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Meibomitis and Lasik, Bladeless Lasik, PRK, LASEK, Epi-Lasik, etc.

Image showing clogged meibomian glands.  
Clogged meibomian glands contribute to dry eye and are a contraindication for Lasik.  

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

Cause and Symptoms

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.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

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

Recent Meibomian Gland Dysfunction Medical Journal Articles...

Related Articles

Meibomian Glands and Ocular Surface Inflammation.

Ocul Surf. 2015 Apr;13(2):133-149

Authors: Suzuki T, Teramukai S, Kinoshita S

The purpose of this review was to systematically analyze publications related to the role of meibomian gland disease in ocular surface inflammation, with special reference to meibomitis as an inflammatory form of meibomian gland dysfunction (MGD). Meibomian gland inflammation is often present with the ocular surface inflammation in conditions such as blepharokeratoconjunctivitis, ocular rosacea, and phlyctenular keratitis, but its contribution is often overlooked, especially in younger subjects. This can result in misdiagnosis, mistreatment, and, sometimes, severe visual impairment. We identified a related disease entity, seen predominantly in young patients, of ocular surface inflammation associated with meibomitis, which we termed meibomitis-related keratoconjunctivitis. Its specific clinical features are similar to those observed in the above-mentioned diseases, and the inflammatory form of MGD was found to be closely involved in the ocular surface inflammation seen in those four diseases, based on our statistical evaluation. The diagnosis and management of meibomitis, an inflammatory form of MGD, is vital for the successful treatment of the induced ocular surface inflammation. We propose that the ocular surface and the adnexal meibomian glands should be considered as one unit, i.e., the "meibomian gland and ocular surface" (MOS), when encountered in the clinical setting.

PMID: 25881997 [PubMed - as supplied by publisher]


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