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Kento Yokobori,1,* Masahiko Ayaki,1,2,* Motoko Kawashima,1 Hidemasa Torii,1 Erisa Yotsukura,1 Sachiko Masui,1 Kazuno Negishi1 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Otake Eye Clinic, Yamato City, Kanagawa, Japan*These authors contributed equally to this workCorrespondence: Masahiko Ayaki, Email mayaki@olive.ocn.ne.jpPurpose: To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional visual acuity (FVA) and higher order aberration, in a randomized controlled study.Methods: Fifty patients who underwent cataract surgery at a single institution were involved. Twenty-five patients were instructed to wipe their eyelids twice a day from one to four weeks postoperatively, whereas the other 25 patients did not perform any eyelid hygiene. Optical measurement, FVA, meibomian glands, the grade of meibum, lid margin findings, fluorescein corneal staining findings, dry eye-related subjective symptoms and surgical satisfaction were assessed both preoperatively and one month postoperatively.Results: In the eyelid hygiene group, the visual maintenance ratio of FVA improved significantly (p = 0.048) and the higher order aberration of the 4th + 6th order deteriorated less (p = 0.027) compared with the control group. Multiple regression analyses showed that the change in visual maintenance ratio was associated with surgical satisfaction (p = 0.003), change in corneal staining score (p = 0.007), history of eye diseases (p = 0.029) and eyelid hygiene (p = 0.048).Conclusions: Eyelid hygiene after cataract surgery may be effective for visual function measured with an FVA test.Keywords: cataract surgery, dry eye, eyelid hygiene, functional visual acuity, higher order aberration, meibomian gland dysfunction, visual maintenance ratio

Purpose: Daily cleansing of eyelids is very important to carry out a successful blepharitis treatment. However, there are no therapeutic guidelines for blepharitis. The aim was to compare the symptomatic relief of anterior blepharitis using Blephamed eye gel, a cosmetic product, versus standard treatment. Methods: The study was a prospective, interventional open label clinical trial at a university-based hospital. The test population was subjects aged 18–65 years who presented with mild to moderate anterior blepharitis. Eyelid hygiene was applied twice a day. At each visit, a detailed assessment of symptomatology was carried out. A two-way repeated measure mixed model ANOVA was used to compare two groups by time. Results: In total, 61 patients with mean age of 60.08 ± 16.69 years were enrolled in the study including 30 patients in standard group and 31 patients in Blephamed group. Two groups did not differ in terms of age (P = 0.31) and eye laterality (P = 0.50). The baseline scores of erythema, edema, debris, and symptoms as well as total score were similar between two groups (all P values >0.50). Two groups became different for all these parameters at day 45 (all P values

Purpose: Daily cleansing of eyelids is very important to carry out a successful blepharitis treatment. However, there are no therapeutic guidelines for blepharitis. The aim was to compare the symptomatic relief of anterior blepharitis using Blephamed eye gel, a cosmetic product, versus standard treatment. Methods: The study was a prospective, interventional open label clinical trial at a university-based hospital. The test population was subjects aged 18--65 years who presented with mild to moderate anterior blepharitis. Eyelid hygiene was applied twice a day. At each visit, a detailed assessment of symptomatology was carried out. A two-way repeated measure mixed model ANOVA was used to compare two groups by time. Results: In total, 61 patients with mean age of 60.08 ± 16.69 years were enrolled in the study including 30 patients in standard group and 31 patients in Blephamed group. Two groups did not differ in terms of age (P = 0.31) and eye laterality (P = 0.50). The baseline scores of erythema, edema, debris, and symptoms as well as total score were similar between two groups (all P values >0.50). Two groups became different for all these parameters at day 45 (all P values <0.001). Significant interaction was detected between time and intervention groups for all severity parameters of blepharitis as well as total score (all P values <0.001). Conclusion: Eyelid hygiene with Blephamed more significantly decreased symptoms of anterior blepharitis compared to standard treatment. [ABSTRACT FROM AUTHOR]

