DIAGNOSTIC FOCUS

SCAN FOR MGD

LIPISCAN PROVIDES HIGH-DEFINITION IMAGES OF THE MEIBOMIAN GLANDS

SCOTT SCHACHTER, O.D.

A 16-YEAR-OLD male presented for his annual exam complaining of watery eyes. His history revealed up to 5 hours per day of video game usage. After a brief explanation regarding the technology, we gathered stunning images of his meibomian glands using LipiScan, from TearScience.

OVERVIEW

The LipiScan Dynamic Meibomian Imager captures and stores digital images of the upper and lower meibomian glands. The device works quickly; total time from patient data entry to completed image acquisition of the lower lids can be well under 90 seconds. Image capture itself takes about 5 to 10 seconds per eye. The autofocus feature ensures sharp, HD-quality images, which are placed in a shared folder and can be viewed in exam rooms. The device also has a small footprint, at 16 in. x 12.4 in x 18.4 in.

PROCEDURE

Patient data is entered; he or she places his or her chin in the rest, looks up, and the lower lid is everted using a small tool. Image capture occurs with the push of a button.

TRAINING

A TearScience trainer spent the day working with staff members, who were able to acquire quality images by the end of the day.

PRACTICE BENEFITS/ROI

We decided to undergo a period of scanning every patient. During this time, we discovered apparent meibomian gland dysfunction (MGD) in patients as young as age 12. As a result, we are now identifying the disease earlier and, thus, intervening earlier. We also are able to track disease progress through time.

Patients have been very interested in seeing their images. It has been my experience that they are more likely to “buy in” to the importance of treatment and follow-up visits when they can see and better understand their condition.

The patient’s right lower lid image with LipiScan.

In catching and addressing patients’ MGD earlier, we offer a high level of care. We also have seen increased revenue via the use of LipiFlow, also from TearScience, a debridement-scaling technique, nutraceuticals, warm compresses and lipid-based artificial tears.

LipiScan is billable to insurance carriers if you establish the medical necessity. It may be reimbursable under CPT code 92285 in some markets. However, check with your local carrier.

PATIENT OUTCOME

With the LipiScan, I was able to see that the aforementioned patient was missing most of his meibomian glands. I educated him on the importance of taking breaks from video games every 20 minutes, prescribed blinking exercises and non-preserved artificial tears q.i.d. OM

DR. SCHACHTER is founder of Advanced Eyecare and the Eyewear Gallery Optometry in Pismo Beach, Calif., where he specializes in contact lens and dry eye treatment and diagnosis. He also serves as administrator, California Central Coast Area for Vision Source and as adjunct clinical professor at Marshall B. Ketchum University in Fullerton, Calif. Dr. Schachter is a Bausch + Lomb contact lens expert and a CORE speaker and key opinion leader for Allergan. Visit tinyurl.com/OMcomment to comment.