Increase in Tear Film Lipid Layer Thickness Following Treatment of Meibomian Gland Dysfunction

Abstract

Meibomian gland lipid secretions contribute to the formation of a stable tear film. Meibomian gland dysfunction may result in dry eye symptoms, keratoconjunctivitis (Keith, 1967; McCulley and Sciallis, 1977) and contact lens intolerance (Henriquez and Korb, 1981), presumably due to an inadequate tear film lipid layer secondary to the meibomian gland dysfunction (MGD) itself. The presence of dysfunctional meibomian glands can often be indicated by serrated and inflamed eyelid margins, although in some instances, signs of inflammation may be lacking. In contrast to normal meibomian glands whose orifices open easily and secrete transparent sebum upon gentle expression, the dysfunctional meibomian gland requires forceful digital pressure to elicit expression of sebum, which is generally cloudy in appearance. Frequently, sebum may not be released from dysfunctional meibomian glands even with forceful digital pressure. The present prospective study evaluated whether a program of manual expression of the meibomian glands of patients with a diagnosis of MGD could increase tear film lipid layer thickness by relieving meibomian gland obstruction.