Case Presentation: 32-Year-Old Female with Severe Dry Eye Disease

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 result (at initial visit) was abnormal at 312mOsms/L in the right eye (OD) and 327mOsms/L in the left eye (OS).

Her SPEED Dry Eye Questionnaire result (at initial visit) was 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,

c) iVizia preservative-free eye drops,

d) RegenerEyes Pro, and

e) Hylonight ointment.