In-home device targets meibomian gland dysfunction/stasis and blepharitis

The “Therapeutic Focus” column presents an optometrist’s firsthand experiences with a new therapy, via answers to questions posed by Optometric Management.

Please describe NuLids: How does it work?

NuLids, from NuSight Medical, is a doctor-prescribed, at-home daily treatment for dry eye disease (DED), specifically meibomian gland dysfunction. It is comprised of a sterile Soft Tip, attached to a handpiece, to which a variety of gels (e.g. viscous lubricants, hypochlorous acid or tea tree oil, depending upon the specific ocular condition), can be applied. Once the handpiece is powered on, it oscillates back and forth, within a 15° arc, stimulating the meibomian glands. The device is used once daily for about 30 to 60 seconds per eye.

For whom is it beneficial?

NuLids was originally designed for the treatment of DED specifically targeting meibomian gland dysfunction (MGD)/stasis and blepharitis (both cylindrical collarettes and demodex). We have also found that patients with chronic chalazion/hordeolum, Sjögren’s syndrome, Steven Johnson Syndrome and eyelid keratinization are appropriate candidates, as these patients may also be at a high risk for MGD.

What results can O.D.’s expect in a patient who uses NuLids?

In a company-sponsored clinical study, performed by Schanzlin, Olkowski, Coble, et. al., there was a 64% improvement in TBUT, an 81% improvement in meibomian gland production, yielding liquid secretions, a 21% improvement in meibomian gland scores, a 48% reduction in ocular staining, a 50% improvement in OSDI scores and an almost 3% reduction in the patients’ tear osmolarity after 30 days of daily use. My clinical findings are in line with this study.

How do you educate the patient on the product?

After making the DED diagnosis and explaining to the patient that the condition is chronic, I introduce NuLids as an effective and easy-to-use treatment that helps control symptoms by stimulating the meibomian glands. I run the device over the patient’s hands to demonstrate how gentle it is. A technician then provides more detailed training. Specifically, the tech uses a fresh, sterile tip with solution applied to demonstrate the device’s use on the patient’s lids. Additionally, the patient views a training video, hosted on NuSight Medical’s website.

How do you dispense NuLids?

NuLids is dispensed directly from our supply in the office. We purchase a case of devices to stock, as this provides the most economical price. Patients then purchase the single-use replacement tips via NuSight’s website, which my staff can track and, potentially, use to contact the patient, if it appears that usage is falling off. I find about 75% of patients offered NuLids make the purchase.

What benefits does it provide to your practice?

By using NuLids daily, at least 75% of patients are able to reduce and/or eliminate the use of artificial tears, gel drops or overnight ointments, making treatment simpler for them and, thus, appreciative of the care the practice provides. Also, the treatment provides me with another revenue stream from the sale of the device and as patients purchase additional sterile tips.