Inflammation Of Meibomian Gland
Meibomianitis is inflammation of the meibomian glands, a group of oil-releasing (sebaceous) glands in the eyelids. These glands have tiny openings to release oils onto the surface of the cornea.
- 1 What is the inflammation of the meibomian gland called?
- 2 Why is my meibomian gland swollen?
- 2.1 How do you treat meibomian gland inflammation?
- 2.2 Can you unclog meibomian glands?
- 2.3 Can I squeeze meibomian glands?
- 3 What is the difference between blepharitis and Meibomianitis?
- 3.1 How long does it take to unblock meibomian glands?
- 3.2 How long does it take for meibomian glands to heal?
- 3.3 Is ice or heat better for swollen meibomian glands?
- 3.4 What reduces eyelid inflammation?
- 3.5 What is the difference between blepharitis and Meibomitis?
- 3.6 What is the medical term for eyelid inflammation?
What is the inflammation of the meibomian gland called?
Meibomitis is a chronic inflammation of the tiny oil glands that line your upper and lower eyelids. The meibomian glands release meibum, the special oil that helps lubricate your eyes and keep your tears from evaporating. When the meibomian glands are blocked, it changes the amount and composition of your meibum.
Your eyes will feel uncomfortable, and your vision may be blurry. The gland blockage also creates an environment favorable for bacteria. Your eyes have about 20 to 40 meibomian glands on each lower lid and 30 to 40 glands on each upper lid. The glands slowly release meibum all the time. Blinking allows more meibum to be released.
People of any age can get meibomitis, including babies. But it’s more common among older people and people who live or work in environments that have a lot of dust or pollen particles. The cause of meibomitis isn’t known. It’s one of the results of meibomian gland dysfunction (MGD), but MGD also occurs without meibomitis,
painfulredswollendryitchyburninggrittysensitive to lighttender to the touch
You may also have a stye that appears as a red, painful bump on the eyelid. This can be caused by an infection as a result of a clogged oil gland. The exact cause of the meibomian gland blockage that gives rise to meibomitis isn’t known. Researchers believe it may be bacterial,
Why is my meibomian gland swollen?
Meibomian gland dysfunction (MGD) is a common eye condition, yet many people don’t realize they have it. You get it when there’s a problem with a few dozen tiny glands in your eyelids that help make the oil layer of your tears. These meibomian glands, named after the German doctor who studied them, make an oil called meibum.
- Meibum, water, and mucus form the three layers of tear film, the fluid that keeps your eyes moist.
- The oil helps prevent the water layer on the eye surface from evaporating or drying out too quickly.
- Changes to the amount or quality of the oil, or to the glands themselves, can lead to MGD.
- It’s often the result of a combination of things.
The most common type, obstructive MGD, happens when the gland openings get clogged, and less and less oil reaches the eye surface. Your doctor will tailor treatment based on the stage of your MGD as well as any underlying medical condition you have. Age plays a part; the number of meibomian glands goes down over time.
High cholesterol and triglycerides Allergic conjunctivitis and other eye diseasesInflamed or damaged eyelid or cornea Bacterial infection Autoimmune diseases like rosacea, lupus, rheumatoid arthritis, and Sjögren’s syndrome
Some medications can cause problems with oil production, including:
Estrogen replacement therapyDrugs that reduce androgenRetinoids, from acne medication to anti-aging creams
In its early stage, you might not have any. But as MGD progresses and you have less oil or poor-quality oil in your tear film, your eyes may burn, itch, or be irritated or dry. It might feel like you have a grain of sand or dust in your eye. An irritated, inflamed eyelid may be red.
- The inner rim of your eyelid looking uneven or rough is a classic sign of MGD, but not everyone has it.
- Some people have moments of blurred vision that improves when they blink.
- Symptoms can get worse when you’re on the computer for a long time or if the air in your home or office is very dry, either from air conditioning or heating.
MGD is the most common cause of dry eye syndrome (also called dry eye disease). MGD may lead to eyelid inflammation, called blepharitis, especially along the rims. There’s a lot of overlap among these three conditions, and it’s possible to have them all at once.
- In fact, experts aren’t entirely sure what comes first, or exactly how they’re connected.
- It could be that MGD causes inflammation that leads to dry eye, or that inflammation from dry eye could hurt the meibomian glands.
- If you’re having eye surgery, untreated MGD raises the chance of getting an infection and inflammation afterward.
