Abstract:
Meibomian gland dysfunction (MGD) is a major etiological factor in the development of evaporative dry eye (EDE), a common manifestation in eye clinics, which can have significant detrimental effects on quality of life. While traditional management strategies often fail to provide alternative solutions, patients and physicians seek alternative options. Thermal therapy is a novel treatment emerging in recent years. Numerous mostly reconsidered or open-label, studies have demonstrated an improvement in the signs and symptoms of EDE after periocular application of thermal therapy.
Purpose
Use contemporary clinical metrics of the mechanism of action (s) to explore the therapeutic efficacy of periocular application of thermal therapy as a treatment for MGD, then to explore the dry eye methods of Pakistani specialists against current evidence-based guidelines.
Methods
Thirty subjects with mild to moderate MGD were enrolled in a prospective and randomized clinical trial. Participants were randomized to receive a course of thermal therapy through eye care eye massage for 3 days, 4 days, and 5 days and evaluated at baseline and after treatment: 1,) certified dry questionnaires, 2) diagnostic techniques, 3) tire breakup time Test and 5) Lid Margin Assessment.
Results
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A total of 30 participants were included in the study and 15 participants (mean ± SD age of 32.67 ± 11) were randomized to the control group of the study and 15 participants (mean ± SD age of 31.33 ± 8) were randomized to the treatment group with 3 days, 4 days, and 5 days follow-up. Following participation, dry eye symptom scores in the treatment group significantly improved from baseline relative to control group. Improvements in lid margin appearance, tear film lipid layer stability, tear break-up time, and meibomian gland function also differed significantly between the groups.
Conclusion
Thermal therapy is well tolerated and has proven to be an effective management option for MGD. Cumulative improvement in EDE properties may be related to changes in tear lipid profile rather than tear film lipid layer stability, meibomian gland capping, and meibum expressibility to reduce ocular surface inflammation, thereby broadening the understanding of the current mechanism of action.
