Joseph Boorady, OD, president and CEO of TearScience, has spent over 20 years in the ophthalmic industry as an executive. Boorady held the role of senior vice president of sales, service and marketing at Carl Zeiss Meditec, Inc, U.S. At Zeiss, he was responsible for all commercial activities of medical devices in ophthalmology, neurosurgery, ENT, spine, dental and radiotherapy. Prior to Zeiss, Boorady held the position of COO of Eyemaginations, was the executive director of SUNY College of Optometry and has owned and operated multiple clinical facilities.
Richard Clompus, OD: Dry eye has become a major complaint for many patients. Treatment methods for evaporative dry eye and meibomian gland dysfunction (MGD) are moving beyond eye drops to meibomian gland therapy. TearScience has been at the forefront of new technology to diagnose and treat MGD. How does the new LipiView II instrument help diagnose dry eye?
Joseph Boorady, OD: Dynamic meibomian imaging (DMI), available on both the LipiView II and the recently launched Lipi-Scan, provides high quality imaging of the meibomian gland structure. LipiScan is fast and has a small footprint, which creates the opportunity for eyecare professionals (ECPs) to easily introduce routine assessment of meibomian gland health. LipiView II with DMI includes additional function metrics evaluating lipid layer thickness and blink dynamics.
RC: There has been significant interest by optometrists in the LipiFlow instrument to treat MGD. Does this treatment system integrate well into primary care practice?
JB: LipiFlow has been met with enthusiasm by the optometric community. The LipiFlow research began 10 years ago. We started with front surface heat devices and found they are not effective due to the cooling effect of the lid. Our research evolved LipiFlow to today’s proven inner-lid heating. LipiFlow has demonstrated unmatched clinical results while setting the standard in MGD and all dry eye treatments. We have focused on making DMI and LipiFlow affordable with smooth integration into the primary ECP’s practice. Our business model has shifted to affordability and simple integration. Now, with LipiScan, speedy high definition images can be obtained in any standard workup.
RC: When do patients typically feel relief of symptoms following a LipiFlow treatment session?
JB: Studies have shown an increase of approximately three times in meibomian gland function and 50% symptom improvement after a single 12-minute LipiFlow treatment. Results vary, but typically, patients feel symptom relief within a couple of weeks, increasing in impact for approximately nine months. However, symptom relief is subjective. The SPEED (Standard Patient Evaluation of Eye Dryness) questionnaire and gland evaluations should be conducted before and after LipiFlow treatments to better manage MGD. We are also very pleased about our outstanding results from a recent multicenter, randomized clinical study for LipiFlow patients reinforcing more than 30 sponsored and unsponsored clinical studies demonstrating LipiFlow efficacy.
RC: Are there any words of advice you can offer to our colleagues who would like to increase dry eye care in their practices?
JB: We now know that MGD is involved in 86% of all dry eye cases and is an unrecognized cause even before symptoms ever show up. It is highly comorbid with cataract and refractive procedures as well as contact lens wearers. My advice to our colleagues is to look and screen all patients for MGD. We have made it convenient to do a 10-second image of each lower lid with the LipiScan and/or a simple push on the lid with a Korb MGE (Meibomian Gland Evaluator) while observing the lid margin at the slit lamp to determine function. It’s now time to optimize care for your patients simply by incorporating MGD into your routine protocol.