In its advanced stage, MGD may lead to cornea disease. There’s no single thing that can show that you have MGD. Your eye doctor will look closely at your eyelids to inspect the gland openings. They may press on your eyelids to squeeze oil out. The Schirmer’s test checks if you make enough tears.
Other tests can measure the quality of your meibum and how fast your tears evaporate. The combination of results can lead to a diagnosis of MGD. Early on, self-care might be all you need. Put a warm, wet washcloth or heat pack over your eyelids for 5 minutes, twice a day, to help loosen the oil. Follow this with a light fingertip massage.
For the upper lid, look down and very gently roll one side of your index finger from the top of your eyelid down to the lash line. For the lower lid, look up at the ceiling and roll your finger up to the lash line. To help unblock gland openings, clean with a non-soap cleanser once a day.
Dab it on a warm, wet washcloth and gently go along your upper and lower lash lines. Use a humidifier to counter the drying effects of air conditioning and indoor heating. If you wear contacts, daily disposable lenses that are the “water gradient” type may be more comfortable. Avoid your eye area completely when you use beauty products with retinoids.
Check with your doctor about taking omega-3 fatty acid supplements, They have anti-inflammatory properties and may boost the quality of your meibum. For more advanced MGD and depending on what other health issues you have, your doctor may add medications to your care plan:
Lubricants Antibiotics for infections Cyclosporine to suppress your immune system Steroids that help ease inflammation
These could be eye drops or spray, creams, or pills. In the office, your doctor may use devices that send heat or pulsed light to open blocked meibomian glands and improve symptoms. It’s important to stick with your treatment, especially home care, to reverse MGD or keep it from getting worse.
What causes inflamed eyelid glands?
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You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. The exact cause of blepharitis isn’t clear. It might be associated with one or more of the following:
Seborrheic dermatitis — dandruff of the scalp and eyebrows Infection Clogged or malfunctioning oil glands in your eyelids Rosacea — a skin condition characterized by facial redness Allergies, including allergic reactions to eye medications, contact lens solutions or eye makeup Eyelash mites or lice Dry eyes
If you have blepharitis, you might also have:
Eyelash problems. Blepharitis can cause your eyelashes to fall out, grow abnormally (misdirected eyelashes) or lose color. Eyelid skin problems. Scarring can develop on your eyelids from long-term blepharitis. Or the eyelid edges might turn inward or outward. Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelids, such as flaking associated with dandruff, can build up in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with keeping your eyelids moist. This can irritate your eyes and cause symptoms of dry eyes or excess tearing. Stye. A stye is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge of your eyelid. A stye is usually most visible on the surface of the eyelid. Chalazion. A chalazion occurs when there’s a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. This blockage causes inflammation of the gland, which makes the eyelid swell and redden. This can clear up or turn into a hard, nontender bump. Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis). Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes can cause a sore to develop on your cornea. Not having enough tears could increase your risk of a corneal infection.
How do you treat inflamed meibomian glands?
Taking tetracycline antibiotics for several weeks. Using LipiFlow, a device that automatically warms the eyelid and helps clear the glands. Taking fish oil to improve the flow of oil from the glands. Using a medicine containing hypochlorous acid, that is sprayed onto the eyelids.
How do you treat meibomian gland inflammation?
HOW IS MGD TREATED? – There are different treatments to help MGD. These include warm compresses, antibiotic or steroid eye drops, artificial tear eye drops, and antibiotics by mouth. Your ophthalmologist may recommend one or more of these treatments depending on the severity of MGD.
They may also discuss ways to improve eyelid/eyelash health by cleaning off crusting, dead skin, oil and bacteria that build up on the eyelid margins.1) WARM COMPRESSES Applying heat to the eyelid margins helps oils flow better out of the eyelid glands and melts the “thickened” oil that is blocking the eyelid glands.
Place a warm (not too hot) wet washcloth gently to the closed eyes to apply heat on the eyelids. Leave in place for four to five minutes. There are also eye masks and pads with gel beads that can be warmed in the microwave and used for warm compresses.
- Warm compresses should be done at least twice a day when the MGD symptoms are bad, and once a day to keep MGD from coming back or getting worse.
- As this is a chronic condition, warm compresses may be needed for weeks to months.
- In the recent years, electronic eyelid heating devices have become available.
These machines are used in the office to heat eyelids for longer periods of time and can be helpful in cases of failed regular at-home warm compress treatments. Speak with your ophthalmologist if you have questions about this treatment.2) MASSAGE Massage can be done immediately after applying the warm compress.
