Methods and apparatuses for treatment of meibomian gland dysfunction

Abstract

A method of treating meibomian gland dysfunction is disclosed that comprises applying heat to an outer surface of a patient's eyelid to a temperature level to melt, loosen, or soften an obstruction located within a meibomian gland. The method also comprises maintaining the heat to the outer surface of the patient's eyelid for a period of time. The method further comprises applying a pressure to the outer surface of the patient's eyelid to express the obstruction from the meibomian gland. The obstruction may be located within a meibomian gland channel of the meibomian gland and the method may comprise expressing the obstruction located within a meibomian gland channel through a meibomian gland orifice. Applying the pressure may be done by positioning a pressure applicator into contact with the outer surface of the patient's eyelid and applying a pressure with the pressure applicator over a substantial portion of the patient's eyelid.

What is claimed is: 
     
         1 . A method of treating meibomian gland dysfunction, comprising:
 applying heat to an outer surface of a patient's eyelid to a temperature level to melt, loosen, or soften an obstruction located within a meibomian gland;   maintaining the heat to the outer surface of the patient's eyelid for a period of time; and   applying a pressure to the outer surface of the patient's eyelid to express the obstruction from the meibomian gland.   
     
     
         2 . The method of  claim 1 , wherein the obstruction is located within a meibomian gland channel of the meibomian gland, the method further comprising expressing the obstruction located within a meibomian gland channel from the meibomian gland channel through a meibomian gland orifice of the meibomian gland. 
     
     
         3 . The method of  claim 1 , wherein the expressing is performed during the maintaining the heat for the period of time. 
     
     
         4 . The method of  claim 1 , further comprising removing the heat from the outer surface of the patient's eyelid, wherein the expressing is performed after the removing the heat from the outer surface of the patient's eyelid. 
     
     
         5 . The method of  claim 1 , further comprising repeatedly performing the applying heat and maintaining of the heat after a selected period of time to maintain the obstruction in a melted, loosened, or softened state. 
     
     
         6 . The method of  claim 1 , wherein the period of time for maintaining the heat is from approximately 1 to 10 minutes. 
     
     
         7 . The method of  claim 1 , wherein the temperature level is between approximately 43 and 47 degrees Celsius. 
     
     
         8 . The method of  claim 1 , further comprising treating the patient's eyelid or meibomian gland with a pharmacological agent to promote free flow of fluids from the meibomian gland. 
     
     
         9 . The method of  claim 8 , wherein the pharamcological agent is an agent selected from the group consisting of antibiotics, topical tetracycline, topical corticosteroids, oral corticosteroids, topical androgens, topical androgen analogues, TGF-β, omega 3 compositions, enzymes that promote lipid productions, agents that stimulate production of enzymes that promote lipid production, agents that act as a secretagogue to enhance meibomian gland secretion, an agent that replaces production of a tear component, and an agent that promotes production of a tear component. 
     
     
         10 . The method of  claim 1 , further comprising maintaining the pressure to the outer surface of the patient's eyelid for a period of time. 
     
     
         11 . The method of  claim 2 , further comprising maintaining the pressure to the outer surface of the patient's eyelid for a period of time, and wherein the maintaining the pressure expresses the obstruction located within the meibomian gland channel from the meibomian gland channel while the obstruction remains in a melted, loosened, or softened state. 
     
     
         12 . The method of  claim 10 , wherein the maintaining the pressure reduces blood flow in the eyelid to reduce thermal dissipation from the patient's eyelid. 
     
     
         13 . The method of  claim 1 , wherein the temperature level is between approximately 43 and 55 degrees Celsius. 
     
     
         14 . The method of  claim 10 , wherein the expressing is performed during the maintaining of the heat for a period of time and maintaining of the pressure for a period of time. 
     
     
         15 . The method of  claim 14 , wherein the obstruction is located within a meibomian gland channel of the meibomian gland, and the method further comprises repeatedly performing the applying heat and maintaining of the heat after a selected period of time, and applying and maintaining the pressure after a selected period of time to express the obstruction located within the meibomian gland channel from the meibomian gland channel while in a melted, loosened, or softened state. 
     
     
         16 . The method of  claim 10 , wherein the period of time for maintaining the pressure is from approximately 1 to 10 minutes. 
     
     
         17 . The method of  claim 1 , further comprising positioning an insulator behind the patient's eyelid on an outer surface of a sclera of an eye. 
     
     
         18 . The method of  claim 1 , further comprising regulating the heat when applying the heat to the outer surface of the patient's eyelid. 
     
     
         19 . The method of  claim 1 , further comprising regulating the pressure when applying the pressure to the outer surface of the patient's eyelid. 
     
