Meibomitis

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.

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Current Meibomitis Medical Journal News...

Ocular toxicities of epidermal growth factor receptor inhibitors and their management.

Related Articles

Ocular toxicities of epidermal growth factor receptor inhibitors and their management.

Cancer Nurs. 2007 Jul-Aug;30(4 Suppl 1):S10-6

Authors: Basti S

Epidermal growth factor receptor (EGFR) inhibitors have become an important therapy for patients with malignant solid tumors, such as non-small cell lung, breast, ovarian, colorectal, renal, esophageal, sarcoma, mesothelioma, prostate, head and neck, and pancreatic cancers. Although these agents are generally well tolerated, some adverse effects will likely occur. The most common adverse effect associated with use of EGFR inhibitors is an acne-like rash. Less reported in the literature are adverse ocular reactions, which occur in approximately one third of patients and can cause significant discomfort. The ocular toxicities that may occur with use of EGFR inhibitors can be broadly categorized as changes in the eyelids (eg, squamous blepharitis, trichomegaly, meibomitis), changes in the tear film (eg, dysfunctional tear syndrome), and miscellaneous changes (eg, iridocyclitis, corneal epithelial defect). Early recognition and management of these adverse ocular reactions are necessary to improve patient comfort, to facilitate compliance, and to avoid interruption of therapy. This article describes the adverse ocular effects reported to occur with use of EGFR inhibitors and presents specific strategies to manage these effects. Mild eyelid and tear film changes usually can be managed by the oncology and nursing staff. More severe ocular reactions require involvement of an ophthalmologist.

PMID: 17666986 [PubMed - indexed for MEDLINE]