- Apply light pressure with your fingertips to the lid margin just above the eyelashes.
- Older children and teenagers may perform the massage by themselves once they understand the technique.
- Roll the finger upward on the lower lid while looking up, then roll the finger downward on the upper lid while looking down.
Pressure from the thumb and pointer finger may also be used to massage the eyelids. Using too much pressure with massage may cause pain and more irritation, so be careful not to press too hard on the eyelids.3) EYELID SCRUBS Washing the eyelids helps remove oil, bacteria and crusting which can block the oil gland openings.
- Use a Q-tip, your fingers, or a warm washcloth on the tips of your fingers to gently wipe along the eyelashes on the top and bottom eyelids.
- You can use a mild soap like Cetaphil or CeraVe or dilute baby shampoo (a few drops in a small cup of water).
- It is best to use a soap which will not burn or irritate the eyes.
Ask your ophthalmologist if you have questions about what types of soaps to use. Eyelid scrubs may need to be done once a day or few times a week, depending on what your ophthalmologist recommends.4) OMEGA- 3 FATTY ACID: FLAX SEED and FISH OIL In addition to the above treatments, studies show that boosting your child’s diet with essential (omega-3) fatty acids can help with MGD.
- Omega-3 fatty acids can help the meibomian glands make better oils to moisturize the eyes.
- Flax seed oil and fish oil are excellent sources of omega-3 fatty acids.
- For flax seed oil, try 1 teaspoon/day for toddlers or 1 tablespoon/day for older children.
- Mix with juice, smoothies, or hot cereal.
- Do not use flax seed oil if your child is on blood-thinning medication or blood-sugar lowering medication.
There are several companies which make “kid friendly” fish oil and flax seed oil liquids and gummies (Nordic Naturals and Barleans are two examples). If your child can take pills, there are several over the counter tablets/capsules which can be taken instead.
Please talk to your child’s pediatrician to be sure that omega-3 vitamins are safe for your child.5) ANTIBIOTICS Although MGD is not an eyelid infection, antibiotics can help with the inflammation and bacteria that cause MGD. Your ophthalmologist may prescribe either an antibiotic eye drop, an antibiotic eye ointment or antibiotics by mouth.
Please be sure to follow the directions for any antibiotics prescribed for MGD, they may be different than what you have done with antibiotics for other problems. MGD is a common condition seen in both children and adults. Newer treatment options are becoming available such as intense pulsed light treatment, surgery options, and immune based eye drops.
Can you unclog meibomian glands?
Warm Compresses – A warm compress can help soothe dry eye symptoms and open the meibomian glands to improve oil flow. The heat can relax the eye, add moisture, and slow tear evaporation. You can easily make a warm compress at home. You just need a clean cloth and clean, warm water.
Can I squeeze meibomian glands?
Meibum is expressed from meibomian glands to promote secretion of the oil or to clear blockage. Expressing meibomian glands can be done with a paddle, rolling forceps, other forceps, or sterile cotton swabs. Gentle pressure is applied to the lids so that meibum flows out of the opening of the glands. In general, it is not recommended to express glands regularly, particularly if there is a risk that the glands may be blocked with fibrous tissue or stagnant meibum, i.e. signs or symptoms of meibomian gland dysfunction (MGD). Applying pressure to the glands regularly can disrupt the normal production and flow of meibum. Important new book about Dry Eye and Meibomian gland dysfunction. Usually it is best to rely on blinking, the process which naturally expresses meibum from the meibomian glands and onto the tear film, rather than on manual expression. Occasionally, when there is a specific purpose for expressing meibomian glands, after meibomian gland probing for example, expression may be useful.
- It may help to clear debris, thickened meibum, or other unwanted material from the meibomian gland, ensuring that the gland has a good chance of producing and expressing meibum naturally.
- In this case, expression would be performed in the office by a health care provider.
- There are different brands of forceps available to doctors.
Some are available to patients. Leduc Meibomian Forceps Mastrota Paddle Rotating Meibomian Gland Forceps Tearse Meibomian Expressor Forceps When expressing with a sterile cotton swab, the swab is placed against the inner side of the eye lid while gentle pressure is applied with another swab, or a finger, to the outer skin of the eye lid.
What destroys meibomian glands?
Demodex mites and MGD – Demodex are microscopic mites that live in the meibomian glands, and eyelashes. The mites come out during the night to eat the skin cells of your eyelids, and lay eggs and expel waste products in your eyelid glands, and eyelash follicles.
