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Meibomitis

Meibomitis and Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, CK, etc.


Meibomitis, also known as Meibomian Gland Dysfunction, is a potential contraindication for all cornea based refractive surgery procedures, especially Lasik and All-Laser Lasik, but a patient with meibomitis may be an appropriate refractive surgery candidate if the problem is manageable and treated.

Dysfunction of these glands causes tears to evaporate more rapidly and leads to symptoms of dryness, burning, and irritation. There is a natural bacteria that thrives on the corneal surface. These bacteria can colonize the meibomian glands and cause problems.

The number one reason the glands dysfunction is because they get clogged up. The reason they get clogged up is usually due to hormonal changes - changes in estrogen levels can cause a thickening of the oils. It has been suggested that changes in estrogen levels also cause a proliferation of the staphylococcal bacteria that inhabit the eyes and these bacteria invade the meibomian glands and thrive there. The double trouble caused by the thickening of the oils plus the bacteria gradually decrease the secretion of oils from the glands. Oral and topical antibiotics are often prescribed.

You can keep the gland oils from solidifying by using warm compresses as they help to melt the lipid "plug".

Punctal occlusion can provide some relief from the symptoms of dry eye, however this may not be the best response for meibomitis. Using temporary plugs may show if occlusion will help. If the temporary plugs do not provide any relief, then this is a good indication that the permanent plugs will not work. If the temporary plugs provide any relief at all, then permanent plugs make sense.
The medication Restasis is the anti-inflammatory cyclosporine in an ophthalmic eye drop that may be helpful for meibomian gland dysfunction and related dry eye. Discuss Restasis with your doctor.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.


Current Meibomitis Medical Journal News...

Hyperosmolarity of the Tear Film in Dry Eye Syndrome.

Related Articles

Hyperosmolarity of the Tear Film in Dry Eye Syndrome.

Dev Ophthalmol. 2010;45:129-138

Authors: Messmer EM, Bulgen M, Kampik A

Hyperosmolarity of the tear film is recognized as an important pathogenetic factor in dry eye syndrome (DES). Hyperosmolarity testing has been hampered in the past by difficulties in tear collection and analytic procedures that required laboratory facilities. The Tearlab(TM) Osmolarity System is a new user-friendly tool that only needs tiny volumes for analysis and determines hyperosmolarity semi-automatically. We measured tear film osmolarity with the Tearlab in 200 healthy individuals and patients with DES. Dry eye diagnosis was established when >/=3 of the following criteria were fulfilled:(1) Ocular Surface Disease Index > 15; (2) staining of the cornea in the typical interpalpebral area; (3) staining of the conjunctiva in the typical interpalpebral area; (4) tear film break-up time < 7 s; (5) Schirmer test < 7 mm in 5 min; (6) the presence of blepharitis or meibomitis. Tear film osmolarity, as measured by Tearlab, did not show any correlation with the 6 clinical signs of dry eye. Moreover, tearfilm osmolarity testing could not discriminate between patients with DES (308.9 +/- 14.0 mosm/l) and the control group (307.1 +/- 11.3 mosml/l). Tear film osmolarity did not correlate to artificial tear use. Technical problems with the Tearlab, reflex tearing, or the difficulty in establishing a dry eye diagnosis with the recommended tests may account for these results. Further investigations are necessary before recommending this tool for daily clinical practice.

PMID: 20502033 [PubMed - as supplied by publisher]

 

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Last updated Monday, April 12, 2010

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