title: Conservative treatment of meibomian gland dysfunction.
abstract: OBJECTIVE
  To evaluate the effectiveness of lid hygiene and preservative-free artificial tears for the treatment of meibomian gland dysfunction (MGD) during a 6-week period.
  
  
  METHODS
  Suitable patients with MGD were educated about their disease and instructed to begin a regimen of lid hygiene, which included the application of a heated saline solution and the use of nonpreserved artificial tears. Baseline measurements obtained at the time of enrollment included basic tear secretion test, tear breakup time, a questionnaire grading MGD symptoms (i.e., burning, irritation, itching, sharp pains, foreign body sensation, and hazy vision), and lid margin slitlamp photographs. All measurements except for basic tear secretion were repeated at the 6-week follow-up visit. Photographs were unlabeled, and two cornea specialists graded them in a masked fashion for the presence of lid erythema, irregularity, thickness, meibomian gland capping, and telangiectasis.
  
  
  RESULTS
  Thirty-seven patients with a clinical diagnosis of MGD were enrolled, and 26 patients (70%) completed the study. Initial measurement of basic tear secretion averaged 17 mm and was more than 10 mm in 81% of eyes. The tear breakup time was prolonged by an average of 3.4 seconds; in 30% of cases, it was normalized to 10 seconds or more. Symptoms improved in 88% of cases; among those, symptoms were graded mild or less in 83%, and none in 39%. Photographs before and after treatment were not significantly different.
  
  
  CONCLUSIONS
  In this noncontrolled case-cohort study of selected patients with MGD, lid hygiene and preservative-free artificial tears significantly improved tear breakup time and relieved symptoms of the condition.
authors.affiliation: Department of Ophthalmology, The New York Eye & Ear Infirmary, New York, NY, USA.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Romero
authors.forename: Seth A
authors.initials: SA
authors.lastname: Biser
authors.forename: Henry D
authors.initials: HD
authors.lastname: Perry
authors.forename: David H
authors.initials: DH
authors.lastname: Levinson
authors.forename: Sima J
authors.initials: SJ
authors.lastname: Doshi
authors.forename: Anthony
authors.initials: A
authors.lastname: Terraciano
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnenfeld
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects* / Q000378:metabolism; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism
chemical_list: D009883:Ophthalmic Solutions; D012965:Sodium Chloride