What happens if meibomian gland dysfunction is left untreated?
What Is Meibomian Gland Dysfunction (MGD)? – Meibomian Gland Dysfunction (MGD) results when the Meibomian glands cease to function optimally. Blocked glands cannot secrete the oils necessary for maintaining a healthy tear film, MGD is believed to be the most common form of lid margin disease —and is thought to be the leading cause of dry eye disease,
- However, MGD is more than just ‘dry eyes’ or ‘sore eyes’.
- These symptoms may get much worse for those with MGD and, if left untreated, MGD can result in permanent damage to the eyes.
- MGD can exist as a single disorder but is often associated with several other diseases such as posterior blepharitis, anterior blepharitis, primary meibomianitis and/or seborrheic dermatitis.
Though the term “MGD” covers a wide number of conditions, the major symptoms are blocked oil glands with thickened secretions, If left untreated, these chronically clogged glands are unable to secrete oil and permanent changes in the tear film will result as well as chronic dry eyes.
The recognition and treatment of MGD will result in eliminating dryness, inflammation and discomfort and is very simple to treat. Patients with MGD often have red, puffy eyes which have implications socially and at work while the itchiness reduces quality of life. It is often impossible for patients with MGD to wear contact lenses.
Diagnosis and treatment of MGD is also a very important step in avoiding complications with cataract and refractive surgery,
What is the difference between blepharitis and Meibomianitis?
Blepharitis & Meibomianitis Blepharitis and meibomianitis are common eyelid conditions that can cause redness, dry eye, eye and/or eyelid infections and may also be associated with skin conditions such as rosacea. There are two forms of blepharitis: 1) anterior, which affects the outer lid and typically involves excessive crusting build up around the eyelashes 2) posterior, which is commonly referred to as meibomianitis.
- This is where the meibomian glands that reside anterior to the eyelashes become plugged and inflamed.
- It is not uncommon for a person to have both anterior and posterior blepharitis.
- Symptoms of these conditions include burning, flaking, crusting, irritation, and redness.
- Treatment options your doctor may choose to treat these conditions include topical antibiotic, topical anti-inflammatory, an oral antibiotic, omega 3 supplements, eyelid wash, and warm compresses.
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How do I know if my meibomian gland is blocked?
Symptoms – The eyelids can become sore and swollen as the glands become blocked. As the eyes become dry, they can feel itchy or gritty, as if there’s something in the eye. The eyes may be red, and if they’re sore, may be watery, which can cause vision to become blurry.
Is blepharitis caused by poor hygiene?
Blepharitis Causes Chronic cases can develop through: Poor hygiene. Seasonal allergies. Ocular rosacea.
What foods to avoid if you have blepharitis?
What can trigger blepharitis? Can stress be a trigger too? – Some people can be genetically predisposed to blepharitis. In some cases, there are possible environmental factors that could trigger a flare-up such as age, diet and certain skin conditions like rosacea,
- We don’t fully understand why some people get blepharitis and others do not.
- In my experience, certain foods may trigger blepharitis.
- These include processed or fried foods, sugar, white flour and fizzy drinks tends to aggravate the condition.
- I have also found that a varied diet with plenty of fruits, vegetables and high intake of natural Omega-3 containing foods helps reduce flare-ups.
Contact lens-wear can also make it worse so it is recommended to hold-off wearing them until it clears up. Whilst there is no evidence to prove that stress is a trigger, we know that stress can deplete vitamins and alter metabolic pathways in the body and can possibly play a role for some people who are more susceptible to stress.
How long does it take to unblock meibomian glands?
iLux – iLux is a treatment that can warm and unplug the meibomian glands. This device provides heat and gentle pressure in the eyelids to open blocked glands and stimulate the release of oil. The overall treatment lasts between 8–12 minutes at your optometrist’s office. Previous research found that iLux can improve dry eye symptoms in as little as 4 weeks,
How long does it take for meibomian glands to heal?
Small glands are located inside the upper and lower eyelids. These are called meibomian glands. They secrete oils that keep the tears from evaporating too quickly and prevent dry eyes. If your meibomian glands become blocked by thickened oils, your eyes will become dry and may feel irritated.
Is ice or heat better for swollen meibomian glands?
