Two New Studies Point to Major Advances

Two New Studies Point to Major Advance in Treatment of Symptoms Associated with Blepharitis and Meibomian Gland Dysfunction

Premier Eye Care Group works hard to provide the best possible eye care to our patients. Part of our job is to stay current on the latest research, so that we can bring new advances to our patients as quickly as possible.

Now, we are excited to highlight two new studies that point to a major advance in how we manage blepharitis and meibomian gland dysfunction.

As every optometrist and ophthalmologist knows, these conditions are widespread among our patients. An estimated 30 million Americans suffer from one or both of the conditions, which can be painful and debilitating.  We see dozens of people every week seeking relief from dry, irritated, red, and/or inflamed eyes and crusty eyelids.

Yet, what has been so frustrating for us and for many of our colleagues, is that we really haven’t had an ideal solution for these patients. Most of the eyelid cleansers we’ve tried bring only temporary relief, at best, and baby shampoo can actually be irritating to the eyelid skin and eye surface, making patients feel worse. Antibiotics can knock back the bacteria that cause the conditions, and steroids can reduce inflammation. But antibiotics can promote the development of bacteria that are resistant to antibiotics and steroids can worsen glaucoma.

Now, however, the new research shows that, for the first time, we can really fight the underlying causes of these conditions. We’ve known for years that blepharitis occurs when Staphylcocci or other bacteria grow on eyelids, bringing swelling, redness, inflammation, irritation and crusty build-up. Crucially, the microbes also produce a fat-eating enzyme, or lipase, that chews up meibum, the lipid-rich secretion from the meibomian glands.

The meibum, of course, is the oily surface on the tear film that stabilizes the tears and prevents them from evaporating. So when the bacterial lipase breaks up the meibum, the tear film dries up and patients suffer from dry, painful eyes.

So how can we best fight both the bacteria and the lipase? One of the new laboratory studies, led by Dr. Arthur B. Epstein, Director of Clinical Research and head of the Dry Eye – Ocular Surface Disease Center at Phoenix Eye Care, compared the ability of six commercial eyelid treatments to neutralize lipase. Those approaches included baby shampoo, products with tea tree oil (which are known to have antimicrobial properties) and a new eyelid cleanser called Avenova™.

The study, presented at the recent Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Denver, found that only Avenova was able to completely inactivate the bacterial lipase. All the others had “minimal effect,” the study found.

The difference in effectiveness was dramatic.

In retrospect, Avenova’s ability to degrade lipase makes sense from a biochemical standpoint. It is the only eyelid cleanser to contain what Avenova’s manufacturer, NovaBay® Pharmaceuticals, Inc. (NYSE MKT: NBY), calls Neutrox™, a 0.01% concentration of pure hypochlorous acid in saline. HOCl is the same bacteria-killing substance used by white blood cells as a first defense against microbial invaders. Earlier lab tests have shown that it has potent antimicrobial activity in vitro and can also neutralize bacterial toxins, yet is non-toxic to healthy human cells.

Based on Epstein’s study and the earlier lab tests, we should expect that Avenova might offer a major step forward in our management of these common conditions. But real proof requires actual patients. Can we show that Avenova’s properties translate into scientifically measurable improvements in real people?

That’s where the second study comes in. Guru Sharma, O.D., Ph.D., Optometrist at Family Eye Care Optometry and Assistant Professor at Western University of the Health Sciences’ College of Optometry, followed 18 patients with mild to moderate blepharitis who were treated twice a day with Avenova.

The results, which Sharma also presented at the ARVO meeting, were impressive. Every single one of the patients with mild blepharitis showed improvement both in objective symptoms, such as redness and swelling, and in subjective symptoms like discomfort and itching. Moreover, the study subjects reported that the eyelid cleanser was extremely easy to use and completely non-irritating.

Sharma’s findings mirror the excellent results we’ve had using Avenova with our own patients. Many of these patients are thrilled, saying that they are finally getting relief after years of chronic pain and inflammation.

As the new studies confirm, we now have an eyelid cleanser that does everything we’ve been asking for. It wipes away the crustiness of blepharitis. Lab tests show that in solution it kills bacteria that are the underlying cause of these common conditions. And it neutralizes the bacterial enzyme that contributes to the conditions. Based on the new research and my own experience, Premier Eye Care Group believes this new approach can make a real difference.