Dry eye is ubiquitous. Its causes are manifold and varied and include long-term contact lens wear, medications, aging, pregnancy and meibomian gland dysfunction (MGD). MGD is now recognized as the leading cause of dry eye. MGD is commonly associated with inflammation and pouting glands, but is most often “non-obvious” without any signs of inflammation noted with standard clinical evaluation techniques.
It is crucial to be able to diagnose MGD. Many patients who present with the typical complaints of dry eye will hae normal tear secretion or a mixed form of dry ye with tear insufficiency and MGD.
Classic signs of MGD include pouting or inspissated meibomian glands, crossing telangiectasias, and eryrthema of the lid margins often associated with rosacea. A cotton swab often is used to express the meibomian technology (LipiView, TearScience) is available to make the diagnosis easier, along with a therapeutic device (LipiFlow Thermal Pulsation System, TearScience) designed to assist in the management of patients with MGD.