Authors
Doga A.V., Borzenok S.A., Mushkova I.A., Karimova A.N., Khubetsova M.Kh., Ostrovskiy D.S., Obraztsova M.R.
S.N. Fyodorov Eye Microsurgery Federal State Institution of the Russian Ministry of Health, Moscow
Abstract
Dysfunction of the meibomian glands, characterized by obstruction of the terminal excretory ducts of the meibomian glands and accompanied by qualitative and/or quantitative changes in the secretion of these glands, is the main cause of the evaporative form of dry eye syndrome due to the lack of proper intake of phospholipids into the lipid layer of the tear film. The main complaints of patients with dysfunction of the meibomian glands and associated evaporative dry eye syndrome are a feeling of sand and dry eyes, irritation of the edges of the eyelids, redness of the ocular surface. In this regard, an important aspect is timely screening of the condition of the ocular surface for dysfunction of the meibomian glands and dry eye syndrome for optimal and comfortable visual work. The article presents a clinical case of a course of conservative treatment to restore the ocular surface and secretory work of the meibomian glands using a microsurgical instrument for eyelid massage developed on the basis of the scientific and technical department.
Keywords: Tear film, dysfunction of the meibomian glands, dry eye syndrome, keratorefractive surgery.
References
1. Nichols KK, Foulks GN, Bron AJ, Glasgow BJ, Dogru M, Tsubota K, Lemp MA, Sullivan DA. The international workshop on meibomian gland dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011;52 (4):1922-1929. doi: 10.1167/iovs.10-6997a.
2. Novack GD, Asbell P, Barabino S, Michael VW, Joseph B, Gary NF, Goldstein M, Michael AL, Schrader S, Stapleton F. FOS DEWS II Clinical Trial Design Report. Ocul Surf. Author manuscript. 2017; 15(3): 629-649. doi: 10.1016/j.jtos.2017.05.009.
3. Viso E, Rodriguez-Ares MT, Abelenda D, Oubiña B, Gude F. Prevalence of asymptomatic and symptomatic meibomian gland dysfunction in the general population of Spain. Invest Ophthalmol Vis Sci. 2012; 53(6): 2601-2606. doi: 10.1167/iovs.11-9228.
4. Foulks GN, Bron AJ. Meibomian gland dysfunction: a clinical scheme for description, diagnosis, classification, and grading. Ocul Surf. 2003;1(3): 107- 126. doi: 10.1016/s1542-0124(12)70139-8.
5. Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI, Yee R, Yokoi N, Arita R, Dogru M. The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):2006-2049. doi: 10.1167/iovs.10-6997f.
6. Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, Gupta PK, Karpecki P, Lazreg S, Pult H, Sullivan BD, Tomlinson A,Tong L, Villani E, Yoon KC, Jones L, Craig JP. TFOS DEWS II Diagnostic Methodology report. Ocul Surf. 2017;15(3):539-574. doi: 10.1016/j.jtos.2017.05.001.
7. Patent RUS №216164. Byul.№2. Mushkova I.A., karimova A.N., Obraztsova M.R. Microsurgical instrument for massage of the meibomian glands in their dysfunction [URL]. Link active on 01.19/2023. (in Russ.)
8. Qiao J, Yan X. Emerging treatment options for meibomian gland dysfunction. Clin Ophthalmol (Auckland, NZ). 2013;7:1797-1803. doi: 10.2147 /OPTH.S33182.
9. Maskin SL. Intraductal meibomian gland probing relieves symptoms of obstructive meibomian gland dysfunction. Cornea. 2010;29(10):1145-1152. doi: 10.1097/ICO.0b013e3181d836f3.
10. Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis) Trans Am Ophthalmol Soc. 2008;106:336-356.
11. Narang P, Donthineni PR, D’Souza S, Basu S. Evaporative dry eye disease due to meibomian gland dysfunction: Preferred practice pattern guidelines for diagnosis and treatment. Indian J Ophthalmol. 2023; 71(4): 1348-1356. doi: 10.4103/IJO.IJO_2841_22.
12. Matsumoto Y, Sato EA, Ibrahim OM, Dogru M, Tsubota K. The application of in vivo laser confocal microscopy to the diagnosis and evaluation of meibomian gland dysfunction. Mol Vis. 2008;14:1263-1271.
13. Downie LE, Craig JP. Tear film evaluation and management in soft contact lens wear:A systematic approach. Clin Exp Optom. 2017;100 (5):438-458. doi: 10.1111 /cxo.12597.
