The NuLids Starter Kit – Nulids at-Home Dry Eye Treatment and Relief – Convenient & Easy to Use Handheld Device for Relief from Dry Eye, Blepharitis, MGD Symtpoms - Includes 30 Day Supply Of Soft Tips

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In a Phase III trial of Cequa, there were statistically significant improvements in Schirmer’s score at three months and ocular surface staining at one month. 6 These improvements are earlier than the six months until improvement in Schirmer’s tear strip wetting and corneal staining seen with the lower concentration cyclosporine, Restasis, and earlier than the three month improvement in corneal staining seen with Xiidra. 8,9 While a promising new drug, one medication won’t work for everyone, especially for a heterogeneous condition such as DED. Chhadva P, Goldhardt R, Galor A. Meibomian gland disease: the role of gland dysfunction in dry eye disease. Ophthalmology. 2017;124(11S):S20-6. These formulation breakthroughs, in conjunction with the invalidation of patents for Restasis, have opened the door for more, and even generic, CsA options. Shrivastava S, Patkar P, Ramakrishnan R, et al. Efficacy of rebamipide 2% ophthalmic solution in the treatment of dry eyes. Oman J Ophthalmol. 2018;11(3):207-12. Thermoflo (MIBO Medical Group, Dallas) The Thermoflo consists of a control unit and handpiece that delivers heat at 108 degrees F through a silver eye pad used with ultrasound gel applied to the tarsal conjunctiva. The control unit features an LCD touch-panel display that lets you adjust treatment time and settings.

Perfluorohexyloctane. NovaTears (Novaliq) is a one-component eye drop containing 100% perfluorohexyloctane. This unique lubricant is a water- and preservative-free lipophilic liquid. NovaTears stabilizes the lipid layer and can improve signs of meibomian gland dysfunction (MGD), as well as symptoms and signs of DED ( Figure 3). 42-44 NovaTears is currently available in Europe and Australia in multidose bottles and is in Phase II clinical trials in the United States. 45 The head oscillates rapidly. It takes fifteen seconds to treat one eyelid. All four eyelids take about one minute. One clinical studyfound that:

Sight Sciences presents additional results of OLYMPIA study of signs and symptoms of dry eye disease using TearCare. Eyewire News. eyewire.news/articles/sight-sciences-presents-additional-results-of-olympia-study-of-signs-and-symptoms-of-dry-eye-disease-using-tearcare/. September 9, 2020. Accessed February 16, 2021. Li B, Fu H, Liu T, et al. Comparison of the therapeutic effect of Meibomian Thermal Pulsation LipiFlow on obstructive and hyposecretory meibomian gland dysfunction patients. Int Ophthalmol. 2020;40(12):3469-79. Xiao J, Adil MY, Chen X, et al. Functional and morphological evaluation of the meibomian glands in the assessment of meibomian gland dysfunction subtype and severity. Am J Ophthalmol. 2020;209:160-7. Vegunta S, Patel D, Shen JF. Combination therapy of intense pulsed light therapy and meibomian gland expression can improve dry eye symptoms and meibomian gland function in patients with refractory dry eye: a retrospective analysis. Cornea. 2016;35(3):318-22.

Chao W, Belmonte C, Benitez Del Castillo JM, et al. Report of the inaugural meeting of the TFOS i(2) ¼ initiating innovation series: targeting the unmet need for dry eye treatment. Ocul Surf. 2016;14(2):264e316. Nulids is not a cure fordry eyes. However, it’s simple to use daily. It can complement what you’re already doing. Nulids users often say that it reduces their use of OTC and prescription eye drops. Trehalose. This disaccharide with high water retention capabilities is naturally found in plants and animals and is both a bioprotectant and an osmoprotectant. 38,39 It protects corneal cells from the harmful effects of desiccation and tear hyperosmolarity—a hallmark of DED—by fortifying cell membranes and preventing the denaturation of proteins in the absence of water. 4,38,39 Research shows trehalose-containing artificial tears improve DED symptoms and signs, including the suppression of inflammation ( Figure 2). 40,41 Recently, three trehalose-containing artificial tears, Theratears Extra (Akorn), Refresh Optive Mega-3 (Allergan) and Thealoz Duo (Théa), entered the market with the potential to benefit DED patients beyond lubrication. At-home gland expression (0). For maintenance, patients may perform manual gland expression at home. While looking down, the patient should apply mild force on the nasal upper lid in a downward motion toward the lash line, progressing laterally across the lid to express all glands. The bottom lid should be expressed similarly with the patient looking up. Appropriate supraduction or infraduction during massage prevents direct mechanical force to the cornea, which could lead to corneal deformation. Alternatively, patients may squeeze sections of the upper and lower lids between their index finger and thumb. 36 Take-home MessageHardten DR, Schanzlin DJ, Dishler JG, et al. Comparison of a handheld infrared heating and compression device and a thermal pulsation device to treat meibomian gland dysfunction. Presented at ASCRS-ASOA Annual Meeting, April 16, 2018; Washington D.C. Asiedu K, Dzasimatu SK, Kyei S. Impact of dry eye on psychosomatic symptoms and quality of life in a healthy youthful clinical sample. Eye Cont Lens. 2018;44(Suppl 2):S404-09. The NuLids II study, presented as a poster at ASCRS 2018, showed even more compelling data. It demonstrated an 81% increase in meibomian glands yielding liquid secretions, a 65% increase in tear-film breakup time and a twofold reduction in OSDI scores compared to pre-trial baseline. Further, 95% of subjects found NuLids to be easy and comfortable to use and were either satisfied or very satisfied following treatment. Valencia-Nieto L, Novo-Diez A, Blanco-Vázquez M, et al. Therapeutic instruments targeting meibomian gland dysfunction. Ophthalmol Ther. 2020:9(4):797-807. Sabeti S, Kheirkhah A, Yin J, et al. Management of meibomian gland dysfunction: a review. Surv Ophthalmol. 2020;65(2):205-17.