OUTER EYELID HEAT AND PRESSURE TREATMENT FOR TREATING MEIBOMIAN GLAND DYSFUNCTION

• US 20080132978A1
• Filed: 01/17/2008
• Published: 06/05/2008
• Est. Priority Date: 05/15/2006
• Status: Active Grant

• Current Assignee: TearScience Inc. (Johnson & Johnson)
• Original Assignee: TearScience Inc. (Johnson & Johnson)
• Inventors: Grenon, Stephen M., Willis, Timothy R., Korb, Donald R., Gravely, Benjamin Tyson
• Granted Patent: US 7,981,147 B2
• Time in Patent Office: Days
• US Class Current: 607/109
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/048 in gaseous form
• CPC Class Codes: A61F 2007/0004 Eyes or part of the face surrounding the eyes
• CPC Class Codes: A61F 2007/0059 with an open fluid circuit
• CPC Class Codes: A61F 7/007 characterised by electric heating
• CPC Class Codes: A61F 7/12 Devices for heating or cooling internal body cavities
• CPC Class Codes: A61F 9/00718 Restoration of lid function
• CPC Class Codes: A61H 2015/0014 cylinder-like, i.e. rollers
• CPC Class Codes: A61H 7/00 Devices for suction-kneading massage; Devices for massaging the skin by rubbing or brushing not otherwise provided for electro-medical massage devices applying electric current by contact A61N1/18
• CPC Class Codes: A61K 31/65 Tetracyclines
• CPC Class Codes: A61K 38/1841 Transforming growth factor [TGF]
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A method of treating meibomian gland dysfunction. Heat is applied to the outside of the eyelid to provide conductive heat transfer to the meibomian glands. The application of heat assists in the expression of obstructions or occlusions in the meibomian glands to restore sufficient sebum flow to the lipid layer to treat dry eye. A force may also be applied to the outside of the patient'"'"'s eyelid to improve conductive heat transfer and reduce blood flow in the eyelid that causes convective heat loss. Thus, the application of force can further increase the temperature level and/or reduce the time to reach desired temperature levels for removing obstructions or occlusions. Reaching increased temperature levels may improve the melting, loosening, or softening of obstructions or occlusions in the meibomian glands while reducing the amount of time to reach desired temperature levels and/or aid in reducing discomfort to the patient during treatment.

Claims

1. A method of treating meibomian gland dysfunction, comprising the steps of:

applying heat to an external surface of a patient'"'"'s eyelid to a temperature level to melt, loosen, or soften an obstruction in a meibomian gland;

maintaining the heat for a period of time; and

applying a force to the external surface of the patient'"'"'s eyelid to apply pressure to the external surface of the patient'"'"'s eyelid.

2. The method of claim 1, further comprising expressing the obstruction from the meibomian gland.

3. The method of claim 2, wherein the step of expressing is performed during the step of maintaining the heat for a period of time.

4. The method of claim 2, further comprising removing the heat from the external surface of the patient'"'"'s eyelid, wherein the step of expressing is performed after the step of removing the heat from the external surface of the patient'"'"'s eyelid.

5. The method of claim 1, further comprising repeatedly performing the steps of applying and maintaining the heat after a selected period of time to maintain the obstruction in the melted, loosened, or softened state.

6. The method of claim 1, wherein the time period for maintaining the heat is from approximately 1 to 10 minutes.

7. The method of claim 1, wherein the temperature level is between approximately 43 and 47 degrees Celsius.

8. The method of claim 1, further comprising treating the eyelid or meibomian gland with a pharmacological agent to promote the free flow of fluids from the meibomian gland

9. The method of claim 8, wherein the pharmacological agent is an agent selected from the group consisting of antibiotics, topical tetracycline, topical corticosteroids, oral corticosteroids, topical androgens, topical androgen analogues, TGF-β

, omega 3 compositions, enzymes that promote lipid productions, agents that stimulate production of enzymes that promote lipid production, agents that act as a secretagogue to enhance meibomian gland secretion, an agent that replaces production of a tear component, and an agent that promotes production of a tear component.

10. The method of claim 1, further comprising maintaining the force to the external surface of the patient'"'"'s eyelid for a period of time.

11. The method of claim 10, wherein maintaining the force expresses the obstruction while the obstruction remains in a melted, loosened, or softened state.

12. The method of claim 10, wherein maintaining the force the force reduces blood flow in the eyelid to reduce thermal dissipation from the eyelid.

13. The method of claim 10, wherein the temperature level is between approximately 43 and 55 degrees Celsius.

14. The method of claim 10, further comprising expressing the obstruction from the meibomian gland.

15. The method of claim 14, wherein the step of expressing is performed during the steps of maintaining the heat for a period of time.

16. The method of claim 14, wherein the step of expressing is performed during the step of maintaining the heat for a period of time and maintaining the force for a period of time.

17. The method of claim 10, further comprising removing the heat from the external surface of the patient'"'"'s eyelid, wherein the step of expressing is performed after the step of removing the heat from the external surface of the patient'"'"'s eyelid.

18. The method of claim 10, further comprising removing the force from the external surface of the patient'"'"'s eyelid, wherein the step of expressing is performed after the step of removing the force from the external surface of the patient'"'"'s eyelid.

19. The method of claim 10, wherein the step of expressing is performed during the maintaining of the force to the external surface of the patient'"'"'s eyelid.

20. The method of claim 14, further comprising repeatedly performing the steps of applying and maintaining the heat after a selected period of time, and applying and maintaining the force after a selected period of time to express the obstruction while in the melted, loosened, or softened state.

21. The method of claim 10, wherein the time period for maintaining the force is from approximately 1 to 10 minutes.

22. The method of claim 10, wherein applying heat further comprises positioning an insulator behind the patient'"'"'s eyelid on the external surface sclera of the eye.

23. The method of claim 1, further comprising regulating the heat when applying the heat to the external surface of the patient'"'"'s eyelid.

24. The method of claim 1, further comprising regulating the force when applying the force to the inner surface of the patient'"'"'s eyelid.

25. The method of claim 1, wherein the force applied to the external surface of the patient'"'"'s eyelid is comprised from the group consisting of a mechanical force, an electrical force, a pneumatic force, and a manual compression force.