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Tim Willis, Caroline A. Blackie, Donald R. Korb; Meibomian Gland Function, Lid Wiper Epitheliopathy, And Dry Eye Symptoms. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3740.
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To evaluate the grade of lid wiper epitheliopathy (LWE) in individuals symptomatic for dry eye with reduced meibomian gland (MG) function.
Eligible non-contact-lens-wearing patients presenting for routine eye examinations were fully consented (according to the tenets of the Declaration of Helsinki) and enrolled in the study (n=24; 19 females; 5 males). Patients were required to report their symptoms using the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Patients with a SPEED score of greater than or equal to 6 (maximum score = 28) were considered symptomatic for dry eye. Meibomian gland expression (MGE), the only method to determine the functionality of an individual MG, was performed using a standardized instrument which exerts ~0.3 PSI over the lower lid MGs. The total number of MGs yielding liquid secretion (MGYLS, therefore functional glands) were recorded and only those with 4 or fewer MGYLS were admitted to the study. Fluorescein and lissamine green, (2 instillations of drops each, 5 min apart) were used to diagnose any LWE. LWE was graded on a scale of 0 - 4. Data is presented for right eyes only.
The mean age of patients = 45.2±14.3. The mean number of MGYLS = 2.1±1.3. The mean symptom score = 12.3±4.3. The mean grade of LWE = 2.0±0.5.
Patients reporting dry eye symptoms are very likely to also have reduced MG function and LWE. Reduced MG function indicates a treatment protocol which targets improving MG function rather than simply increasing artificial lubrication as might be indicated for isolated LWE. This small study indicates a need to perform standardized MGE on all patients who are symptomatic for dry eye to evaluate MG function in order to optimize any treatment plan.
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