Inner eyelid heat and pressure treatment for treating meibomian gland dysfunction

• US 7,976,573 B2
• Filed: 01/17/2008
• Issued: 07/12/2011
• 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., Korb, Donald R.
• Primary Examiner(s): Gibson; Roy
• Assistant Examiner(s): SMITH, KAITLYN ELIZABETH
• Application Number:
  US12/015,567
• Publication Number:
  US 20080114421A1
• Time in Patent Office: 1,272 Days
• Field of Search: 607/96, 128/898, 424/443
• US Class Current: 607/96
• 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 9/00772 Apparatus for restoration of tear ducts
• 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: 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 inside 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. Temperatures at the meibomian glands reach desired levels more quickly and efficiently when heating the inside of the eyelid. Reaching such higher temperature levels may be instrumental in removing obstructions in the meibomian glands. Less time may also be required to reach desired temperature levels when applying heat to the inside of the eyelid. A force may also be applied to the inside 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.

Claims

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

placing a heat source between an inner surface of a patient'"'"'s eyelid and eyeball;

applying heat from the heat source to the inner surface of a the 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 inner surface of the patient'"'"'s eyelid to apply pressure to the inner surface of the patient'"'"'s eyelid.

2. The method of claim 1, further comprising expressing the obstruction from the meibomian gland by applying a force to the patient'"'"'s eyelid.

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

4. The method of claim 2, further comprising removing the heat from the inner surface of the patient'"'"'s eyelid.

5. The method of claim 2, further comprising removing the force from the inner surface of the patient'"'"'s eyelid, wherein the applying the force is performed after the removing of the force from the inner surface of the patient'"'"'s eyelid.

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

7. The method of claim 2, wherein the expressing comprises expressing the obstruction from within a meibomian gland channel of the meibomian gland through a meibomian gland orifice of the meibomian gland channel.

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

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

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

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

12. The method of claim 11, 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.

13. The method of claim 1, wherein the force applied to the inner 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.

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

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

16. The method of claim 1, further comprising applying heat to an external surface of the patient'"'"'s eyelid to the temperature level to melt, loosen, or soften the obstruction in the meibomian gland.

17. The method of claim 1, further comprising applying a force to the inner surface of the patient'"'"'s eyelid to express the obstruction from the meibomian gland.

18. The method of claim 17, further comprising maintaining the force to the inner surface of the patient'"'"'s eyelid for a period of time.

19. The method of claim 18, wherein the maintaining the force expresses the obstruction while the obstruction remains in a melted, loosened, or softened state.

20. The method of claim 18, wherein the maintaining the force reduces blood flow in the patient'"'"'s eyelid to reduce thermal dissipation in the patient'"'"'s eyelid.

21. The method of claim 18, wherein the temperature level is between approximately 43 and 55 degrees Celsius.

22. The method of claim 18, further comprising mechanically expressing the obstruction from the meibomian gland.

23. The method of claim 22, wherein the applying the force is performed during the maintaining of the heat for a period of time.

24. The method of claim 22, wherein the applying the force is performed during the maintaining of the heat for a period of time and the maintaining of the force for a period of time.

25. The method of claim 22, further comprising repeatedly performing the applying and maintaining of 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.

26. The method of claim 18, further comprising removing the heat from the inner surface of the patient'"'"'s eyelid, wherein the expressing is performed after the removing of the heat from the inner surface of the patient'"'"'s eyelid.

27. The method of claim 18, further comprising expressing the obstruction from the meibomian gland,

wherein the expressing is performed during the maintaining of the force to the inner surface of the patient'"'"'s eyelid.

28. The method of claim 18, wherein the period of time for maintaining the force is from approximately 1 to 10 minutes.

29. The method of claim 18, further comprising expressing the obstruction while the obstruction remains in a melted, loosened, or softened state.

30. The method of claim 1, wherein the applying heat is comprised of applying heat from the heat source to the inner surface of the patient'"'"'s eyelid to a temperature level to melt, loosen, or soften an obstruction in a meibomian gland channel of the meibomian gland.