Renewed Eyes – Renewed Life
How Intraductal Meibomian Gland Probing and Surgery Relieved my Dry Eye Symptoms
It happened gradually. My eyes appeared extra tired and red after a long day, especially after traveling somewhere. A doctor’s diagnosis was dry eye syndrome. Dry eye, he explained, sometimes affects menopausal women, like me. He prescribed lubricant eye drops, periodic Lotemax (a steroid), Restasis (induces more tears), Omega-3 supplements, and punctal plugs. I was also taking an over the counter eye whitener, about once a day. This therapy gave me little success. Eventually my eyelids became swollen. Lotemax temporarily help calmed these flare-ups.
Three years of struggling with this regimen shook my self-confidence. I couldn’t remember what normal eyes felt like. My eyes began to affect every situation, personal and professional. I couldn’t imagine what my life would be like as an older woman.
A computer search led me to Dr. Steven Maskin in Tampa, Florida. He reviewed my records and made the following diagnosis:
• Tear deficiency in left eye
• Obstructive Meibomian gland dysfunction (MGD)
• Large vein mass in both eyes, nasal area
• Superior limbal keratoconjunctivitus (SLK), both eyes
Obstructive MGD occurs when the meibomian glands become plugged. The oil (meibum) cannot flow, reducing the required amount for adequate tear film balance. SLK occurs when the eyelid is tight to the eye globe, creating mechanical friction trauma. The result is a wrinkling or looseness of the conjunctiva. The looseness creates a potentially inflammatory situation in the eye. The large vein mass in each eye is probably due to my overuse of eye whiteners.
He explained my problems and my personal plan. The left eye tear deficiency was treated by cauterization. He prefers this technique over punctual plugs, which tend to fall out and/or cause other problems. The MGD was treated with Intraductal Meibomian Gland Probing, a new procedure he invented (www.drmaskin.com). Finally, ocular surface reconstructive surgery was performed on both eyes to remove the SLKs and enlarged vein masses.
Probing is currently the only procedure to completely clear the obstruction in the meibomian glands. Each gland is mechanically penetrated with a tiny stainless steel probe. The matter from the glands is then expressed, if possible. Next, a steroid is inserted into each gland through an intraductal microtube.
Surgery on each eye was performed, with a three week delay between surgeries. Dr. Maskin first removed the SLK, and then removed the large vein mass from the conjunctiva. He grafted amniotic membrane tissue from a donated elective caesarian section for the resurfacing.
My eyes are now comfortable, and my self-confidence has returned. Dr. Maskin’s approach of first clearing the obstruction in the glands, and then correcting the underlying conditions, such as resurfacing, has been life changing for me.