Ocular surface diseases are disorders of the surface of the cornea—the transparent layer that forms the front of the eye. These diseases include dry eye syndrome, meibomian gland dysfunction blepharitis, rosaceous, allergies, scarring from glaucoma medications, chemical burns, thermal burns, and immunological conditions such as Mucous Membrane Pemphigoid and Sjogren’s Syndrome.

What are the Symptoms?

• Blurry vision
• Discomfort or pain
• Redness and itching
• And in severe cases, blindness due to corneal scarring

Unfortunately, cases often go undiagnosed and undertreated, due to a lack of understanding of symptoms and inaccurate evaluation. And, as people are living longer, these disorders are becoming more prevalent.

Effective diagnosis, care, and management of ocular surface disorders demand highly specialized expertise. This type of board-certified expertise is what you will find at Bascom Palmer. 

Tests

High-resolution, Non-invasive Optical Coherent Tomography - This state-of-the-art technology allows your team of experts to obtain microscopic imaging of the ocular surface. That way, they see changes that cannot be seen by standard equipment. The team is also establishing a unique biological diagnostic program that utilizes biochemical, genetic, molecular, and immunological analysis of tear fluid and cellular tissue. Their findings help them to better characterize patients by disease process, develop new biomarkers that will help them monitor progression of disease, and provide customized therapy for each individual patient.

Treatments

Non-surgical Treatments

Meibomian Gland Dysfunction (MGD) is a common and underdiagnosed cause of the signs and symptoms of Dry Eye Syndrome. It has been estimated that MGD accounts for three out of every five cases of dry eye. Bascom Palmer offers “physical therapy” to the lid and meibomian glands at different levels, beginning with heat therapy and lid massage for mild cases.

Lipiview and Lipiflow Thermal Pulsation System - For advanced disease, the Lipiview and Lipiflow system provides the ophthalmologist with a tool to improve the screening and diagnosis of evaporative dry eye in patients with MGD and treat it in an efficient manner. 

The Lipiflow system works by safely and comfortably applying a combination of heat and pressure to the eyelids to effectively remove blockages and open the passages found in the Meibomian glands. Once the glands are free of blockages, they can resume producing the essential oil that makes up the protective lipid layer of the eye’s tear film. A Dry Eye specialist will determine if LipiFlow is right for you based on a complete eye exam. Lipiflow treatment is quick with a duration of 12 minutes and minimal discomfort.  

Scleral lenses: Scleral lenses are custom-designed contact lenses that rest on the sclera, the white part of the eye. They create a fluid-filled vault over the cornea, providing a protective and therapeutic environment for the ocular surface. These lenses have proven to be a valuable tool in managing various ocular surface conditions, including but not limited to keratoconus or dry eye syndrome.

Surgical Treatments

In some instances, ocular surface disorders result in scarring of the lacrimal gland, conjunctiva, and/or cornea, resulting in poor vision. Our ocular surface experts use surgical therapies to successfully treat these conditions. Procedures include limbal stem cells and cornea transplants to rehabilitate the surface of damaged scarred tissue.

In severe, end-stage cases of blindness-causing scarring, Bascom Palmer surgeons also use artificial corneas (Boston keratoprosthesis type I). And, Bascom Palmer is the only center in the United States that performs the complex “eye-tooth” surgery known as MOOKP (Modified osteo odonto keratoprosthesis) for patients with ocular surface disorders. This fascinating surgery actually implants an eye-tooth into the patient’s eye, to restore sight.

Protective devices - The team is currently working with the Boston Foundation for Sight’s Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE). This treatment involves the custom-designing of a prosthetic device made for patients with ocular surface diseases, to help protect and heal the ocular surface. The device can also correct for refractive errors.

Stem cell-based therapy - The use of patients’ own cells for the treatment of ocular surface diseases has been a successful modality of treatment. In fact, Bascom Palmer performed the first autologous transplant of limbal stem cells from the fellow eye of a patient with stem cell deficiency. New technology in stem cell research has opened broader doors for the use of cell-based therapy for eyes. In collaboration with the University of Miami Interdisciplinary Stem Cell Program, we are developing an ex-vivo expansion progenitor stem cell program. This groundbreaking program will expand the use of this innovative eye therapy to regenerate damaged tissue and establish lost function and vision health.

Clinical studies - With its “real time” comprehensive data-base of ocular surface patients around the world, Bascom Palmer is a major center for ocular clinical research, including the testing of novel compounds and therapeutic strategies.

Other promising new surgical treatments being studied at Bascom Palmer include transplantation of salivary glands, and methods that hold the potential to improve the longevity and success of artificial corneas.

Why Choose Bascom Palmer Eye Institute?

#1 in the Nation. When you choose Bascom Palmer, you choose America’s No. 1 eye care provider, according to U.S. News & World Report. Our respected physicians, advanced treatments and groundbreaking research drive high-quality patient care.

Trusted Specialists. Our 1,800-member team includes respected corneal specialists trained to care for patients with every corneal condition – from the routine to rare.

Research-based Medicine. Choosing a university-based eye care provider means having access to leading-edge treatments and technologies, as well as promising clinical research trials. At Bascom Palmer, we close the gap between groundbreaking laboratory discoveries and treatment.