Episode 8: Dynamic Muscle Stimulation and the Blink Physiology Behind Dry Eye

In Episode 8 of From Paper to Clinic, "Dynamic Muscle Stimulation and the Blink Physiology Behind Dry Eye," Cory Lappin, OD, MS, FAAO, of The Dry Eye Center of Ohio, joins the show to unpack a paper examining dynamic muscle stimulation of the periorbital area (DMST) as a treatment for dry eye disease. The conversation centers on an underappreciated driver of dry eye—lower lid laxity and impaired blink mechanics—and how a non-surgical device-based approach can restore normal blink function.

For decades, lower lid laxity has been treated as a surgical problem: a mechanical defect addressed only with horizontal lid-tightening procedures. The paper anchoring this episode challenges that framing by targeting the muscle of Riolan and the orbicularis oculi directly, using dynamic electrical muscle stimulation to retrain the lid's contractile function rather than surgically shortening it. The result is a treatment aimed at the root cause of an incomplete or poorly apposed blink—rather than only its downstream tear-film consequences.

The paper inspiring this discussion is the "Dynamic Muscle Stimulation of the Periorbital Area for Improvement of Blinking in Dry Eye Patients" by James G. Chelnis and Alexandra Chelnis, published in Clinical Ophthalmology.