Dry Eye, and LLLT, and Periodontitis, Oh My!

HOT TOPIC

Study Finds Improvement in Dry Eye After LLLT

A recent study published in Ophthalmic and Physiological Optics shows low-level light therapy (LLLT) significantly improved signs and symptoms of dry eye in the early phases of treatment, suggesting its efficacy for managing dry eye disease (DED).

For those unaware, LLLT, or photobiomodulation, directly applies red light to the eye and the periorbital area to treat dry eye; however, thus far, few studies have investigated its efficacy for this purpose—especially as a stand-alone treatment.

The 3-week study included 30 participants (14 male and 16 female) with an average age of 31 years who had DED caused by meibomian gland dysfunction. Study visits were approximately 7 days apart, and all participants received LLLT at precisely 633 nm for 15 minutes at each visit. The success of the treatment was measured with a first and average noninvasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH), tear film lipid layer thickness (TFLLT), Schirmer test, ocular surface disease index score (OSDI) score, and eyelid temperatures.

According to the study, LLLT resulted in a statistically significant increase in first and average NIKBUT, TMH, and TFLLT. Additionally, there was a statistically significant decrease in OSDI score (10.2%).

My Two Cents

This study’s details need to be analyzed further. That said, this is where treatment patterns begin to change. If further studies prove that LLLT as a stand-alone treatment is beneficial for our patients, it could change the practice patterns and recommendations in our dry eye clinic. Hats off to the study designers and researchers on a potentially game-changing study!

OUTSIDE THE LANE

Could DED and Periodontitis Be Linked?

A Turkish study claims to have discovered a significant correlation between DED and periodontitis, stating that the shared inflammatory pathways strongly link the two conditions.

Researchers divided 684 participants into four groups: healthy controls, patients with both DED and periodontitis, patients with only DED, and patients with only periodontitis. Their goal was to explore the interplay between the two conditions by further examining various ocular and oral health metrics.

Their findings revealed that patients with both DED and periodontitis exhibited significantly elevated tear osmolarity levels, increased ocular surface disease index (OSDI) scores, decreased tear break-up time, and lower Schirmer values compared with patients with only DED or with only periodontitis. The researchers hypothesized that the presence of periodontitis exacerbates DED symptoms. They also found higher neutrophil-to-lymphocyte ratios, which is a critical inflammatory biomarker, present in patients with both conditions.

My Two Cents

Okay, so this isn’t precisely “outside the lane,” but it incorporates another profession’s exam lane, so I included it here. Besides, how cool is this as a way to tie us into another health care profession? I would be interested to see what these patients’ meibographies look like to determine if there is a correlation between meibomian gland disease and periodontitis. If I were a student at a university that has both a dental and optometry school on the same campus (eg, Nova Southeastern University, The Ohio State University, University of Alabama at Birmingham), this sure would be an interesting study to conduct (hint hint).

CAN YOU RELATE

Podcasts are something I’ve enjoyed for a long time, and we in the eye care space are lucky to have some absolute superstars providing us with interesting, informative, entertaining, and free content on a regular basis. If you haven’t opened your music app of choice and searched “optometry,” “eye care,” or other relevant keywords, you’re seriously missing out. One of the podcasts I’ve taken a particular interest in lately is the recently revamped The Power Hour with new host, Eugene Shatsman.

The Power Hour is optometry’s longest-running show, originally launched by the incredible myopia management advocate Gary Gerber, OD, some years ago. Recently, Mr. Shatsman interviewed Doug Breaker, CEO of MDHearing, and Jed Grisel, MD, Chief Medical Officer and President of Amplify Hearing, about the incorporation of audiology in optometry practices. This is something I hadn’t thought of before, but it seems to be a synergistic pairing that has been practiced in Europe for quite some time. According to the podcast guests, there are opticals in Europe where more hearing exams are performed than eye exams!

A casual search of our industry’s most prominent trade magazines shows that around 10 to 15 years ago, this was a relatively hot topic, with many practices seriously looking into getting into the audiology game. When I consider my practice, most patients are older than 40, with many substantially older than that. Offering these patients, who are a captive audience, the opportunity to be tested and treated for hearing issues could help all involved. Older patients are the most likely to experience hearing loss, and many don’t know where to go or who to see about improving this sense. Who better to help guide them on yet another health care journey than their trusted optometrist? In the days of declining reimbursements, the potential for an added revenue stream seems like a win-win!

Some of my additional favorite optometry podcasts:

• The MOD Pod
• To the Point
• Four Eyes
• 20/20 Money
• Ophthalmology off the Grid
• The Depth Perception Podcast
• The 20/20 Podcast

IMAGE OF THE WEEK

Peripheral ulcerative keratitis secondary to granulomatosis with polyangiitis.

Paul Hammond, OD, FAAO, @kmkoptometrypro

QUOTE OF THE WEEK

“Seeing, hearing, feeling, are miracles, and each part and tag of me is a miracle.”

— Walt Whitman