On April 4th, 2023, we had a lovely 32-year-old female patient present with a recent history of Retinoid use (for 6 months) and upper eyelid surgery (blepharoplasty with suture approach).
At her in-depth consultation visit, we identified and diagnosed her with significant Lid Wiper Epitheliopathy (LWE), Filamentary Keratitis (FK), Lissamine Green (LG) Staining, Punctate Epithelial Erosions (PEE), & Meibomian Gland Dysfunction (MGD). Negative findings for nocturnal or blink lagophthalmos.
Her Tearlab tear osmolarity results (at initial visit) were abnormal at 312mOsms/L in the right eye (OD) and 327mOsms/L in the left eye (OS).
Her SPEED Dry Eye Questionnaire results (at initial visit) were abnormal at 22 out of 28.
Customized & Combined Treatment Plan:
1) In-office approach includes
a) OptiLight IPL (at least 4 sessions)
b) ZEST Eyelid Exfoliation (at least 1 session)
c) Meibomian Gland Probing (1 session of all eyelids).
2) Pharma approach includes
a) Mucomyst 4x/day in both eyes,
b) Eysuvis 2x/day x 2 weeks and once daily x 2 weeks in both eyes.
3) At-Home approach includes
a) Zocushield gel,
b) HydroEye supplement, i
c) Vizia preservative-free eye drops,
d) RegenerEyes Pro, and
e) Hylonight ointment.