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Dry-Eye Disease
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Signs of meibomian gland dysfunction (MGD) are present in 30–35% of Caucasian individuals (Viso et al., 2009, 2012, 2014; Hashemi et al., 2014) and in 33–50% of Asian individuals (Tian et al., 2009; Han et al., 2011; Siak et al., 2012; Arita et al., 2019), rising to 51.8–60.8% in the over-65 age group (Lin et al., 2003; Han et al., 2011; Siak et al., 2012). In an Iranian population-based study, the prevalence of MGD was 26.3% in an adult population (Hashemi et al., 2017), rising to 71.2% in the over-60s age group (Hashemi et al., 2021). It is recognized, however, that up to two-thirds of the disease may be asymptomatic (Viso et al., 2012) and that age-related lid and gland changes underpin high rates of asymptomatic disease in older adults. A systematic review of interethnic disparities in the natural history of DED suggested that meibomian gland changes were apparent earlier in life in South-East Asian compared with Caucasian eyes (Wang and Craig, 2019). In comparison with studies exploring signs and symptoms of dry eye, several studies have suggested a higher prevalence of MGD in males (up to 2.5×) compared with females (Arita et al., 2019; Hashemi et al., 2021).
Photophobia and Anterior Uveitis
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
The eyelids: Are examined for meibomian gland dysfunction and blepharitis, which mainly involves looking for scales at the level of the eyelashes or rows of blocked meibomian glands behind the eyelashes, which can sometimes secrete a toothpaste-like substance when handled.
Ophthalmologic Side Effects
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Isotretinoin changes the structure of the meibomian glands by decreasing the density of goblet cells and increasing the thickness and keratinization of the meibomian gland ducts at the histologic level in rabbits, leading to a lower lipid content and smaller acini (13). Human meibomian glands also become less dense and atrophic in shape after isotretinoin treatment, which can be demonstrated noninvasively with meibomiography. This condition further induces changes in the thickness of meibum, a decrease in the volume of secreted meibum, and increased tear osmolarity (14). Representative clinical images of a patient with meibomian gland dysfunction (MGD) are seen in Figure 12.1.
Ocular Surface Disease in Glaucoma Patients
Published in Current Eye Research, 2023
Christina Scelfo, Reem H. ElSheikh, Muhammad M. Shamim, Javaneh Abbasian, Alireza Ghaffarieh, Abdelrahman M. Elhusseiny
Meibomian gland dysfunction plays a prominent role in ocular surface disease in the setting of glaucoma.89,90 New modalities such as the thermal pulsatile system (Lipiflow®) augment traditional therapies such as lid hygiene and warm compresses.91 One study by Kasetsuwan et al.92 aimed to evaluate the use of this in glaucoma patients with MGD. Patients were randomized to receive either Lipiflow with lid hygiene versus lid hygiene alone. Meibomian gland expression was scored and compared, and additional outcome measures included OSDI score, Schirmer I score, TBUT, corneal staining, LLT, and meibography score. Gland expression score (p = 0.404), OSDI (p = 0.57), LLT (p = 0.351), and meibography score (p = 0.479) improved after 6 months in each group compared to baseline, but no significant difference was found in these outcomes between groups. In addition, the authors comment that change in meibomian gland expression score, although improved, was smaller than prior studies not involving glaucoma patients.93–95 One reason for this may be the more advanced MGD in the glaucoma population compared to patients with MGD without a history of glaucoma or frequent topical drop use.92
Association between dry eye disease, self-perceived health status, and self-reported psychological stress burden
Published in Clinical and Experimental Optometry, 2021
Michael TM Wang, Alex Muntz, James S Wolffsohn, Jennifer P Craig
Participants were assessed at a single site, with a mean ± SD room temperature of 20.3 ± 0.5°C and a mean ± SD relative humidity of 63.5 ± 6.4%. Assessments for all ocular surface parameters were conducted on the right eye of each participant, with the exception of tear osmolarity measurements, which were performed in both eyes. Clinical assessments were conducted in accordance with the recommendations of the TFOS DEWS II Diagnostic Methodology subcommittee.24 To minimise the impact on ocular surface and tear film physiology for subsequent tests, clinical assessments were performed in ascending order of invasiveness,24 as listed in Table 1, with an interval of at least 60 seconds between measurements to minimise the impacts of reflex tearing. The diagnostic criteria for dry eye disease, aqueous tear deficiency, and meibomian gland dysfunction were based on the global consensus recommendations of the Tear Film and Ocular Surface Society Dry Eye Workshop II and the International Workshop on Meibomian Gland Dysfunction,24,25 as summarised in Figure 1.
Characterization and Management of Inflammatory Eye Disease in Patients with Hidradenitis Suppurativa
Published in Ocular Immunology and Inflammation, 2021
Daniel J. Lee, Sapna Desai, Emily Laurent, Laura J. Kopplin
In our present study, some overlap was observed between HS and KCS (2.5% of patients). However, we found inconsistencies in charting and diagnosis codes of KCS to be common, confounding our analysis. We sought to minimize possible overdiagnosis of KCS in our study by only including subjects with ocular exam findings consistent with KCS; however, this may have resulted in the exclusion of patients effectively treating their KCS and an underestimate of the true rate of KCS in the HS population. Meibomian gland dysfunction was not evaluated in our study, but possible association between Meibomian gland dysfunction and HS should be explored in future studies. A large number of the identified KCS patients had other concurrent systemic autoimmune disease, which further confounds elucidating a relationship between HS and KCS.