Laura M. Periman, MD knew she wanted to be a doctor from the age of 12.
“I’ve always loved eyeballs,” she said. “Growing up in the wilds of Montana, I was fascinated with the eyes of frogs and fish and different animals.”
As an undergraduate, she received a scholarship to study at the Oregon Regional Primate Research Center, where she focused on proopiomelanocortin (POMC) gene expression in primates under hormonal conditions. She credits this molecular biology experience as a major stepping stone in her career, as it enabled her to secure a position at Immunex Corporation (now Amgen). Once there, she worked on Enbrel®, which suppresses the immune system. She quickly became interested in inflammation and immunopathophysiology, making medical school a logical next step.
Dr. Periman’s deep scientific perspective, mechanical aptitude, and fascination with the human eye made ocular surface disease an ideal challenge for her, as getting to the root cause of dry eye required both her curiosity and core skill set.
What is BEISTO?
Initially, the only prescription medication for dry eye disease was steroid drops, which still play an important role in immunoregulation and treating flare-ups. However, meibomian gland disease has another more chronic component, which Dr. Periman has simplifies into BEISTO, which stands for:
- Bugs and bacteria—Demodex mites and bacteria can cause inflammation or blockage of meibomian glands.
- Enzymatic compromise—Medications, inflammation, and omega-3 deficiency can prevent normal production of healthy meibum.
- Inflammation—This can be local or systemic.
- Stasis—If the meibum becomes too thick, it can’t move and clogs the pores.
- Temperature—Abnormal meibum melts at a higher temperature than normal meibum.
- Obstruction—Whether from Demodex mites or abnormal meibum, clogged glands cause dry eye symptoms because of the lack of tears.
How does OptiLight™ work?
Using a patented Optimal Pulse Technology (OPT™), OptiLight™ reduces inflammation, alleviates abnormal blood vessels that perpetuate inflammation, decreases Demodex mites, improves tear breakup time, and restores meibomian glands.
To learn more about this technology, check out The Ultimate Guide to Optilight!
“No treatment hits all six causes of dry eye,” said Dr. Periman. “That’s why we layer therapies. But OptiLight™ gets five of the six, and it’s high up in my therapeutic offering window.”
Before offering any therapeutic treatments, Dr. Periman first recommends lifestyle changes, including eating more foods high in omega-3 fatty acids, taking supplements, and eliminating smoking and drinking alcohol.
OptiLight™ is often the next step for treatment because Dr. Periman credits the algorithms, platform, and energy delivery as the basis for FDA approval.
At its core, OptiLight™ applies OPT energy to the skin and eyelids with optimized settings and safety functions as well as a handpiece that fits the contour and geometry of the eye. As a result, OptiLight™ provides FDA-approved treatment that’s comfortable for patients.
How to treat advanced dry eye
For typical patients, Dr. Periman recommends about four treatments spaced about 2 to 4 weeks apart, because that seems to be the optimal interval to see an improvement in MMP-9 indicators.
However, advanced cases might require additional treatments. Because Periman Eye Institute is a dedicated dry eye treatment center, Dr. Periman had learned to spot patients who might need additional care.
“I like to do a re-evaluation at visits three and four to see how things are going,” said Dr. Periman. “Then I check meibomian gland expressibility, osmolarity, and MMP-9 load. If those aren’t adequately controlled while the patient is also following diet and lifestyle changes, then I recommend a few follow-on treatments so patients can receive optimal benefits.”
Dr. Periman also does due diligence to ensure her patients had their prescription medications filled and that her patients aren’t also suffering from allergies.
“As dry eye specialists, we know this disease doesn’t follow an algorithm,” said Dr. Periman. “There is no if-then. It doesn’t work like that. That’s why we have to use all the parts of our brain to develop an appropriate plan and engage our patients. Luckily, I love the challenge.”
