Single-Dose LipiFlow® Treatment Relieves Dry Eye Symptoms Interview with:

Dr. Caroline A. Blackie, OD PhD FAAO Medical Director, Dry Eye Johnson & Johnson Vision

Dr. Caroline Blackie

Dr. Caroline A. Blackie, OD PhD FAAO
Medical Director, Dry Eye
Johnson & Johnson Vision What is the background for these studies? Would you briefly explain the problem of dry eye, how common it is and why it is difficult to treat? 

Response: Dry eye disease is a condition where the eyelids and/or the tear film are unable to protect the ocular surface from the negative effects of desiccating stress. If left untreated, a vicious cycle ensues resulting in a broad spectrum of sequelae, including ocular discomfort and compromised vision. The result is partial or pervasive reduced quality of life for the individual along with a significant economic burden on our society. Conversely, when the ocular surface is healthy, patients feel better, see better and live better.

Meibomian gland health is essential for ocular surface health. Meibomian glands secrete the oils necessary to protect the ocular surface from the negative effects of desiccating stress. Predictably, meibomian gland dysfunction (MGD) is a leading cause of dry eye disease. MGD is almost always the result of thickened and stagnated gland secretions. These stagnated secretions obstruct and/or limit the flow of functional oil into the tear film. MGD is the most common form of dry eye disease and is also known as evaporative dry eye. While management of dry eye in general can be complex, the management of MGD affords a relatively straightforward approach, which is to improve meibomian gland function by treating obstruction.

Dry eye disease is pretty common – more than 340 million people suffer from it globally. Short-term management of dry eye involves improving signs and symptoms of the condition, including the use of tear supplementation and reducing ocular surface inflammation.

Long-term dry eye management requires that the cause (or causes) of the condition is also diagnosed and treated. That cause is often MGD, and MGD can be successfully managed with LipiFlow®. What are the main findings of the studies?  How does the LipiFlow® system work and differ from other dry eye therapies?

Response: LipiFlow® is the only single-dose treatment for meibomian gland dysfunction (MGD) shown to significantly improve gland function and dry eye symptoms with sustained duration. Early LipiFlow® intervention for MGD has been shown to be associated with improved treatment outcomes. LipiFlow® is the only FDA-cleared electronic medical device for MGD shown to restore gland function by applying simultaneous heat and pressure to the eyelid to remove gland contents and obstructions while also protecting structures of the eye. Sponsored and unsponsored multicenter, randomized, controlled clinical studies of LipiFlow® continue to demonstrate its safety and sustained effectiveness.

Two recent studies published in Clinical Ophthalmology examined the use of LipiFlow® in MGD patients. The first study demonstrated that a single LipiFlow® treatment significantly improved mean meibomian gland function and reduced dry eye signs and symptoms for soft contact lens wearers with MGD compared to an untreated control arm. Treatment with LipiFlow® also increased comfortable contact lens wearing time by an average of four hours per day. These data are relevant because the most frequent complaint among contact lens wearers is reduced comfort due to dryness, and MGD is highly prevalent in contact lens wearing populations.

In the second study, a single LipiFlow® treatment was demonstrated to be significantly more effective at improving dry eye symptoms in MGD patients than three months of a twice daily dose of the antibiotic doxycycline. The use of doxycycline in MGD patients has been frequently reported. However, long-term daily antibiotic use raises the risk of patients experiencing adverse events. Conversely, the rate of adverse events with LipiFlow® remains low. Consistent with prior clinical studies, no serious adverse events were reported after the LipiFlow® treatments in either study. What should readers take away from your report?

Response: These results add to the growing body of evidence showing that just a single 12-minute LipiFlow® treatment can provide effective relief from MGD and dry eye. We’re hearing positive anecdotal feedback from eye care professionals around the country whose patients are learning, for the first time, that there is a device that can treat a primary underlying cause of dry eye disease. These studies reflect the impact of diagnosing and treating MGD. As a company committed to healthy sight, ocular comfort and quality of life for all patients, it’s gratifying to hear our customers report that our products are enhancing patient care in their practice. What recommendations do you have for future research as a result of this work?

Response: One of the most exciting aspects of this field is that we have the potential to move beyond reactive care and towards proactive care. The health of the ocular surface impacts everything we choose to do with our eyes. For example, whether it be the ability to work for long hours on a computer, wear contact lenses or have eye surgery, the health of the ocular surface will either enhance or limit our choices. Future research should target ways to detect ocular surface distress in its earliest stages along with ways to predict when ocular surface distress will occur. In combination, we could envision a culture of prevention. In the meantime, we remain committed to bringing and developing effective treatments for MGD in particular and dry eye in general. Is there anything else you would like to add? Any disclosures?

Response: LipiFlow® is currently available in nearly 1,000 optometrist and ophthalmologist offices in the U.S. and Canada. In just twelve minutes, MGD patients may significantly improve ocular comfort and most importantly, Meibomian gland function, which is critical for eye health. For more information, go to

Brief Bio:

Caroline Blackie is an internationally recognized expert in the field of dry eye with specific focus on meibomian gland dysfunction. She currently serves as the Medical Director for Dry Eye for Johnson and Johnson Vision. She joined Johnson and Johnson vision after 12 years with TearScience. Her most recent role with TearScience was the Head of Medical Affairs. Caroline also worked in private practice for approximately 20 years, first in South Africa and then in the United States. Caroline received a PhD in Neurobiology from Cornell and an OD from UC Berkeley.


  1. Hagen KB, Bedi R, Blackie CA, Christenson-Akagi KJ. Comparison of a single-dose vectored thermal pulsation procedure with a 3-month course of daily oral doxycycline for moderate-to-severe meibomian gland dysfunction. Clinical Ophthalmology (Auckland, NZ). 2018;12:161-168. doi:10.2147/OPTH.S150433.

Clin Ophthalmol. 2017 Apr 13;11:701-706. doi: 10.2147/OPTH.S119926. eCollection 2017.


2.  Meibomian gland dysfunction patients with novel Sjögren’s syndrome biomarkers benefit significantly from a single vectored thermal pulsation procedure: a retrospective analysis.

Epitropoulos AT1,2Goslin K2Bedi R3Blackie CA4.

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