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Meibomian Gland Dysfunction and Dry Eye
Definition
Symptoms
Meibomian gland Dysfunction (MGD) is a
chronic diffuse abnormality of the meibomian
gland commonly characterized by terminal
duct obstruction which may result in
alteration of the tear film.
Prevalence is found to be greater than
60% in population studies from Asia.
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Pathogenesis of MGD
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Meibomian gland located in the tarsal plates
of the eye lids opens at the posterior lid
margin. It is the chief source of lipids for the
human tear film and functions in stabilizing
the tear film. It forms a protective barrier
against microbes, dust and pollen. MGD is an
obstruction of terminal ducts.
Factors such as age,sex,hormonal
disturbances and topical medication influence
the obstructive process. MGD results in
increased evaporation and instability of the
tear film. It increases bacterial growth on the
lid margin,evaporative dry eye and ocular
surface inflammation.
Clinical
Irritation in eye
Clinically apparent inflammation
Ocular surface disease
Signs of MGD
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Meibomianitis –plugging of the
meibomian duct opening
Frothy discharge
Toothpaste sign
Blocked duct
Diagnosis of MGD
MGD in symptomatic patients:
- Orifice plugging or lid margin signs of
MGD
- Applying moderate digital pressure over
the central third of the lower and upper
lids to determine the extent and severity.
MGD in asymptomatic patients:
- Non- obvious MGD may be diagnosed by
gland expression digital pressure over the
eye lid
Prevalence - presence; Alteration - changes; Microbes - microorganism like bacteria; Frothy - covered with a mass of small bubbles;
Toothpaste sign - when squeezed hard enough, a secretion that has the appearance of toothpaste squeezed from a tube.
A R A V I N D
E Y E
C A R E
S Y S T E M
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Test for dry eye
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Administration of a symptom
questionnaire
Measurement of the blink rate and
calculation of the blink interval
Measurement of lower tear meniscus
height
Measurement of tear osmolarity (if
available)
Instilling of fluorescein and measurement
of the tear film break up time (if but) and
ocular protection index
Grading of corneal and conjunctival
fluorescein staining
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Schirmer’s test or alternate test [phenol
red thread test]
Treatment for MGD related dry eye
MGD related dry eye requires
- Supplementation and stabilization of
lipid deficient tear film.
- Rehydration and lubrication of the ocular
surface with topical lubricants are the
main stage of treatments.
- Warm compresses 2-3 times day
- Lid scrubs and eye lid massage
- Anti -inflammatory antibiotics such as
tetracycline and omega-3 fatty acids.
- Sr.Thenmozhi
OP, Aravind - Coimbatore
Digital glasses for lazy eyes
Lazy eye or amblyopia occurs in one eye, which did not develop normal vision and
become lazy . Traditionally drops and eye patches are used to cure this lazy eye. Recently
programmable electronic glasses are invented to improve vision in the children.
Amblyopia has to be treated before the age of eight for better results. It can be treated
till seventeen. Researchers at the Glick Eye Institute tested the effectiveness of this digital
glasses.
The researchers recruited 33 subjects with lazy eye, aged 3-8. In the study the lens over
the lazy eye switched from clear to opaque, every 30 seconds. After three months there was a
good improvement in the lazy eye.
The US Food and Drug administration (FDA) had approved the amblyopia occlusion
glasses as a medical device. They are available for 450 dollars there.
-www.medicalnews. 16 Nov 2015
Compassion Oct - Dec, 2015