Therapeutic eyelids hygiene in the algorithms of prevention and treatment of ocular surface diseases

When acute inflammation in anterior eye segment of a forward piece of an eye was stopped, ophthalmologists face a problem of absence of acute inflammation signs and at the same time complaints to the remain discomfort feelings. It causes dissatisfaction from the treatment. The complaints are typically caused by disturbance of tears productions. No accidental that the new group of diseases was allocated — the diseases of the ocular surface. Ocular surface is a difficult biologic system, including epithelium of the conjunctiva, cornea and limb, as well as the area costal margin eyelid and meibomian gland ducts. Pathological processes in conjunctiva, cornea and eyelids are linked with tears production. Ophthalmologists prescribes tears substitutions, providing short-term relief to patients. However, in respect that the lipid component of the tear film plays the key role in the preservation of its stability, eyelids hygiene is the basis for the treatment of dry eye associated with ocular surface diseases. Eyelids hygiene provides normal functioning of glands, restores the metabolic processes in skin and ensures the formation of a complete tear film. Protection of eyelids, especially the marginal edge from aggressive environmental agents, infections and parasites and is the basis for the prevention and treatment of blepharitis and dry eye syndrome. The most common clinical situations and algorithms of their treatment and prevention of dysfunction of the meibomian glands; demodectic blepharitis; seborrheic blepharitis; staphylococcal blepharitis; allergic blepharitis; barley and chalazion are discussed in the article. The prevention keratoconjunctival xerosis (before and postoperative period, caused by contact lenses, computer vision syndrome, remission after acute conjunctiva and cornea inflammation) is also presented. The first part of the article presents the treatment and prevention algorithms for dysfunction of the meibomian glands, as well as demodectic blepharitis.

1. Tsubota K., Tseng S. C. G., Nordlund M. L. Anatomy and physiology of the ocular surface. In: Holland E. J., Mannis M. J., eds. Ocular surface disease: medical and surgical management. New York: Springer-Verlag; 2002: 3‑15.

2. Brzheskij V. V. [«Ocular surface» and other terms]. «Glaznaja poverhnost’» i drugie terminy [Annals of Ophthalmology]. Vestnik oftal’mologii. 2014;6:108‑109. (in Russ.).

3. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5 (2):75‑92.

4. Polunin G. S., Polunina E. G. [From dry eye to tear film disorder]. Ot «sukhogo gla- za» k «bolezni sleznoy plenki». [Ophthalmology]. Oftal’mologiya. 2012;2:4‑7. (in Russ.).

5. Markova E. Yu., Frolov M. A., Kurganova O. V. [Possible association between corneal infections and the use of contact lenses of various design for ametropia correction in children]. Vozmozhnaya svyaz’ infektsionnykh porazhenii rogovitsy s nosheniem kontaktnykh linz razlichnogo dizayna pri korrektsii ametropii u detey. [Ophthalmology]. Oftal’mologiya. 2014;11 (1):63‑66. (in Russ.).

6. Knop E., Knop N., Brewitt H., Pleyer U., Rieck P., Seitz B., Schirra F. [Meibomian glands: part III. Dysfunction — argument for a discrete disease entity and as an important cause of dry eye]. Ophthalmologe. 2009;106 (11):966‑979.

7. Sharma A., Hindman H. B. Aging: a predisposition to dry eyes. J. Ophthalmol. 2014; 2014:781683

8. Kasparova E. A., Kasparov A. A., Marchenko N. R., Pur-Akbarian N. A., Makaro- va M. A., Borodina N. V., Smirennaja E. V. [Diagnosis and treatment of recurrent herpetic corneal erosion]. Diagnostika i lechenie gerpeticheskoj recidivirujush- hej jerozii rogovicy. [Annals of Ophthalmology]. Vestnik oftal’mologii. 2010;126 (5):3‑8. (in Russ.).

9. Al-Faky YH.Physiological utility of ultrasound biomicroscopy inthe lacrimal drainage system.Br J. Ophthalmol. 2013; Oct. 97 (10):1325‑9.

10. Diec J Evans VE Tilia D Naduvilath T Holden BA Lazon de la Jara P. Comparison of ocular comfort, vision, and SICS during silicone hydrogel contact lens daily wear. Eye Contact Lens. -2012;38:2‑6.

11. Knop Е.; Nadja Knop; Thomas Millar; Hiroto Obata; David A. SullivanPathophysiology of the Meibomian Gland Investigative Ophthalmology & Visual Science March. 2011;52:1938‑1978.

12. Lemp MA, Baudouin C, Baum J, Dogru M, et al. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. The Ocular Surface. 2007;5:75‑92.

13. Nichols K. K., Foulks G. N., Bron A. J., Glasgow B. J., Dogru M., TsubotaK., Lemp M. A., Sullivan D. International seminar on meibomian gland dysfunction: General conclusions. Inv. Ophthalmology & Visual Science, Special Issue. 2011;52:1922‑1932.

14. Schaumberg DA Sullivan DA Dana MR. Epidemiology of dry eye syndrome. Adv Exp Med Biol. 2002;506:989‑998.

15. Makarov I. A., Polunin G. S., Kurenkov V. V., Zabegaylo A. O., Safonova T. N., Zhemchugova A. V., Alieva A., Polunina E. G. [The efficacy of some physiotherapeutic and hygienic procedures for treatment of blepharoconjunctival form of dry eye]. Jeffektivnost’

16. i nekotorye fizioterapevticheskie i gigienicheskie procedury dlja lechenija blefarokon#junktival’noj formy sindroma suhogo glaza [Ophthalmology]. Oftal’mologiya. 2012;9 (2):65‑71. (In Russ.)