To make appropriate therapeutic decisions of intense pulsed light (IPL) for meibomian gland dysfunction (MGD) patients. Sixty patients with MGD stage 2–3 were enrolled in IPL Group1 and Self-hygiene Group; 110 patients with MGD stage 3–4 were included in IPL + MGX Group and IPL Group2. Patients in IPL groups received IPL treatment once a month for three times. Meibomian gland expression (MGX) was combined with IPL treatment in IPL + MGX Group. Meibomian gland (MG) functions, MGD stage, associated ocular-surface indexes, and response rate were evaluated. Population characteristics and clinical conditions were comparable between groups. In patients with MGD stage 2–3, both IPL Group1 and Self-hygiene Group improved in MG functions, ocular surface disease index (OSDI) and tear break-up time (TBUT). No statistical difference was found in improvements. Posttreatment response rate was 64.3–66.7% in two groups. In patients with MGD stage 3–4, IPL + MGX Group achieved better improvements in MG expressibility and higher response rate (75.5%) than IPL Group2 (63.3%). Referring to IPL treatment, no statistical difference in MG functions and OSDI improvements was found among MGD patients with different ages, genders, and IPL energy exposure. Patients with higher Fitzpatrick scale improved more in MG expressibility. Self-eyelid hygiene is cost-effective for milder MGD stages. Combining MGX with IPL is necessary in more severe stages. Adult patients with all age and different genders can benefit from IPL treatment. Patients with darker skin can benefit more in expressiblity. [ABSTRACT FROM AUTHOR]

Background: Progressively increasing number of eye surgeries forces the development of simple-to-use, effective methods to reduce the risk of postoperative endophthalmitis. We wondered whether the eyelid margin wipes containing 0,1% polyhexamethylene biguanide (PHMB) (HexaClean, VERCO, Poland) influence the reduction of bacterial flora localized in the conjunctival sac and whether it can be used for prophylaxis before the cataract surgery. MATERIAL AND METHODS: 95 patients before the cataract surgery were included in the study. The conjunctival swab was collected from patients twice -- before using eye wipes and after 5 days of eye wipes usage. The swabs were plated on microbiological enriched media and incubated under aerobic and microaerophilic conditions for 24-48 hours at 35°C ± 2°C. Then the identification of microorganisms was carried out using classic microbiological methods and tests. RESULTS: Bacterial strains were isolated from the conjunctival sac in 84% of patients before using the eye wipes. The largest group of isolated pathogens was Gram-positive cocci, and these were mainly methicillin-sensitive and methicillin-resistant coagulase-negative staphylococci, which accounted for 72% of isolated strains. When the eye wipes were used, the bacterial flora was eliminated from the conjunctival sac in 54% of patients. A reduction in isolated strains and decreased variety of bacteria was observed in another 22% of patients. CONCLUSION: These results indicate that the application of eyelid wipes with polyhexanide reduces a significant amount of the conjunctival sac microbiota, which may prevent inflammation after cataract surgery. [ABSTRACT FROM AUTHOR]

Preseptal cellulitis is a commonly observed inflammation of the eyelid and the surrounding skin in pediatric patients, especially after a minor trauma. Although preseptal cellulitis is generally associated with a more favorable prognosis, it is vital to remember that all orbital infections require prompt diagnosis and treatment because of the risk of severe complications. Inadequate or failure to adhere to the treatment plan and unmet hygiene standards can lead to severe complications; therefore, diligent follow-up care should be undertaken by both the physician and the patient., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Acibadem University Clinical Research Ethics Committee issued approval 75088915. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kiliccioglu et al.)

The meibomian gland is a unique sebaceous gland located in the eyelid. Its main function is to secrete lipids and form the lipid layer of the tear film to delay the evaporation of waterborne tears, increase the surface tension of the tear film, and to lubricate the contact area of the eyelid and eyeball. Abnormal secretion of the meibomian gland is known as meibomian gland dysfunction (MGD), which has become the most important cause of evaporative dry eye disease (DED). The clinical pathophysio-logical process and underlying molecular mechanisms of MGD are not clear. As serious side effects may occur with the long-term use of hormonotherapy and non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of MGD, meibomian gland physiotherapy is considered the most effective and safest therapy for MGD. This review summarizes the physical therapy modalities of western medicine (WM) and traditiond Chinese medicine (TCM) for the treatment of MGD to provide optimal treatments for these patients and to further lay a foundation for mechanistic studies of MGD.

