Initial clinical data

• Osmolarity: 297 OD, 326 OS
• Lower meibomian gland atrophy: 59.4% OD, 59% OS
• Meibum: pasty appearance
• Initial symptoms: tired eyes, burning and tingling, discomfort rated at 6/10
• Dx: demodex blepharitis, evaporative dry eye, ocular rosacea

Initial treatment plan

• Home Treatments: Blephadex Wipes, Thealoz Duo, Omega-3 Supplement (PRN), Lotemax Gel (4-3-2 x 6 weeks)
• Clinical treatment: IPL and Jett Plasma combined with photobiomodulation (LLLT)

Evolution and results

MGX at the initial assessment after IPL 1

MGX after the last protocol treatment

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Over the course of treatments, a marked improvement in symptoms was observed. Initially, the patient experienced almost daily discomfort with limited tolerance to screens and the wearing of contact lenses. The first IPL sessions allowed for a gradual reduction in the intensity and frequency of symptoms, while improving the quality of meibum.

The introduction of Jett Plasma completed this improvement by promoting greater tear film stability and increasing tolerance to prolonged screen activities. By the end of the protocol, the patient no longer had symptoms of dryness, could wear her contact lenses without discomfort, and used the screens without significant discomfort.

Meibum, which was initially pasty, became more fluid for most glands, confirming the improvement in meibomian gland function. Ocular osmolarity has also stabilized, resulting in a better quality of the tear film.

Conclusion

‍The combined approach to treatment of blepharitis with Demodex and clinical care resulted in a lasting improvement in dry eye symptoms and a better quality of life for the patient. A maintenance strategy with home care was recommended in order to prevent recurrences and maintain the benefits gained.