What is Blephasteam^®?

• B - - -> Blepharitis Blepharitis is the most common condition seen in the ophthalmologist’s practice (1). It is a common cause of eyelid inflammation, and causes irritation, itching of the eyelids, red eyes, and dandruff-like scales on eyelashes. Blepharitis can be classified by the anatomic location: anterior blepharitis (affects the base of the eyelashes) and posterior blepharitis (affects the Meibomian glands and their duct orifices). Blepharitis has traditionally classified in subcategories as staphylococcal, seborrheic, Meibomian Gland Dysfunction (MGD), or a combination thereof (2).
• L - - -> Lids/Eyelids There are 4 eyelids, two per eye: an upper eyelid and a lower eyelid. Eyelids are a mucocutaneous layer covered in skin. Eyelids are composed of muscles which allow blinking, a tarsal part which controls their shape and contains glands like Meibomian glands and accessory lacrimal glands. Eyelids play an important role in protecting ocular surface from damage.
• E - - -> Evaporative Dry Eye Evaporative dry eye is due to excessive water loss from the exposed ocular surface in the presence of normal lacrimal secretory function. Its causes have been described as intrinsic, affecting lid structures, or extrinsic, where ocular surface diseases occur due to some extrinsic exposure. Meibomian glands and their excretion of lipids play an important function in the lipid layer thickness and the tear film integrity (3).
• P - - -> Prevalence Meibomian Gland Dysfunction is widespread in the general population; several studies estimate the prevalence at 39% to 50% in general population (4). This condition has been noted in nearly half of contact lens wearers. MGD is also prevalent in patients with dry eye and is associated with tear film instability. MGD often occurs in conjunction with cutaneous disease and sebaceous gland disorders (5).
• H - - -> Heat Meibum from subjects with MGD were observed to begin melting at 35°C, whereas meibum from normal subjects started to melt at 32°C (6). It is important in MGD patients to warm the eyelids up to 40°C to ensure successful melting and outflow of obstructing meibum.
• A - - -> Air Blephasteam^® delivers latent and controlled heat and moist air around the eyelids which melt the obstructing meibum thereby, helping its evacuation through massaging and pressure. Blephasteam^® has been studied and validated to ensure device safety.
• S - - -> Safety Blephasteam^® has been designed and developed to ensure efficacy and safety. All data meet CE requirements. The temperature of the eyelids never rose above 40°C. Blephasteam^® was considered as safe. None of these experiments with human volunteers was reported as uncomfortable.
• T - - -> Treatment The treatment of MGD consists of eyelid hygiene, systemic antibiotics, topical antibiotics and steroids, as well as treatment of any dermatologic conditions (1). It is essential to explain to the patient that the mainstay treatment is lid hygiene to unblock the glands and prevent them from blocking again as much as possible. The first step in lid hygiene consists in increasing the flow of meibum by raising the temperature above its melting point. Blephasteam^® is an innovative eyelid warming device which delivers latent heat therapy to raise the meibum temperature. The second step consists of an eyelid massage in order to express the heated meibum. This is best done by means of rotary action of the fingers at the lid margin. The last step consists of eyelids cleansing to clear the lashes of oily secretions, bacterial flora and debris.
• E - - -> Efficacy The efficacy of Blephasteam^® was widely studied and validated (7, 8, 9, 10). Blephasteam^® improves visual acuity in patients with MGD and increases tear film lipid layer thickness and ocular comfort in patients with dry eye symptoms with or without Sjögren syndrome. Blephasteam^® is well tolerated and very convenient and useful for patients with dry eye symptoms.
• A - - -> Acne Rosacea Acne rosacea is a chronic skin disease characterised by persistent erythema, telangiectasis, papule, pustules, and sebaceous gland hypertrophy, preferentially affecting the convexities of the face. The Meibomian glands are affected by the disease process itself, as they are modified sebaceous glands (1). Rosacea may involve the eye with a prevalence of 3% to 58% (11) and the prevalence of ocular complaints in patient with acne rosacea is estimated between 45% and 85% of cases (12). It was reported that in patients with a subset of MGD called primary (diffuse) meibomitis, 74% had a seborrheic dermatitis and 51% had rosacea (acne rosacea) (1).
• M - - -> Meibomian Gland Dysfunction MGD is common and is an important form of posterior blepharitis. Usually, patients suffering from MGD complain about dry eye-like symptoms such as burning and irritation sensations and decreased vision. In practice, examination of the lids shows a Meibomian gland obstruction and/or a production of abnormal secretion. Pressure applied to the lid margin results in either no expression of fluid or expression of turbid, foamy, or solidified excreta. Telangiectasia and pouting of the orifices is frequently seen. The lids may be thickened and erythematous (1).