Abstract The most prevalent type of meibomian gland dysfunction (MGD), which is obstructive, is the main cause of evaporative dry eye and is characterized by changes in the meibum composition and duct obstruction. Eyelid hygiene has usually been the most common clinical approach. However, alternative therapies for MGD are emerging on the market. Some warming and humidity devices have led to an improvement in the signs and symptoms in MGD patients. Likewise, eyelid massaging and cleaning devices are also beneficial for ocular signs and symptoms; however, patients usually need more than one session to maintain the therapeutic effect. Thermal pulsation has been reported to be more efficient than other strategies, and the effects can last up to 12 months. Moreover, intense pulsed light therapy has been demonstrated to improve ocular signs and symptoms alone and in combination with other therapies. Proper counseling of clinicians considering MGD status and patient compliance will help patients to undergo the adequate technique that best suits their condition.

PURPOSE: Incidences of ocular conditions, including meibomian gland dysfunction (MGD), blepharitis, and dry eye have been increasing globally. Eyelid hygiene is key to maintaining ocular surface health and improving ocular symptoms. This study investigated the awareness of eyelid hygiene among the Saudi population. METHODS: This cross-sectional survey was conducted between April 2020 and May 2020 across all regions of Saudi Arabia through the distribution of an electronic self-administered questionnaire among the Saudi population. RESULTS: A total of 1102 responses were received (women, 76.3%; men, 23.7%). Only 33.2% respondents reported consciously washing their eyelids, while 70.1% had never heard about MGD; however, most of the respondents (93.2%) had heard about dry eye. Based on the questionnaire results, the Saudi population had suboptimal (18.4%) level of awareness of eyelid hygiene. At least one ocular symptom was reported by 98.1% of the respondents. CONCLUSION: The level of awareness of eyelid hygiene in Saudi Arabia was found to be suboptimal, particularly among patients with MGD and dry eyes. Poor knowledge about the benefits of daily eyelid hygiene was the primary barrier to its practice. We recommend that ophthalmologists raise awareness of good eyelid hygiene among patients with MGD and eye dryness. Despite the current findings, further studies and evidence are required before recommending daily eyelid hygiene practices in the general population, including those without clinical symptoms of MGD or eye dryness. [ABSTRACT FROM AUTHOR]

Riadh Messaoud,1 Lamia El Fekih,2,3 Anis Mahmoud,1 Hager Ben Amor,4 Radhouane Bannour,5 Serge Doan,6,7 Moncef Khairallah41Department of Ophthalmology, Tahar Sfar University Hospital, Mahdia, Tunisia; 2Department of Ophthalmology, Internal Security Forces Hospital, La Marsa, Tunisia; 3Faculty of Medicine, Tunis-El Manar University, Tunis, Tunisia; 4Fattouma Bourguiba University Hospital, Monastir, Tunisia; 5Ophthalmology Private Practice, Monastir, Tunisia; 6Department of Ophthalmology, Bichat Hospital, Paris, France; 7Fondation A de Rothschild, Paris, FrancePurpose: To evaluate the clinical improvement in ocular symptoms and signs in patients suffering from Demodex anterior blepharitis after using a novel cleansing wipe impregnated with 2.5% terpinen-4-ol and 0.2% hyaluronic acid.Study design: This was an exploratory, multicenter, open, randomized, two-parallel group comparative study.Methods: Forty-eight patients with Demodex anterior blepharitis were randomly assigned to apply the sterile wipe T1172 (Blephademodex®), either once daily (n=24, Group 1) or twice daily (n=24, Group 2) for 29 days. Overall ocular discomfort and other individual symptoms were measured using a 0–10 numeric rating scale at Day 8 and Day 29. Ocular signs, including eyelid margin hyperemia and number of cylindrical dandruff, were examined at slit lamp. Overall treatment performance by investigator, patient satisfaction and tolerance were evaluated with questionnaires.Results: Overall ocular discomfort was significantly reduced from baseline (p

The most prevalent type of meibomian gland dysfunction (MGD), which is obstructive, is the main cause of evaporative dry eye and is characterized by changes in the meibum composition and duct obstruction. Eyelid hygiene has usually been the most common clinical approach. However, alternative therapies for MGD are emerging on the market. Some warming and humidity devices have led to an improvement in the signs and symptoms in MGD patients. Likewise, eyelid massaging and cleaning devices are also beneficial for ocular signs and symptoms; however, patients usually need more than one session to maintain the therapeutic effect. Thermal pulsation has been reported to be more efficient than other strategies, and the effects can last up to 12 months. Moreover, intense pulsed light therapy has been demonstrated to improve ocular signs and symptoms alone and in combination with other therapies. Proper counseling of clinicians considering MGD status and patient compliance will help patients to undergo the adequate technique that best suits their condition. [ABSTRACT FROM AUTHOR]

