MEIBOMIAN GLAND DISEASE

Course overview

MEIBOMIAN GLAND DISEASE (MGD) IS A BROAD TERM INVOLVING MEIBOMIAN GLAND DYSFUNCTION THAT RESULTS IN ALTERED MEIBOMIAN GLAND SECRETIONS AND TEAR-FILM ABNORMALITIES. MGD CAN BE CONGENITAL OR ACQUIRED BUT IS MORE COMMONLY ACQUIRED IN NATURE. IT IS SEEN MORE COMMONLY WITH ADVANCING AGE BUT ALSO TYPICAL IN YOUNGSTERS, PARTICULARLY THOSE INVOLVED IN EXCESSIVE DIGITAL DEVICE USE, EXPOSED TO WIND OR EXTREME SUNLIGHT CONDITIONS, OR CONTACT LENS USERS. MGD AFFECTS THE MEIBUM SECRETIONS, WHICH LEADS TO BLOCKED MEIBOMIAN DUCTS AND THUS DECREASED LIPID SECRETION, ALTERING THE TEAR FILM COMPOSITION. THE REDUCED TEAR FILM STABILITY RESULTS IN INCREASED EVAPORATION, HYPEROSMOLARITY, INFLAMMATION, AND OCULAR SURFACE DISORDER. MGD SEVERITY IS BASED ON STAGING, INCLUDING SYMPTOMS, CORNEAL AND CONJUNCTIVAL STAINING, AND QUALITY OF MEIBUM SECRETIONS. DIAGNOSIS IS BASED ON SIMPLE TESTS THAT CAN BE DONE IN THE OUTPATIENT DEPARTMENT AND INCLUDES THE DETERMINATION OF OCULAR SYMPTOMS USING SPECIFIC QUESTIONNAIRES. TREATMENT DEPENDS ON WHETHER THE PATIENT IS DIAGNOSED IN AN ASYMPTOMATIC OR SYMPTOMATIC STAGE AND SEVERITY AT TREATMENT INITIATION. THIS ACTIVITY HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE MANAGEMENT OF PATIENTS WITH MEIBOMIAN GLAND DISEASE.