Off the Cuff: Simple, Yet Effective

One of the most exciting aspects of treating dry eye and ocular surface disease is the seemingly constant stream of innovation ranging from novel therapeutic molecules to high-tech treatment devices. However, sometimes innovation can come in relatively simple packages. Several months ago, before Vision Expo East, my friend Joe Boyd emailed me about a new startup he was working with. The product was an irrigating device for the ocular surface developed by a retinal specialist in Pittsburgh. My initial reaction was one of relative uncertainty as to where such a device would fit in our current dry eye protocol—what could a simple saline rinse achieve beyond what our advanced treatments could already offer? However, I try to keep an open mind when it comes to new therapies, so I set up a meeting with Joe and Srini Kondapalli, the creator of the device.

I was introduced to Rinsada, an irrigating lid retractor, a device that attaches to the end of a syringe and allows for a high-pressure rinse of the conjunctival fornices and ocular surface by hooking beneath the lids and jetting water into these difficult-to-reach spaces. The high-pressure jets of water that are created by the device likely allow it to “strip” the tear film from the ocular surface at a deeper level, much like power washing an oil and dirt coated driveway, which essentially allows us to manually reset the tear film. Srini initially got the idea for the device from the rinse he performs on his patients after instilling betadine for intraocular injections. He also shared some early data that showed a decrease in inflammatory factors on the ocular surface after use, which is beneficial given that it is well-established that dry eye patients have increased levels of inflammatory factors present in the tear film and on the ocular surface. I initially performed a one-eyed trial on my tech, Danae, a long-time dry eye sufferer and contact lens wearer, and the next day she could tell a difference in comfort between the irrigated and untreated eye.

I am now routinely performing Rinsada with NuLids PRO to pair this ocular surface lavage with microblepharoexfoliation—essentially cleaning the ocular surface inside and out. This also fits well in the oft-discussed “dental model” of ocular surface care, as the vast majority of patients (if not every patient given our screen-centric lifestyles) would likely benefit from such routine cleanings performed at least once or twice a year. Additionally, I have found it useful in cases where patients have allergies, an excessively mucoid tear film, or the ubiquitous “I feel like there is something under my eyelid” complaint. As I look forward to finding more uses for this new device, I am reminded that sometimes all innovation needs to be is simple, yet effective.

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Write to Dr. Shannon L. Steinhäuser, OD, MS, FAAO at ssteinhauser@gmail.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.