The commensal microorganisms may overpopulate and increase the risk of inflammatory conditions, such as blepharitis [[3]], either involving the eyelashes (anterior blepharitis) or the posterior portion of the eyelid margin, involving the meibomian glands (posterior blepharitis). To identify relevant studies, a search strategy was developed with a University Health Science's librarian to identify keywords related to the lids, lashes, lid hygiene and the treatment of lid margin disease (i.e. blepharitis) in electronic databases. Typically, eyelid cleaners are found in the formulations as discussed above (ie. wipes, gels, foams or creams), but more recently, some eyelid cleansers have been formulated as sprays which are applied to a cotton pad and then rubbed onto the closed eyelids. [Extracted from the article]

Purpose: To investigate if the application of Blephagel, an eyelid cleansing gel, causes subjective and/or objective cooling effects by measuring ocular symptomology and temperature.Methods: Twenty-five healthy subjects underwent baseline non-invasive temperature measurements on the closed upper eyelid (centrally, nasally, and temporally) and ocular surface temperature (OST) on both eyes using an infrared camera. A standard application of Blephagel was then applied to the closed upper eyelid and eyelashes with a sterile cotton-wool to one eye selected at random. Temperature measures were then repeated on both eyes after 30-60, 120-150, and 180-210 s. At each interval, subjects rated the comfort and any cooling sensation of each eye on a 0-10 scale.Results: After application of the gel, there was a significant difference in temperature at all locations on the eyelid between the test and control eyes over time (F = 9.322, p < 0.001). Post hoc analysis revealed this was significant from 30 to 60 s interval (36.3 ± 1.1 °C versus 37.2 ± 0.7 °C; p < 0.001) and the 120-150 s interval (36.8 ± 0.8 °C versus 37.2 ± 0.6 °C; p < 0.001). There was no significant variation between the OST locations over time (F = 3.350, p = 0.07). With respect to symptoms, there was a significant increase in cooling sensation in the test eye compared to the control eye over time (F = 10.438, p < 0.001), that remained throughout the experiment.Conclusions: Blephagel produces a reduction in temperature of the eyelids that is accompanied with a subjective cooling sensation. [ABSTRACT FROM AUTHOR]

Purpose: To compare the in vitro anti-demodectic activity of four commercially available dedicated eyelid cleansers (Cliradex® towelette cleanser, Oust™ Demodex® cleanser, Blephadex™ eyelid foam, TheraTears® SteriLid® eyelid cleanser), tea tree oil, undiluted terpinen-4-ol and linalool; and to assess the terpinen-4-ol content of the commercial cleansers and tea tree oil.Methods: In vitro anti-demodectic efficacy assessment: 93 viable Demodex mites were acquired from the epilated eyelashes of 10 participants, and were randomised to application with one of the four eyelid cleansers, 100% and 50% tea tree oil, undiluted terpinen-4-ol and linalool, or no treatment. Following treatment application, mite viability was assessed for 300 min, based on limb/body movement and/or the development of a crenated/translucent appearance. Kaplan-Meier survival analysis was then performed.Mass Spectrometry Analysis: The absolute concentration of terpinen-4-ol and the relative abundance of linalool in the four eyelid cleansers and tea tree oil were determined.Results: In vitro anti-demodectic efficacy assessment: No significant differences were observed between undiluted tea tree oil, terpinen-4-ol and linalool (all p > 0.05). Although all commercial eyelid cleansers effected lower mite survival probabilities than the untreated group, Cliradex® was the only eyelid cleanser that demonstrated comparable antiparastic activity to 50% tea tree oil (p = 0.36).Mass Spectrometry Analysis: Among the four eyelid cleansers, Cliradex® contained the highest concentration of terpinen-4-ol, while linalool was present in TheraTears® SteriLid® only.Conclusions: Of the four commercial eyelid cleansers, Cliradex® demonstrated the highest levels of in vitro anti-demodectic activity and terpinen-4-ol content. Undiluted linalool and terpenin-4-ol showed comparable antiparasitic efficacy, and the use of linalool in the management of demodectic blepharitis warrants further investigation. [ABSTRACT FROM AUTHOR]

