Meibomian keratoconjunctivitis.
We evaluated, dermatologically and ophthalmologically, 26 patients who had chronic blepharitis (meibomitis); we also investigated 26 age- and sex-matched controls. All of the blepharitic patients had an abnormality of sebaceous gland function ranging from seborrhea sicca to seborrheic dermatitis or acne rosacea, suggesting a generalized sebaceous gland dysfunction that included the meibomian glands. Sebaceous gland abnormalities most frequently involved the cool areas of the face or scalp. Stagnation of the meibomian glands presumably caused a defect in the tear lipid layer; this resulted in an unstable tear film that produced superficial punctate keratopathy. The break-up time was much lower in these patients than in controls. The break-up time returned to normal or super-normal levels when fresh meibomian secretions were expressed into the tear film. The superficial punctate keratopathy had the characteristics of those seen in conditions with a known unstable tear film and not of those experimentally produced by staphylococcus toxin.
D000328:Adult; D000368:Aged; D001762:Blepharitis / Q000150:complications* / Q000382:microbiology; D012628:Dermatitis, Seborrheic / Q000150:complications; D005141:Eyelid Diseases / Q000150:complications*; D005143:Eyelids / Q000378:metabolism*; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications; D007637:Keratoconjunctivitis / Q000209:etiology* / Q000382:microbiology; D007766:Lacrimal Apparatus Diseases / Q000150:complications; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism* / Q000382:microbiology; D008875:Middle Aged; D012393:Rosacea / Q000150:complications; D013666:Tears / Q000502:physiology