This article is more than 5 years old. Information may no longer be current.
Committee aims to hone meibomian gland dysfunction diagnosis, treatment
Click Here to Manage Email Alerts
FORT LAUDERDALE, Fla. — A team of clinicians is devoted to refining the classification of meibomian gland dysfunction by developing diagnostic and treatment protocols and making research recommendations, a speaker said here.
J. Daniel Nelson, MD, was one of a number of speakers to report preliminary findings and strategies of the International Workshop on Meibomian Gland Dysfunction at the Association for Research in Vision and Ophthalmology meeting. The workshop was sponsored by the nonprofit organization Tear Film and Ocular Surface Society.
"Any classification system that we choose needs to be useful both for the clinician and the researcher," Dr. Nelson said. "The committee felt that one based upon pathophysiological changes was one that was most important and useful."
The committee's proposed classification system breaks down meibomian gland dysfunction into low delivery and high delivery states of secretion and obstructive conditions.
"Primary causes are used to describe conditions for which no discernable etiology or cause can be found," Dr. Nelson said. "All of these conditions can lead to alterations in the tear film, eye irritation, clinically apparent inflammation and ocular surface disease, including dry eye."
Meibomian gland dysfunction is not synonymous with blepharitis or meibomitis, Dr. Nelson said.
"Oftentimes, meibomian gland dysfunction and posterior blepharitis are used as synonymous terms, but these terms are not interchangeable," he said. "Meibomian gland dysfunction is often present without inflammation."
In addition, meibomian gland dysfunction must be distinguished from meibomian gland disease and chalazion, a type of localized gland inflammation, Dr. Nelson said.
As we learn more about the problems associated with the meibomian glands and the eyelids, and as we develop new and improved therapies for the problems they cause, it is time for a review of our classification system for diseases of the tear film and eyelids. Whether you tend to be a “lumper” — calling these issues “ocular surface disease” — or a “splitter” — knowing the many subcategories — an advanced classification system is important for assistance in directing therapy. Still, our main problem in clinical practice is just identifying the patient with ocular surface disease and giving it the attention it deserves. We have many therapies for this problem, and more are becoming available for it, so it is important to realize that it is a clinical issue with which patients want our help.
– David R. Hardten, MD
OSN
Cornea/External Disease Section Editor
Follow OSNSuperSite.com
on Twitter.