Purpose: To compare the in vitro antiparasitic effects of MGO™ Manuka honey and tea tree oil against ocular Demodex.Methods: Fifty-two viable Demodex mites were acquired from the epilated eyelashes of 9 participants with blepharitis and symptomatic dry eye. Viable mites were randomised to one of five treatment groups: cyclodextrin-complexed and uncomplexed Manuka Honey, 100% and 50% tea tree oil, and no treatment. Following treatment application, mite viability was assessed for 240 min, based on limb and body movement and/or the development of a crenated/translucent appearance. Kaplan-Meier survival analysis was then performed.Results: The log-rank test demonstrated a significant treatment effect on the survival distribution of Demodex mites (p < 0.001). Bonferroni-corrected post-hoc pairwise analysis showed that all treatments except for uncomplexed honey effected lower survival probabilities than the untreated group (all p < 0.001). Among the four treatments, survival probabilities were lowest with 100% tea tree oil (all p < 0.001), and highest with uncomplexed honey (all p ≤ 0.001). No difference was observed between complexed honey and 50% tea tree oil (p = 0.81).Conclusions: The in vitro efficacy of cyclodextrin-complexed Manuka honey was comparable with 50% tea tree oil, an established treatment for ocular Demodex. The findings support future clinical trials investigating the therapeutic effects of complexed honey in demodectic blepharitis patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the antimicrobial activity of a novel preservative-free lid wipe formulation containing Aloe vera gel and hyaluronic acid that is commercialized for the hygiene of the periocular area.Methods: In vitro susceptibility testing of the solution contained in wipes against bacteria and fungi commonly colonizing the periocular area, both reference strains and multidrug-resistant (MDR) clinical isolates, was assessed following the CLSI M07-A9 and M27-A3 broth methods, respectively. The solution was 2-fold serially diluted in broth from 25 μL (25% v/v) to 0.012 μL (0.012% v/v) in microtiter plates. Plates were incubated and minimal inhibitory concentrations (MICs) were read visually. The antimicrobial effectiveness test was performed by inoculating the wipe solution with microbial suspensions at the initial concentration of 105-106 CFU/mL, as recommended by the international Pharmacopoeias. At different time intervals, samples were tested for microbial count.Results: The MIC value of the solution ranged from 25% to 12.5% for bacteria and was 6.25% for Candida albicans. The MIC for MDR isolates was 12.5%. By assessing antimicrobial effectiveness, we found that the solution meets the criteria reported by the European Pharmacopoeia and United States Pharmacopeia for its preservative effect.Conclusions: This study demonstrates that the novel wipes herein tested possess antimicrobial activity against bacteria and yeast commonly found in the periocular area, and against MDR clinical isolates. The microbial death curves obtained following deliberate contamination of the wipe solution revealed potent bactericidal and fungicidal activity of the formulation. [ABSTRACT FROM AUTHOR]

Purpose: To observe (1) changes in meibomian gland (MG) after exposure to intense pulsed light (IPL) and (2) to understand the mechanism by which IPL treats meibomian gland dysfunction (MGD) in patients. Methods: A cohort study, including 35 MGD patients, was conducted. IPL treatment was administered in one group (IPL group;n = 18), and eyelid hygiene in another (control group;n = 17) for 3 months. All patients were given artificial tears during the treatment period. Associated ocular-surface indexes (ocular surface disease index, OSDI; tear breakup time, TBUT, Schirmer 1Test, corneal staining, and conjunctival staining), MG function, MG macro-morphology, and MG micro-morphology were examined before and after treatment. The relationships between the change in symptom score and the change in the other indexes (related ocular-surface indexes, MG functional indexes, and MG morphological indexes) were evaluated. Results: There was no statistical difference in pretreatment between the IPL and the control groups in terms of age, gender, related medical history, MGD stage, and all examined indexes, with the exception of conjunctival staining. OSDI, TBUT, meibum quality, MG expressibility, and MG dropout improved after treatment in both of the two groups (allP < 0.05). The MG microstructure indexes, including the MG acinar longest diameter (ALD), MG acinar unit density (AUD), and the positive rate of inflammatory cells (ICs) around glandular structures were significantly improved in the IPL group. No improvements of microstructure were found in the control group. Conclusion: IPL treatment improves the symptom score of patients, associated ocular-surface indexes, MG function, and MG macrostructure as well as eyelid hygiene. And IPL treatment particularly improves MG microstructure and decreases MG inflammation in MGD patients. [ABSTRACT FROM PUBLISHER]