When a Warm Compress for Eyes is Appropriate – Warm compresses are used to soothe aches and pain, relax muscle spasms and joints, increase circulation and help heal injuries. A warm compress is particularly useful to treat dry eye syndrome caused by meibomian gland dysfunction.
- Meibomian glands, which are located on the rim of the eyelids, secrete lipids (oils) that help slow the evaporation of tears.
- When meibomian glands malfunction or become plugged, tears evaporative too quickly, resulting in dry eye.
- A warm compress can be used to help melt away stagnant secretions from the meibomian glands, which allows the glands to produce the oils needed to slow the evaporation of tears.
Warm compresses are also commonly used to treat blepharitis, a common eyelid inflammation that sometimes accompanies,
What reduces eyelid inflammation?
The eyelid is a complex, fully functioning skin tissue that consists of eyelashes, tear glands (lacrimal), sweat glands (glands of Zeis or Moll), and sebaceous (oil or meibomian) glands. These tissues can develop inflammatory reactions, leading to a swollen eyelid.
Allergies Clogged oil glands in your eyelid (called a chalazion )Eyelid infection (called a stye )Infection around your eye socket (called orbital cellulitis )Inflamed eyelids (called blepharitis ) Pink eye (called conjunctivitis) Shingles Thyroid conditions such as Graves’ disease
Depending on the cause, you may experience swelling in one or both eyelids. Most of these conditions are not serious, but you should make sure to clean and care for your eyes if your eyelid is swollen. The treatment for a swollen eyelid depends on the cause.
If you have an eye infection, you may need to use antibiotic eye drops, ointment, or other topical medication — meaning a medication to be applied on the body — to help remove the infection and ease your symptoms. Your doctor may give you antibiotics or steroids to take orally if the topical treatment is ineffective.
To relieve eyelid swelling and keep your eyes clear and healthy, try these home remedies for swollen eyelids: Apply a Compress Run a clean cloth under warm water and hold it gently on your eyes. Do this twice a day for 15 minutes at a time to help loosen crusty discharge and get rid of any oil that might be plugging your glands.
Gently Wash the Area After using a compress, use a cotton swab or washcloth to gently clean your eyelids with diluted baby shampoo. Make sure to rinse your eye area well afterward. You can also use a saline solution to rinse the area if you have any discharge or crust around your eye or in your eyelashes.
Leave Your Eyes Alone While you have symptoms, don’t wear eye makeup or contact lenses. Get plenty of sleep and avoid direct sunlight so your eyes can rest. Use Eye Drops Use over-the-counter artificial tears to keep your eyes moist and comfortable. Antihistamine drops can help with allergies and may help if your eyelid is swollen due to allergens.
- Eyelid swelling usually goes away on its own within a day or so.
- If it doesn’t get better in 24 to 48 hours, you should call your primary care physician or see your eye doctor,
- Your doctor will ask about your symptoms and examine your eye and eyelid.
- Your doctor will ask questions about other symptoms or changes that may be causing your eyelid or eyelids to swell.
These could include contact with allergens or irritants, infections, or other health conditions. Children frequently experience eye irritation, typically from touching their eyes with unwashed hands. But there are several possible causes for eyelid swelling in children in addition to the causes listed above.
Rubbing the eye: Children often rub their eyes for various reasons but especially after getting an irritant in their eye.Insect bite near the eye: The loose tissues around the eye swell easily, which can happen as a reaction to a mosquito or other insect bite. Contact dermatitis near the eye: Contact with poison ivy, detergents, or other irritants may affect the eyelid.
To treat your child, try these home remedies: Cold Pack Apply ice or a cold pack wrapped in a clean, wet washcloth to the eye for 15 to 20 minutes at a time to decrease eyelid swelling and pain. Allergy Medicine You can safely give your child an allergy medicine or antihistamine by mouth.
- This will help to decrease eyelid swelling and itching.
- Benadryl every 6 hours or so is best.
- Eye Drops For eyelid swelling that interferes with your child’s vision, use a long-lasting vasoconstrictor eye drop (such as a tetrahydrozoline, like Visine).
- No prescription is needed.
- The recommended dose is one drop every eight to 12 hours as needed for one to two days.
You should seek emergency medical care or call your doctor right away if you or your child experience:
Drooping of the eyelidFever that won’t breakLight sensitivity, seeing flashing lights or wavy linesLoss of vision or double visionSevere redness, inflammation, and a hot feelingSevere swelling (the eye is shut or almost shut)
What is Meibomitis also known as?
