New Technologies & Latest Advancements

On this page you will find some new technologies and advancements that I have gleaned from the latest scientific journals. I will only report on those I feel have true value for patients and not a flash in the pan. The latter would be “discoveries” that one reads about one time and never hear about again. If it is some new drug that shows great promise for example, treating dry eye, we may never hear about it again if it does not make it through the rigorous Federal Drug Administration protocols. If the drug fails to make it all the way through, it will not come to market. That is just one example and such a “breakthrough” won’t make it onto this page. I will categorize each new technology or treatment according to the structure of the eye that it pertains to.

New Drug Approved to Treat the Signs and Symptoms of Dry Eye Disease

This new drug is called Xiidra (lifitegrast solution 5%) and according to the manufacturer’s website (Shire US Inc.) According to them, Xiidra is the first prescription eye drop approved by the FDA for both the signs and symptoms of dry eye disease. We have heard good reports about how well it works and have begun prescribing it for our patients who suffer from significant dry eye problems here in the dry air of Montana. Their website is They have a savings program that helps with the cost of the medication. One can sign up at

Update on Meibomian Gland Disease “Avenova”

Many people with red, itchy, inflamed eyes actually are suffering from Meibomian Gland Disease. This is where the glands in the eyelids get plugged or even infected and quit producing the oily layer of human tears which helps prevent the evaporation of the tears as they ride on the very front of the eye. The lids themselves can look red and have rough margins. The problem can seem to come and go with exacerbation and remissions. In the past we have used the application of heat to the lids or a combination antibiotic/steroid ointment to try and bring the problem into remission. People can have significant symptoms and this problem is more common than one would expect.

There is a new treatment for this disease and it is called Avenova. Their website is We have been prescribing this drug which is pure hypochlorous acid and patients have been very pleased with the results. Right now it is available from two on-line pharmacies which are described on their webpage. An office call appointment is necessary to determine if Meibomian Gland Disease is actually causing the symptoms described above.


Lipiflow treatment for Meibomian Gland DiseaseOne of the most common problems I see is called Meibomian Gland Disease. There are between 24 and 28 vertically oriented glands in each eyelid. In this disease process they become inflamed and can cause red eyelid margins. The glands may become plugged which prevents the glands from secreting the oil that rides over the top of the tear pool. That oil helps prevent evaporation of the tears and thus helps prevent dry eye symptoms. First line treatment involves hot compresses, lid scrubs, massage of the glands with a finger or q-tip and the addition of fish oil or flaxseed oil capsules to the diet. The next line of treatment is a fairly long term (up to 90 days) low dose of the antibiotic doxycycline. Some folks do get some benefit from a topical antibiotic eyedrop such as Zylet or the application of a topical antibiotic ointment to the eyelid and eyelash bases. The relatively new treatment is with a machine type treatment called the Lipiflow device from Tearscience. You can read about it at Failure to treat Meibomian gland disease may eventually cause the Meibomian glands to atrophy and the production of the oil drop off to the extent that the dry uncomfortable eye symptoms become more constant.

Contact Lenses

I thought I should mention scleral contact lenses. Although they have been out for some time, I have never written about them on my website. These are relatively large rigid contact lenses which are quite comfortable because they rest on the white part of the eye (the conjunctiva) and not the sensory nerve rich cornea. They are designed to vault over the cornea so that they do not touch its surface. I have found them to be very effective for patients with keratoconus, irregularly shaped corneas, corneas that have had a corneal transplant and many other special conditions. We also fit the Synergeyes hybrid contact lens which works well on many patients with special needs. The hybrid contact lens has a gas permeable center and a soft contact lens flange fused to its periphery.