescribed just did not work for me. “Then one day, I received a copy of Florida Health Care News in the mail. On the front page was a story about a woman who underwent a procedure called LipiFlow®. In the article, the woman said it was a very good procedure that helped a lot, so I decided to try it for myself.”

The LipiFlow Thermal Pulsation System from TearScience® is a revolutionary, FDA-approved method for clearing the debris that clogs the eye’s oil glands and leads to dry eye. It is available at The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens.

Paradoxical Yet Common 

“Mr. Driscoll first came to us on July 23, 2021,” explains Clifford L. Salinger, MD, a cornea specialist and founder of The Dry Eye Spa & V.I.P. Laser Eye Center. “He’s a 67-year-old man with a history of LASIK surgery in both eyes. Years later, he underwent cataract surgery with lens implants in both eyes. “He came to us with symptoms of dry eye that included burning, stinging, irritation and excessive tearing, which is a paradoxical yet common symptom of dry eye disease. Its cause is related to the quantity and quality of the tears. “In Mr. Driscoll’s case, he had an adequate quantity of tears, but the tears he was producing were of poor quality. More specifically, there was a lack of balance between the oil and the water in his tears.” 

Oil and water are the two most important components of the tear layer, according to Dr. Salinger. Without oil, the tear layer becomes unstable and fails to spread evenly across the surface of the eye, where the tears evaporate more quickly and cause dry eyes. “If there’s not a good balance between oil and water in the tear layer, it does not stay uniform and stable between blinks, and very quickly it becomes uneven,” the cornea specialist describes. “The tears bead up, overflow and evaporate off the eye. 

“The analogy I use for patients is going to a buffet. If there’s one piece of the most exquisite-tasting food you’ve ever eaten, it’s great quality but not enough quantity. You likely won’t go back to that buffet. If there’s a great quantity of food but the quality is poor, you won’t go back either. You want a good balance between quantity and quality.” An insufficient amount of oil in the tear layer comes as a result of blockages and inflammation in the meibomian glands, the oil glands in the eyelids. As they did with Michael, these blockages compromise the flow of oil through the glands and lead to symptoms.

To correct the problem, Dr. Salinger first used a comprehensive treatment regimen, which includes hot compresses, artificial tears, lid cleansing, vitamin supplements containing omega-3 and omega-6, topical steroid drops to reduce inflammation and a topical antibiotic drop. “Mr. Driscoll came back to us on August 31 because he was experiencing a reaction to the preservatives in the eyedrops he was using, including the artificial tears and the topical steroid,” Dr. Salinger details. “We took him off of those eyedrops and prescribed preservative-free preparations.

“At that same time, we also performed the LipiFlow procedure, which starts with a very thorough deep cleaning using the BlephEx®. The BlephEx is a patented handpiece that precisely and carefully spins a medical grade microsponge along the eyelids and lashes to remove debris and exfoliate the eyelids. The BlephEx can do a much deeper cleaning than individuals can do themselves at home.”  Dr. Salinger follows the BlephEx deep cleaning with the LipiFlow procedure. LipiFlow combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquefy, then remove clogging debris from the eyelid glands, enabling them to function efficiently. 

“After the LipiFlow treatment, we perform a manual expression of the meibomian glands to remove any remaining clogging material,” Dr. Salinger details. “This makes room for healthier oil material to populate the glands and flow normally so the tear layer is more stable and uniform, which improves the dryness.” Following the three-step LipiFlow process, Dr. Salinger maintains his dry eye patients on the previous treatment regimen, which helps amplify and extend the benefits of the LipiFlow. His goal is to find the least amount of treatment that can maintain the benefits realized with the LipiFlow. He achieved that goal with Michael.

“Mr. Driscoll returned to our office three weeks after his procedure. At that time, he reported 80 to 90 percent improvement in his dry eye symptoms,” the doctor notes. “By then, he had stopped using the steroid and antibiotic drops and prescription medications, and was only using hot compresses, lid cleansing, artificial tears and vitamin supplements.

“What I Wanted”

By the time Michael read about The Dry Eye Spa & V.I.P. Laser Eye Center and its LipiFlow treatment in Florida Health Care News, he had reached a turning point in his life. “I resolved to do anything to make my dry eye symptoms tolerable, to get them to where I could live with them,” Michael reveals. “That’s why I went to see Dr. Salinger.

Since he performed the LipiFlow procedure, I have experienced a great deal of relief, even on bad days. The discomfort in my eyes is down to a two, which is tolerable, and that’s what I wanted. I’m very happy with my results. “I still have dry eye, but for the first time in years I can live with it. It’s much, much better than it used to be. And I don’t need any medications, just the hot compresses and the over-the-counter moisturizing drops, so I’m very happy.”

Michael is equally pleased with the physician and staff members that treated him. “Dr. Salinger is very nice and professional,” Michael describes. “He’s very knowledgeable, an expert on dry eye. He and his team are excellent. Everyone at that practice is well-trained, very accommodating and good at what they do. “I highly recommend the LipiFlow and The Dry Eye Spa & V.I.P. Laser Eye Center. Dr. Salinger is the only doctor I know that does the LipiFlow procedure, so I absolutely recommend him.”

© iFoundMyDoctor.com article by Patti DiPanfilo. 

Clifford L. Salinger, MD

Featured in Unclog Glands That Cause Dry Eye

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