Optometrists have considered meibomian gland dysfunction (MGD) as an age-related disease; however, meibomian gland dropout is now being noted in the younger population, especially in females for unknown reasons.5 Every day we see MGD patients in our practices. Dry eye and ocular irritation are common reasons that patients seek eye care.6
Meibomian gland imaging was first described in 1977, using a transillumination technique. Meibography allows evaluation of the gland structure and may help in the diagnosis and treatment of MGD. Thanks to advances in technology, we now have access to high quality imaging in everyday practice.
Meibomian gland imaging clearly has a role, yet most practitioners aren’t looking at meibomian glands at all.7 Possible reasons for this may include lack of time, MGD is not sight threatening, patients may not comply unless overtly symptomatic, and they may not see it as a profitable endeavor.
Previously from Dr. Schachter: Dry eye checklist may help ODs treat patients more efficiently
Dry eye disease overall affects an increasing number of Americans and is expected to affect approximately 29 million by 2022.1 The Beaver Dam Offspring Study showed dry eye prevalence of 14.5 percent,2 of which, studies have shown meibomian gland dysfunction (MGD) prevalence of 78 percent to 86 percent.3,4
Meibomian gland dysfunction has many untoward effects. Studies have shown increased ocular symptoms (Figure 1) such as itching, burning, watering and redness, thickened meibum, increased superficial punctate keratitis, and decreased tear film break-up time.8
Not only are patients uncomfortable, vison is adversely affected.9 When a tear film breaks up uniformly, the most power change possible across the ocular surface is 0.10 D. When it breaks up irregularly, power changes of up to 1.30 D can occur, causing higher order aberrations.10 This can cause blurred, fluctuating vision and can also result in inaccurate preoperative measurements prior to refractive and cataract surgery.
In addition, two recent studies have shown a correlation between cardiovascular disease and MGD, underscoring its potential significance to overall patient health.10,11