Commonly associated with dry eye, blepharitis is the most commonly encountered disorder in general ophthalmologic practice. Although anti-infective and anti-inflammatory therapies are available, eyelid hygiene is the cornerstone of effective management. A variety of products have been used to assist and encourage eyelid cleansing and massage. The present study examines the ocular and periocular tolerability and acceptability of Blephagel, a cosmetic, poloxamer-containing gel designed specifically for cleansing the eyelid in subjects with sensitive skin or eyes or contact lens users. Subjects with blepharitis and sensitive skin or eyes, a history of atopy, or who use contact lenses applied Blephagel twice daily at home. Clinical ophthalmologic examinations were conducted before and 21 days after aqueous gel application, and subjects completed a questionnaire on the acceptability of the preparation. Thirty-three predominantly female subjects entered and completed the study. A total of 36% of the subjects had used similar products in the past, 21% regularly. Upon questioning by the ophthalmologist, 85% of the subjects reported acceptability of the preparation as good to very good, and 73% rated the efficacy as good to very good. There were minor but statistically nonsignificant changes in fluorescein tear breakup time and visual acuity before and after 21 days of aqueous gel application. The questionnaire results indicated that the subjects found the product to be effective for cleansing the eyelids of mucus and squama around eyelash roots. Moreover, cosmetic qualities, sensation in use, and acceptability were also appreciated. No subject reported any adverse event considered to be related to the aqueous gel. Although the safety of Blephagel has already been established in standard tests, the current results suggest that it is also pleasant to use and acceptable to blepharitis patients with sensitive skin as an aid to an eyelid hygiene regime. [ABSTRACT FROM AUTHOR]