     
         20 . The method of  claim 1 , wherein the pressure applied to the outer surface of the patient's eyelid is comprised from the group consisting of a mechanical force, an electrical force, a pneumatic force, and a manual force. 
     
     
         21 . The method of  claim 2 , further comprising removing the heat from the outer surface of the patient's eyelid. 
     
     
         22 . The method of  claim 1 , wherein the applying the pressure comprises positioning a pressure applicator into contact with the outer surface of the patient's eyelid and applying a pressure with the pressure applicator over a substantial portion of the patient's eyelid to express the obstruction from the meibomian gland. 
     
     
         23 . An apparatus for treating meibomian gland dysfunction, comprising:
 a heater configured to apply heat to an outer surface of a patient's eyelid to a temperature level to melt, loosen, or soften an obstruction located within a meibomian gland;   a controller configured to maintaining the heat to the outer surface of the patient's eyelid for a period of time; and   a pressure applicator configured to apply a pressure to the outer surface of the patient's eyelid to express the obstruction from the meibomian gland.   
     
     
         24 . The apparatus of  claim 23 , wherein the obstruction is located within a meibomian gland channel of the meibomian gland, and the pressure applicator is configured to express the obstruction located within a meibomian gland channel from the meibomian gland channel through a meibomian gland orifice of the meibomian gland. 
     
     
         25 . The apparatus of  claim 23 , wherein the pressure applicator is configured to apply the pressure during the maintaining the heat for the period of time. 
     
     
         26 . The apparatus of  claim 23 , wherein the pressure applicator is configured to apply pressure to express the obstruction after the heat applied by the heater is removed from the outer surface of the patient's eyelid. 
     
     
         27 . The apparatus of  claim 23 , wherein the controller is configured to control the heater to repeatedly perform the applying heat and maintaining of the heat after a selected period of time to maintain the obstruction in a melted, loosened, or softened state. 
     
     
         28 . The apparatus of  claim 23 , wherein the period of time for maintaining the heat is from approximately 1 to 10 minutes. 
     
     
         29 . The apparatus of  claim 23 , wherein the temperature level is between approximately 43 and 47 degrees Celsius. 
     
     
         30 . The apparatus of  claim 23 , wherein the pressure applicator is configured to maintain the pressure to the outer surface of the patient's eyelid for a period of time. 
     
     
         31 . The apparatus of  claim 24 , wherein the pressure applicator is configured to maintain the pressure to the outer surface of the patient's eyelid for a period of time, and wherein the pressure expresses the obstruction located within the meibomian gland channel from the meibomian gland channel while the obstruction remains in a melted, loosened, or softened state. 
     
     
         32 . The apparatus of  claim 31 , wherein the maintaining the pressure by the pressure applicator reduces blood flow in the eyelid to reduce thermal dissipation from the patient's eyelid. 
     
     
         33 . The apparatus of  claim 23 , wherein the temperature level is between approximately 43 and 55 degrees Celsius. 
     
     
         34 . The apparatus of  claim 30 , wherein the pressure applicator is configured to apply pressure to express the obstruction from the meibomian gland during the maintaining of the heat for a period of time and maintaining of the pressure for a period of time. 
     
     
         35 . The apparatus of  claim 34 , wherein the obstruction is located within a meibomian gland channel of the meibomian gland, and wherein the heater and the controller are configured to repeatedly perform the applying heat and maintaining of the heat after a selected period of time, and the pressure applicator is configured to apply and maintain the pressure after a selected period of time to express the obstruction located within the meibomian gland channel from the meibomian gland channel while in a melted, loosened, or softened state. 
     
     
         36 . The apparatus of  claim 30 , wherein the period of time for maintaining the pressure is from approximately 1 to 10 minutes. 
     
     
         37 . The apparatus of  claim 23 , further comprising an insulator configured to be positioned behind the patient's eyelid on an outer surface of a sclera of an eye. 
     
     
         38 . The apparatus of  claim 23 , wherein the heater is configured to regulate the heat when applying the heat to the outer surface of the patient's eyelid. 
     
     
         39 . The apparatus of  claim 23 , wherein the pressure applicator is configured to regulate the pressure when applying the pressure to the outer surface of the patient's eyelid. 
     
     
         40 . The apparatus of  claim 23 , wherein the pressure applied to the outer surface of the patient's eyelid by the pressure applicator is comprised from the group consisting of a mechanical force, an electrical force, a pneumatic force, and a manual force. 
     
     
         41 . The apparatus of  claim 24 , wherein the controller is further configured to control the heater to remove the heat from the outer surface of the patient's eyelid. 
     
     
         42 . The apparatus of  claim 24 , wherein pressure applicator is configured to be positioned into contact with the outer surface of the patient's eyelid and is configured to apply a pressure over a substantial portion of the patient's eyelid to express the obstruction from the meibomian gland.