Meibomian gland dysfunction

Perry HD, Doshi-Carnevale S, Donnenfeld ED, et al. Efficacy of commerciaUy available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction. Cornea 2006 25 171-175. 

A significant positive correlation has been observed between the levels of inflammatory cytokines in the conjunctival epithelium and the severity of ocular irritation symptoms and corneal fluorescein staining. The inflammatory cytokines and other inflammatory mediators also correlate positively to severity of conjimctival squamous metaplasia in Sjogren patients. These proin-flammatory cytokines also have been implicated in regulation of epithelial mucin expression, with several studies suggesting inflammation is central to the pathogenesis of meibomian gland dysfunction as well. 

Mixed seborrheic-staphylococcal blepharitis Posterior lid margin Meibomian gland dysfunction Meibomian seborrhea Meibomitis Primary Secondary... 

Driver PJ, Lemp MA. Meibomian gland dysfunction major review. Surv Ophthalmol April-March 1996 40 343-366. 

Olson MC, Korb DR, Greiner JV. Increase in tear film Upid layer thickness following treatment with warm compresses in patients with meibomian gland dysfunction. Eye Contact Lens 2003 29 96-99. 

Sullivan D, SuUivan B, Evans J, et al. Androgen deficiency, meibomian gland dysfunction, and evaporative dry eye. Ann N Y Acad Sci 2002 966 211-222. 

Propionibacterium acnes, commonly isolated from the skin, is the most frequently found anaerobe. Factors and conditions such as blepharitis, dry eye syndrome, meibomian gland dysfunction, and contact lens use may influence the composition of the normal flora or cause disruption to normal epithelial microbial barriers, either of which can lead to disease in susceptible patients. Although immunocompromised individuals may harbor Candida albicans, fungi are considered opportunistic pathogens. Little evidence supports the existence of any indigenous fungi in the normal conjunctival flora. 

There are many other causes of RCE, but they occur much less frequently. Among these causes are chemical or thermal burns, herpes simplex keratitis, neuroparalytic keratitis, bullous keratopathy, severe dry eyes, nocturnal lagophthalmos, diabetes mellitus, meibomian gland dysfunction, ocular rosacea, and Alport syndrome. Approximately 5% to 30% of RCEs occur spontaneously without any known predisposing fector. 

The lipid composition is kept within physiological limits by androgens [17]. The decrease of their secretion in elderly people is one of the reasons for development of dry eye syndrome. Patients with Meibomian gland dysfunction show a high tear film evaporation rate and a high tear osmolality [18, 19]. 

Cuevas M, Gonzalez-Garcia MJ, Castellanos E et al (2012) Correlations among symptoms, signs, and clinical tests in evaporative-type dry eye disease caused by meibomian gland dysfunction (MGD). Curr Eye Res 37 855-63... 

Green-Church KB, Butovich I, Willcox M et al (2011) The international workshop on Meibomian gland dysfunction report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease. Invest Ophthalmol Vis Sci 52 1979-93... 

The eyes are the organs most sensitive to SM injury. Acute effects are conjunctivitis, with dry eye, pain and photophobia. More than 60% of eye injuries recover and vision is restored. The remaining patients develop chronic or delayed-onset mustard gas keratopathy (MGK). Khateri et al (2003) reported that 35% of injured veterans had mild ocular injury (dry eye, conjunctival scarring and decreased visual acuity) and 3.6% had moderate injury that included some corneal involvement. Severe symptoms were described in fewer than 1% of patients. MGK is characterized by chronic blepharitis, meibomian gland dysfunction, dry eye, perilimbal conjunctival ischemia. 

The mechanical properties of CL became particularly important after the marketing of the first Si-Hy contact lenses, as these materials induced changes to the ocular surface that were not commonly seen with less stiff HEMA-based materials. Most of these issues have been addressed by new Si-Hy materials while others need further investigation, such as the potential interaction of Si-Hy with the eyelids in the development of lid wiper epitheliopathy or meibomian gland dysfunction [32]. During the past 12 years, we learnt how critical mechanical properties are in the production of these materials. 

Evaporative dysfunction is caused by a reduction in the lipid layer of the tear film. Most often, this condition is caused by MGD or blepharitis. MGD is traditionally conceptualized as a triad of meibomianitis (stagnated secretions within the meibomian glands), meibomian seborrhea (overabundance of meibomian secretions into the tear film), and seborrheic blepharitis (oily debris visible on the eyelashes and ocular adnexal surfeces). Additionally, we have become increasingly aware of the influence of male hormones, or androgens, on the health of the meibomian glands. Clinically significant androgen deficiency, which naturally occurs in women of menopausal age and men in... 

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