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Integrated Dry Eye, Blepharitis & Rosacea Treatment

Integrated Dry Eye, Blepharitis & Rosacea Treatment

A New Division of Visionary Eye Doctors

Dry Eye TreatmentVisionary Eye Doctors is excited to present a new division of patient care, ‘Integrated Dry Eye, Blepharitis and Rosacea Treatment Center,” focused on helping our patients suffering from dry eye due to rosacea, meibomian gland dysfunction, blepharitis, and other systemic syndromes.

The incidence of dry eye in our patients is close to 15%. Many of them have been told that there is nothing more that can be done to help them other than warm compresses, lid hygiene and artificial tears. Traditional therapies have failed to consistently provide effective results, leading to ongoing suffering and frustration for patients and for doctors, as well.

Your Dry Eye, Blepharitis & Rosacea Doctor

Dr Cremers

We are thrilled to report there is incredible new research and treatments now available to help, and we are excited to be able to offer this state of the art technology to our patients.

Sandra Lora Cremers, M.D., F.A.C.S. is a widely respected and experienced researcher who has received multiple grants to study the etiology of dry eye from ocular rosacea at Harvard Medical School’s Department of Ophthalmology at the Massachusetts Eye and Ear Infirmary. She is passionate about helping her patients with dry eye and, in particular, finding a cure for patients with ocular rosacea. She has conducted research, in particular on the angiogenesis basis of ocular rosacea in relation to its association with other systemic, angiogenesis-based diseases.

In her many years at Harvard Medical School, she has seen countless patients with severe dry eye. She has worked and learned from the best in the world, and she has developed an effective incremental approach to treating patients with mild, moderate and severe dry eyes, which includes the most advanced treatments available internationally. Her team at Visionary Eye Doctors has put together these treatments at one location, close to our patients.

Visionary Eye Doctors has always routinely evaluated patients with dry eye symptoms.  We are excited to announce that we are one of the only centers in the country with the ability to treat our patients with the following leading edge treatment modalities: Intense Pulsed Light, LipiFlow®, Meibomian Gland Probing (MGP) and Autologous Serum.

Intense Pulsed Light Therapy (IPL)

Intense Pulsed Light Therapy (IPL) is a new therapy to unplug the oil glands that line the upper and lower lid margins, relieving chronic dry eye sufferers dramatically. IPL works as a powerful warm compress to liquefy the toothpaste-like secretion plugging the meibomian glands and to improve their pumping mechanism when blinking. Relief is immediate and the frequency and intensity of flare-ups of blepharitis – an inflammation of the margins of the eyelids – is dramatically reduced.

In addition, many people with blepharitis also suffer from rosacea, a redness and inflammation of the central part of the face (especially the nose and cheeks). IPL, in addition to reducing blepharitis, reduces the signs and symptoms of rosacea.

IPL therapies are relatively comfortable and quick. They require a set of monthly 10 to 15-minute sessions at the beginning and maintenance treatments on an annual basis. IPL treatment is not covered by medical insurance. A minimum of four sessions is required to see results, and sessions are usually spread out three to four weeks apart.

If the traditional route of treatment for dry eyes and blepharitis – drops, compresses, punctual or punctum plugs, lid scrubbing – hasn’t brought you satisfactory relief, you could benefit from the benefits of IPL.

Introducing NEW LipiFlow Treatment for dry eye sufferers


Visionary Eye Doctors is now offering a new, breakthrough treatment for dry eye sufferers. If you are experiencing eye dryness, irritation, light sensitivity, vision fluctuations, contact lens intolerence and eye fatigue, you may be a candidate for a new treatment called LipiFlow.

Dry Eye Syndrome RockvilleIn a clinical study, 79% of patients reported improvement of their overall dry eye symptoms within four weeks, ranging from 10%-100% improvement. LipiFlow is a new procedure designed to treat the root cause of evaporative dry eye, or blocked meibomian glands. Opening and clearing these blocked glands can allow them to resume natural production of lipids (oils) needed for a healthy tear film.

Some treatments attempt to add more liquid to your tears, but without the complex natural oil, tears continue to evaporate faster than produced. LipiFlow is intended for the application of localized heat and pressure in adult patients with meibomian gland dysfunction (MGD), also known as evaporative dry eye or lipid-deficient dry eye. Unlike traditional dry eye treatments (e.g., warm compresses, wetting drops and ointments) that address dry eye symptoms, LipiFlow treats the root cause, the obstructed meibomian glands. The goal of unblocking the glands is to allow them to resume their natural production of lipids required for a healthy tear film.

Our new Integrated Dry Eye, Blepharitis and Rosacea Treatment Center, under the leadership of Sandra L. Cremers, M.D., F.A.C.S., will be focusing on offering Lipiflow as an option to many patients that want new options to relieve their discomfort caused by dry eyes and blepharitis.

Autologous Serum Drops

Autologous serum is a new treatment for eye surface disorders, such as severe dry eyes intractable to common therapy and certain corneal ulcers and wounds. The blood serum is the fluid component of full blood, which remains after clotting.

“Autologous” means that the blood to be used in the preparation of the serum will be the the patient’s own blood. Blood serum drops have been proven to maintain the shape and function of the corneal cells much better than pharmaceutical tear substitutes, since its biological properties are similar to natural tears as it contains a complex composition of water, salts, proteins, vitamins, lipids, immunoglobulines and growth factors.

Even though many doctors and scientists worldwide have conducted studies that show the benefits of using autologous serum drops, the US does not currently have a Food and Drug Administration (FDA)-approved protocol or guidance for this process. Visionary Eye Doctors is the only practice in the DC metro area that offers autologous serum drops.

To make your eye drops, we will need to collect some of your blood in several tubes and it will need to be allowed to clot for one to two hours. Then it will be placed into a machine that spins the blood at very high speed, causing the red cells to separate from the serum. The serum will be taken and mixed with artificial tears or balanced saline solution at a specific concentration.

The bottles need to be kept in your freezer at home and you will to remove one bottle at the time, leaving it to thaw at room temperature. After thawing, the bottle should be kept in the refrigerator. Your eyeMD will advise you how frequently you should use the drops, but the most common recommendation is to apply the drops eight times daily.

This therapy is restricted to individual physicians for their patients only. It is not covered under medical insurance, and patients are responsible for their cost.

Meibomian Gland Probing (MGP)

Meibomian gland probing (MGP) is highly successful in restoring meibum-secreting lid functionality persisting up to at least seven months. MGP is a more invasive procedure where a cannula (not a needle) is used to probe the meibomian glands. Sometimes steroids are injected into the gland to open the gland and break open scar tissue.

Many people have felt immediate relief, though it can take two or three sessions and time for dry eye symptoms to improve. MGP has been shown in studies to rapidly increase the number of expressible glands per lid which was maintained up to at least seven months post-probing. If most of the meibomian glands are scarred and no longer functioning, it is possible to have minimal relief even with MGP. (See Step Ladder to see other options if MGP does not help).

MGP with steroid injection may enable even greater symptom reduction than MGP alone in select cases of moderate to severe symptoms and/or signs, significant co-morbid disease, retreatment and possibly chalazion.

Our doctors will be happy to evaluate you and decide which of all these options are right for you. Call us at (301) 896-0890 or use our online Request an Appointment form to schedule your consultation.

Integrated Dry Eye, Blepharitis & Rosacea Treatment

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