Snyder Eye Group in Ship Bottom Sets Gaze on Latest in Industry Technology

Jul 25, 2018
Photo by: Ryan Morrill

A lot can happen in the blink of an eye – like, say, the formation of a protective layer over the eye’s cornea. But what happens when we’re not blinking as fully and frequently as we should be? According to Dr. Robert Snyder of Snyder Eye Group in Ship Bottom, infrequent or incomplete blinking can lead to one of the most common issues in the eye care industry today: dry eye.

When we blink, our eyelids meet and squeeze out water and oil from the glands along the inside of our upper and lower lids. Ideally, the water and oil meet and mix to create a protective film over the cornea of our eyes. However, when the meibomian glands containing the oil are defective and fail to release oil when we blink, the tears from our water glands evaporate, and we have nothing protecting our eyes from potentially threatening environmental conditions. This problem concerning defunct oil glands is called meibomian gland dysfunction, or MGD.

Eighty-five percent of dry eye cases involve MGD, which is why Snyder has recently added some weaponry to his MGD-defeating armory: the OCULUS Keratograph, the LipiScan and the LipiFlow. With these pieces of equipment, Snyder and his colleagues can effectively diagnose and treat dry eye.

The OCULUS Keratograph measures tear production, while the LipiScan measures the quality of an eye’s meibomian glands. These two instruments allow the Snyder Eye Group staff to identify whether or not a patient has MGD.

“I’ve always wanted to scan the glands. We used to use a little penlight, and I would look at the glands and say that there has to be a better way,” said Snyder, harking back to their previous MGD diagnostic methods.

“Finally, I got this machine and I’m looking at all of these crappy glands, and then of course I say to myself, ‘Now what do I do when I tell them their glands are dying?’” he said. Then came the fascinating missing piece of the puzzle: the LipiFlow.

The LipiFlow is used to administer treatment once the optometrists of Snyder Eye Group have scanned a patient and determined him or her to have MGD. The LipiFlow is a thermal pulsation device that heats the oil glands and clears blockage. Snyder compared the blockage to butter; in order to clean the glands and make way for new oil, you have to melt down the butter and extract it.

It works like this: The LipiFlow machine applicators latch onto the closed eyelids of the patient, heat up to 103 degrees and pulsate, gently massaging the user’s eyes. The blockage, or butter, melts and is cleared from the oil glands. The whole process takes 12 minutes.

“The first two minutes are just a kind of constant pressure, warming up the glands and melting down the butter. And then it kind of slowly builds off the pressure for another two minutes. For the next four to six minutes it’s just constant pulsing to get all of the stuff out. And then it heats up again and repeats the sequence,” said Dr. David Klatz, an optometrist at Snyder Eye Group who specializes in dry eye syndrome.

Dr. Freddie Davis, a practicing optometrist at the Ship Bottom office, was the guinea pig when the LipiFlow first arrived.

“I have crappy glands,” Davis joked, before likening the machine to an eye massage.

Snyder was sure to assert that Davis’ and other patients’ glands, once gone, are not repairable. “You can’t make the glands with the oil grow any better; they’re dead. The damage is done. But the whole idea behind treating this is to make whatever glands she has left work better,” said Snyder. “So her glands will always be crappy, but whatever oil is in there, we want it to function better.”

Once patients undergo treatment for MGD, they are required to use moisture drops and participate in prescribed blinking exercises.

“We give them blinking exercises to blink because to get the oil to come out, you need to do a whole blink. When you don’t do a whole blink, it gets clogged,” said Snyder.

One of the aforementioned causes of MGD, infrequent and incomplete blinking, can come from staring at computers, tablets and smartphones for an extended period of time. According to Davis, we blink a third less often when we’ve been gazing at lit screens, and often our eyelids aren’t even completely meeting, which means they aren’t squeezing water and oil from the glands. But blinking deficits aren’t the sole cause of MGD and subsequent dry eye. Others include aging, medications, inflammation, hormonal changes, contact lenses and more. The list rambles on.

This isn’t a new disease, but the solution is one that is new to Snyder’s practice. “What I used to do was I would squeeze the patients’ glands. I would take a special tweezer and numb their eyes and squeeze it and all of this white gunk would come out of it.”

The LipiFlow offers a more comfortable alternative to tweezing. Patients even have the option to kick back and listen to their favorite tunes for the 12-minute duration of their treatment. “I’ll ask patients what their favorite music is and I’ll play it for them,” said Klatz.

LipiFlow is the only machine of this type that is FDA approved, and the only one of its kind in the immediate area, a fact that Snyder is very proud of.

“I’ve had it for several months. I’ve done 11 people so far, maybe 12. Four patients that couldn’t wear contacts are now wearing contacts,” said Snyder.

“My goal is to give the best care I can to my patients. It’s good for my practice. It’s good for me. Patients come in with dry eye, what can we do about it? I have something to offer.”

More information regarding this new technology from Snyder Eye Group can be found at

— Sarah Hodgson

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