Clinical significance – Meibomian glands in the lower eyelid imaged under amber light to show vasculature support and the gland structure. Dysfunctional meibomian glands often cause dry eyes, one of the more common eye conditions. They may also contribute to blepharitis, Inflammation of the meibomian glands (also known as meibomitis, meibomian gland dysfunction, or posterior blepharitis ) causes the glands to be obstructed by thick, cloudy-to-yellow, more opaque and viscous-like, oily and waxy secretions, a change from the glands’ normal clear secretions.
Besides leading to dry eyes, the obstructions can be degraded by bacterial lipases, resulting in the formation of free fatty acids, which irritate the eyes and sometimes cause punctate keratopathy, Meibomian gland dysfunction is more often seen in women and is regarded as the main cause of dry eye disease,
Factors that contribute to meibomian gland dysfunction can include things such as a person’s age and/or hormones, or severe infestation of Demodex brevis mite. Treatment can include warm compresses to thin the secretions and eyelid scrubs with a commercial eyelid cleanser as multiple studies have shown baby shampoo to be therapeutically ineffective, or emptying (“expression”) of the gland by a professional.
- Lifitegrast and Restasis are topical medication commonly used to control the inflammation and improve the oil quality.
- In some cases, topical steroids and topical (drops or ointment)/oral antibiotics (to reduce bacteria on the lid margin) are also prescribed to reduce inflammation.
- Intense pulsed light (IPL) treatments have also been shown to reduce inflammation and improve gland function.
Meibomian gland probing is also used on patients who experience deep clogging of the glands. Meibomian gland dysfunction may be caused by some prescription medications, notably isotretinoin, A blocked meibomian gland can cause a chalazion (or “meibomian cyst”) to form in the eyelid.
What is the difference between blepharitis and Meibomitis?
Often bacteria enter these glands, which can contribute to blepharitis and meibomitis. Meibomitis causes the glands to become irritated and inflamed, whereas with blepharitis, the roots of the eyelashes are affected.
What is the medical term for eyelid inflammation?
What Is Blepharitis? – Blepharitis is the persistent inflammation of the eyelids. The membrane covering the eyelid and eyeball (conjunctiva) can also become inflamed. Blepharitis is a common condition and often occurs in otherwise healthy people. The condition rarely threatens the eye itself or causes permanent loss of vision.
What is the other name for meibomian gland?
Disease – Figure 1. Dr. Heinrich Meibom. Reprinted with permission of the Herzog August Bibliothek, Wolfenbu¨ttel, Germany, Signatur B 100 Meibomian glands or glandulae tarsales are large sebaceous glands present in eyelids which secrete lipids that form the superficial layer of tear film to protect evaporation of the aqueous phase.
These glands were first described in detail by German physician Heinrich Meibom (1638-1700) and named after him (Fig 1). There are about 25-40 glands in the human upper eyelid and about 20-30 in the lower eyelid with lengths of about 5.5 mm in upper eyelid versus 2 mm in lower eyelid in Caucasian eyes.
Each gland consists of clusters of about 10-15 secretory acini in the upper eyelid which secrete lipid material through small ductules via a central duct at the lid margin contributing to the outermost layer of the tear film. The contraction of the orbicularis muscle during blinking and the contraction of Riolan muscle at the terminal part of the ductal system generates mechanical force that facilitates the secretion of meibum. Figure 2. Images demonstrating representative cases of each grade of the meibomian gland changes. The upper and lower eyelids were turned over and meibomian glands were observed using an infrared transmitting filter and an infrared charge-coupled device video camera.
Changes in meibomian glands were scored using the following grades in each eyelid (meiboscore): grade 0, no loss of meibomian glands; grade 1, area loss was less than one third of the total meibomian gland area; grade 2, area loss was between one third and two thirds; grade 3, area loss was more than two thirds.
Reprinted with permission from American Academy of Ophthalmology from the article by Arita, Reiko et al (2008), Noncontact Infrared Meibography to Document Age-Related Changes of the Meibomian Glands in a Normal Population Ophthalmology, 115: 911-915.
Orb and Henriquez coined the term Meibomian Gland Dysfunction (MGD) in a study addressing contact lens intolerance and the obstruction of the Meibomian gland orifices by desquamated epithelial cells. The International Workshop on MGD defined the disease as “a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/ quantitative changes in the glandular secretion.
It may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular surface disease”. Images of normal and progressive gland loss in patients with MGD are shown in Figure 2.