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Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral

CPT4 code

Name of the Procedure:

Evacuation of Meibomian Glands, Automated, Using Heat and Intermittent Pressure, Unilateral

Summary

This procedure involves clearing blocked Meibomian glands in the eyelids using an automated device that applies heat and intermittent pressure. It is typically done on one eye at a time to improve gland function and alleviate symptoms.

Purpose

The procedure addresses Meibomian gland dysfunction (MGD), which can lead to dry eyes and discomfort. The goal is to restore normal gland function, thereby reducing symptoms like dryness, irritation, and redness.

Indications

  • Chronic dry eye syndrome
  • Blepharitis (inflammation of the eyelids)
  • Meibomian gland dysfunction (MGD)
  • Persistent eyelid and eye discomfort
  • Poor response to conventional treatments like eyedrops or warm compresses

Preparation

  • Avoid using contact lenses and makeup for 24 hours before the procedure.
  • Inform the doctor about any medications or eye drops currently being used.
  • No need for fasting or significant medication adjustments.
  • Preliminary eye examination and possibly imaging to assess gland status.

Procedure Description

  1. The patient is seated comfortably in a treatment chair.
  2. Local anesthetic drops are administered to numb the eye.
  3. An automated device is placed over the eyelid.
  4. The device applies controlled heat to soften the gland blockages.
  5. Intermittent pressure is applied to evacuate the contents of the Meibomian glands.
  6. The device is removed, and the eye is cleaned.
  7. The procedure is repeated if necessary on the other eye at a different session.

Duration

Usually completed in 12-15 minutes per eye.

Setting

Performed in an outpatient clinic specializing in eye care or a dedicated ophthalmology center.

Personnel

  • Ophthalmologist or optometrist specialized in ocular surface diseases.
  • Trained clinical staff or nurses for assistance.

Risks and Complications

  • Temporary eye irritation or redness
  • Mild discomfort during the procedure
  • Infection (rare)
  • Potential for temporary blurring of vision
  • In rare cases, gland damage or scarring

Benefits

  • Relief from dry eye symptoms
  • Improved comfort and reduced irritation
  • Enhanced function of the Meibomian glands
  • Benefits typically seen within a few days to weeks post-procedure

Recovery

  • Use of prescribed lubricating eye drops if needed.
  • Avoid rubbing the eyes and using makeup for 24 hours post-procedure.
  • Most patients return to normal activities immediately afterwards.
  • Follow-up visit may be scheduled to assess the effectiveness and need for repeat treatments.

Alternatives

  • Warm compresses applied at home
  • Lid scrubs and hygiene
  • Prescription eye drops (e.g., anti-inflammatories)
  • Oral antibiotics in certain cases
  • Each alternative varies in invasiveness and effectiveness compared to the procedure.

Patient Experience

Patients might feel mild pressure or heat during the procedure, but it is generally well-tolerated. Post-procedure, there might be slight redness or irritation which typically resolves quickly. Pain management is minimal due to the use of numbing eye drops, ensuring a comfortable experience.

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