New knowledge, technology, diagnostic methods and treatments have led to more accurate diagnosis of MGD and treatment of dry eye
On Tuesday, November 4, 2014, Dr. Donald R. Korb presented a provocative lecture, “Dry Eye is the Wrong Diagnosis for Millions,” to faculty and students at the New England College of Optometry. The lecture was streamed live to clinicians at New England Eye. Dr. Korb is a Boston researcher with more than 50 patents and 100 publications, a practicing optometrist, and an affiliated clinical professor at School of Optometry, University of California, Berkeley. In the past month, he has presented this topic as the invited Myers Lecturer at the Ohio State University and to the faculty at the Illinois College of Optometry.
An estimated 25 million people in the US and 300 million people worldwide suffer from dry eye disease. Dr. Korb, however, contends that millions of these individuals are incorrectly diagnosed with dry eye and that 86% of those diagnosed actually suffer from Meibomian Gland Dysfunction (MGD). Presently, many conventional dry eye treatments focus on treating the aqueous-water phase of the tear film and fail to provide significant help for the majority of dry eye sufferers. Dr. Korb asserts by identifying the deficiency of the meibomian gland, treatment can instead focus on the insufficient oil produced by the glands. The importance of MGD was recently confirmed by a two-year study by the well-respected Tear Film and Ocular Surface Society, which concluded, “MGD may well be the leading cause of dry eye disease throughout the world.”
Dr. Korb’s primary research interest for the past 35 years has been dry eye and MGD. Over thirty years ago, in a landmark publication, he coined the name Meibomian Gland Dysfunction to convey that ocular dryness is frequently the result of obstruction of these oil glands located in the eyelids. Consequently, the volume of oil secreted in the tear film is inadequate to control evaporation. As a result, the mistaken approach that the tear film is water deficient developed. MGD produces many of the same symptoms as dry eye – burning, tearing, scratchiness, redness, blurring of vision, and general eye fatigue. Dr. Korb noted that it is important for a precise diagnosis of MGD in order to focus on the root cause of the dry eye condition, rather than treating the tear film with methods not designed to address the oil deficiency.
These findings may be revolutionary in the treatment of dry eye since the current treatments are palliative rather than restorative. Dr. Korb notes that new imaging technology can help identify the atrophy of meibomian glands at an early stage. Since MGD is chronic and progressive, it can lead to decreased function and altered tissue structure if not appropriately treated. Practitioners can utilize new treatment strategies for patients to counteract the debilitating process before the changes are irreversible. New diagnostic metrics help practitioners quantify the gland secretion, tear break-up time and dry eye symptoms to help determine treatment. Dr. Korb urges practitioners to be accurate in their diagnoses to help effectively treat and prevent further deterioration.
Dr. Korb, in his pursuit of a treatment for the oil-deficient tear film co-founded TearScience and invented the LipiFlow® treatment, which eliminates meibomian gland blockages and restores the flow of the oil in these glands. LipiFlow was introduced by TearScience in 2012 as the only treatment for MGD approved by the U.S. Food and Drug Administration. It has been touted by many medical professionals as revolutionary because, for the first time, the treatment addresses the root cause of the majority of dry eye disease. Dr. Korb has also developed new tests to disclose other factors that complicate dry eye diagnosis.
In the past three years, more than 40,000 patients have been treated in more than 250 eye care practices by ophthalmologists and optometrists. Dr. Alan N. Carlson, chief of corneal and refractive surgery at the Duke University Eye Center worked with Dr. Korb in the introduction of this technology and noted, “Many of us have been guilty of under-treating dry eye and MGD. Once you start looking for MGD and evaporative dry eye, you quickly realize just how prevalent this condition is across the entire patient spectrum, and especially in the elderly. LipiFlow® is a complete paradigm shift in our understanding of dry eye due to MGD and our ability to treat it. After nearly three years of experience with LipiFlow®, I characterize this device as revolutionary, not merely evolutionary.”
Dr. Korb will be part of a panel discussion on the “Emerging Trends in the Management of Dry Eye” with lecturers from Korb Associates at NECO as part of the Continuing Ed Sunday Seminar Series on December 7, 2014.
Learn more about the panel on December 7, 2014.
Register for the Sunday Seminar Event.
Dr. Donald Korb