Do most optometrists think to look at and evaluate the meibomian glands in everyday practice?
With the majority of treatments, both over-the-counter and prescription, focusing on tear supplements and the increase of the natural tear, there may not have been a shift in focus or thinking by most practitioners.
Undoubtedly, poor aqueous production will result in a compromised tear film and ultimately ocular surface disease. However, with a poor lipid component in the tear film, evaporation of the tears will surely cause a breakdown of the ocular surface and cause symptoms to occur.
Meibomian gland dysfunction and its role in ocular surface disease is an increasingly common topic. In fact, the Tear Film & Ocular Surface Society formed a subcommittee whose sole purpose was to evaluate the meibomian glands.1
Examining the blink
Blinking occurs about once every three to four seconds in most patients.2 However, when one uses a digital device or reads, blink rates slow to 4.5 per minute,2 or once every 13.5 seconds.
If a slowed blink rate is then combined with other factors that may affect eyelid mobility (such as lagopthalmos, scarring, ectropion, etc.), that patient is at serious risk for meibomian gland atrophy and ultimately chronic ocular surface disease.1
Early detection is important when it comes to meibomian gland dysfunction prevention. While we know that dry eye disease is more prevalent with increasing age,3 it’s likely that many meibomian gland problems may be occurring much earlier in life.4,5
Related: Diagnosing and treating lagopthalmos