To determine the efficacy duration of eyelid hygiene for meibomian gland dysfunction (MGD) treatment, a total of 1015 participants with primary MGD, followed for at least 6 months, were enrolled. The participants were classified into the eyelid hygiene group and the control group. The participants who had stopped eyelid hygiene at any point in the observation period after the initial 2 months were classified into the withdrawal group. Analysis was conducted with a generalized linear mixed model. Treatment group, age, sex, ocular surface inflammation, anti-inflammatory treatments, and baseline MGD subtype were considered as fixed effects, and the individual factor was considered as a random effect. The MGD stage decreased significantly for the observational period in the eyelid hygiene group (p < 0.001). Approximately 40.1% of the participants continuously maintained eyelid hygiene throughout the observational period. The MGD stage in the eyelid hygiene group continued to decrease for 6 months and was maintained thereafter. After 4 months of stopping eyelid hygiene, the MGD stage in the withdrawal group was worse than in the eyelid hygiene group (p < 0.001) and similar to that in the control group (p = 0.762). Maintaining eyelid hygiene was significantly effective in MGD treatment. Efficacy increased with treatment for 6 months, and the efficacy duration was maintained for 4 months even after stopping eyelid hygiene. Therefore, we recommend that patients with MGD maintain eyelid hygiene, and compliance should be checked continuously. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy of a dedicated eyelid cleanser and diluted baby shampoo in the management of blepharitis., Methods: Forty-three participants with clinical blepharitis signs were enrolled in a prospective, randomized, double-masked, paired-eye trial. A dedicated eyelid cleanser (TheraTears ® SteriLid ® ) was applied to the eyelids of one eye (randomized) and diluted baby shampoo (Johnson's ® No More Tears ® ) to the fellow eye, twice daily for 4 weeks. Tear film parameters, ocular surface characteristics, symptomology and cytology markers were assessed at baseline and day 28., Results: Baseline measurements did not differ between treatments (all p > 0.05). The eyelid cleanser was preferred over baby shampoo by the majority of participants (p < 0.001). Improvements in the tear lipid layer, inferior lid wiper epitheliopathy (LWE), cylindrical collarettes, and MMP-9 expression were limited to the dedicated eyelid cleanser (all p < 0.05), and a greater decrease in SANDE symptoms score was also observed (p = 0.04). Meibomian gland capping and MUC5AC expression worsened with baby shampoo treatment (both p < 0.05). SPEED symptoms score, superior LWE, seborrhoeic lash crusting, and trichiasis decreased significantly following application of both treatments (all p < 0.05), but did not differ between treatments (all p > 0.05)., Conclusion: Clinical improvements in blepharitis occurred with both treatments. However, only the dedicated eyelid cleanser proved effective in reducing ocular surface inflammation, and was the preferred therapy. Long term impact of decreased goblet cell function secondary to baby shampoo treatment requires further exploration., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To compare the efficacy of 3 treatment options in patients with chronic blepharitis., Methodology: An experimental, randomized, controlled study was conducted on 45 patients (female 67%; Mean age: 40.5 years) diagnosed with chronic blepharitis, in order to compare the effectiveness of three treatment options. Group 1: eyelid hygiene with neutral shampoo three times/day; group 2: neutral shampoo eyelid hygiene plus topical metronidazole gel 0.75% twice/day; group 3: neutral eyelid hygiene with shampoo plus neomycin 3.5% and polymyxin 10% antibiotic ointment with 0.5% dexamethasone 3 times/day. The symptoms and signs were assessed by assigning scores from 0: no symptoms and/or signs; 1: mild symptoms and/or signs, 2: moderate symptoms and/or signs; and 3: severe symptoms and/or signs., Results: A significant improvement was observed in the signs and symptoms in all 3 treatment groups. While groups 1 and 2 had more improvement in all variables studied (P<.05), Group 3 showed no clinical improvement for itching (P=.16), dry eye (P=.29), eyelashes falling (P=.16), and erythema at the eyelid margin (P=.29)., Conclusions: Shampoo eyelid hygiene neutral and neutral shampoo combined with the use of metronidazole gel reported better hygiene results than neutral shampoo lid with antibiotic ointment and neomycin and polymyxin dexamethasone., (Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Eyelid hygiene, including massage and warm compresses, is an important part of the treatment and prevention of Meibomian gland dysfunction (MGD). Although effective, it requires active participation of the patient and lacks standardisation. Blephasteam is a medical device designed to warm and humidify the eyelid with heating glasses, in order to liquify meibum, thus relieving symptoms and preventing relapse., Materials and Methods: The ESPOIR study (Evaluation of the Satisfaction of Patients with Management of Ocular Surface Diseases) presented herein was designed to evaluate the safety and efficacy of this medical device in patients with MGD. A total of 28 French centers participated in the study. One hundred and two patients presenting with symptomatic dysfunction or Meibomian-related dry eye underwent two sessions per day with the eyelid warming device and recorded diary entries on a number of parameters every 2 days for the first week and then weekly for the remaining 2 weeks. Patients were assessed on days 0 and 21., Results: Symptomatology, as recorded on a visual analogue scale (VAS) by the investigator (the primary efficacy variable) was significantly (P<0.001) improved at the end of the study (59.97, 95% CI 55.64-64.30 vs. 39.71, 95% CI 34.78-44.65 on Days 0 and 21 respectively), as was the mean symptoms score (mean decrease of 19.93 ± 22.15 VAS units; P<0.001), hyperemia score (-1.57 ± 1.96 and -1.45 ± 1.85; P<0.001, in the worse and contralateral eye respectively), and quality of meibum (mean -4.03 ± 3.08; P<0.001 and -3.32 ± 3.20; P<0.01, in the worse and contralateral eye respectively). More than twice as many reported their symptoms had improved or disappeared compared with those whose symptoms had not changed or had worsened. Global symptomatology, as assessed by the patients, declined throughout the study, and a large majority of patients were satisfied or very satisfied with the treatment. Clear vision and blinking were not impaired during use of the eyelid warming device, which insures proper spreading of the tear film, and patients were able to continue daily activities such as reading and watching television. No adverse events were reported, and there were no changes in intraocular pressure or visual acuity. Safety was rated as satisfactory or very satisfactory by more than 95% of the investigators., Conclusion: The study suggests that the eyelid warming device is safe and effective in reducing ocular discomfort and symptoms in MGD., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)