I work on my computer a lot.  Whether it’s looking at patient charts, managing the business side of the practice, writing articles, learning about the latest eye care trends, participating in webinars, or reading digital books – I stare at a computer screen for hours most days.  After awhile, I notice that my eyes feel dry and my vision fluctuates.  I often need to blink repeatedly to keep my vision clear and try to make my eyes feel better.

I Have Dry Eye Disease (DED)

DED, also known as ocular surface disease (OSD), is a complex condition whose root cause (like a lot of other diseases) is inflammation.  That means that it’s chronic and progressive (like arthritis) unless we diagnose and treat it in the early or middle stages.  However, many patients with early dry eye inflammatory changes, don’t have symptoms yet.

There are two types of DED, evaporative and aqueous deficient.  The evaporative type is most common and is responsible for more than 80% of dry eye cases.  The meibomian glands (see the picture above) in our eyelids are responsible for producing the oily or lipid portion of our tears.  That oil is what prevents the evaporation of our tears.

When the meibomian glands become inflamed, the oil they produce is affected.  Instead of being clear and flowing easily from the glands, it starts changing into something resembling toothpaste and the glands begin to get clogged up with this material.  Oil production slows down and eventually stops entirely in the advanced form of the disease.  As this process progresses, our eyes become dry.  Our tears evaporate too quickly.  This is when patients start noticing dry eye symptoms that include the following:

  • Gritty/sandy feeling
  • Red eyes
  • Burning
  • Itching
  • Blurry/fluctuating vision
  • Excessive tearing (Yes, this can be a sign of dry eye)
  • Tired eyes

Traditional treatments for these symptoms involve using lubricating eye drops, and we still use them to give our patients temporary relief.  This is what we call “outside-in” treatment.  But if someone has aqueous deficient DED, we aren’t getting to the root cause of the problem.  Lubrication only gives short term relief.  It’s not the cure.

Our office has advanced technology that helps us diagnose what’s happening with a patient’s dry eye disease.  As mentioned earlier, we often find that their meibomian glands are dysfunctional.

This Calls For “Inside Out” Treatment

This is a one or two part process, depending on how severe the meibomian gland dysfunction is.  If it is moderate or severe disease, we usually recommend both parts.  Milder cases (like mine) only require part two.

PART ONE OF THE INSIDE OUT TREATMENT – is about getting rid of the bad oil inside the glands.  This is done using a three-step process that goes like this:

  1. One of our doctors will manually “express” the glands to push out the bad oil that’s clogging the openings located on the eyelid margins.  It’s kind of like squeezing a toothpaste tube and the bad oil does look like toothpaste.  This doesn’t get all of the bad oil out, but clears the way for step 2.
  2. Our MiboFlow procedure is used to express the glands at a deeper level and gets more of the bad oil out.  A well trained technician uses a high tech heating device to gently massage the eyelids.  This MiboFlow procedure is done in our dry eye spa while the patient relaxes in a massage chair.  It’s a very enjoyable process and patients often fall asleep before it’s finished.
  3. Far infrared treatment is used at home.  Patients use a Mibo Heating Pad that keeps their meibomian glands dilated so that good oil can begin flowing properly..  Far infrared heat penetrates the lids much better than traditional heating pads and uses a lower temperature.  This is also a very relaxing process and be done while napping or relaxing in a comfortable position.

PART TWO OF THE INSIDE OUT TREATMENT – is about reducing inflammation and getting good oil flowing again.  This is a two step process that goes like this:

  1. A high quality omega fatty acid product called Hydroeye is used to reduce inflammation in the meibomian glands.  It also provides the glands with the nutrients necessary for them to produce good oil for the tears.
  2. Patients use the Mibo Heating Pad described above to administer far infrared heat to their lids at home.  This keeps the glands dilated so the good oil can flow properly.

My meibomian gland testing showed that I was in the mild category, so I skipped  Part One and went directly to Part Two of the Inside Out Plan.  I’ve done this less than a month but can already tell that my eyes feel more comfortable using the computer, and my vision fluctuates less.

For those of you who have mild to moderate dry eye symptoms, we recommend trying the Part Two treatment like I did.  There is no office visit involved and we guarantee your satisfaction.


  • Omega oil treatment involves taking 4 capsules a day.  This may not be appropriate for patients that have difficulty taking pills, although the capsules can be divided up so one can be taken at each meal.
  • This treatment can take some time to work.  It can be a month or more before meibomian gland inflammation is reduced and good oil starts flowing from the glands again.  But many people notice results much sooner (like me).
  • We guarantee results.  If your aren’t getting better we will apply the total amount of your purchase towards Part One of the inside out treatment in our office.  You will need more aggressive treatment in our office.

You can do part two of the Inside Out Treatment without an office visit.  These products are very safe and the omega oil offers many other health benefits including reduced risk of cardio vascular disease and dementia.

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