Induced videokeratography alterations in patients with excessive meibomian secretions.
OBJECTIVE
To describe lipid-induced specific videokeratographic (VKG) corneal changes and subsequent resolution after eyelid washing.


METHODS
VKG was performed with C-Scan corneal topography. In all patients an excessive meibomian gland lipid secretion was found with or without coexistent chronic posterior blepharitis. After the initial VKG, a meticulous cleaning of the lids with a mild alkali shampoo (10% Johnson's baby shampoo in sterile water) was done, first by gently scrubbing the closed eyelid fissure with the solution to mobilize and emulsify any Meibomian gland secretions followed by cleaning of the upper and lower margins individually, using Q-tip applicators soaked in the detergent.


RESULTS
Three patients with tear film lipid layer excess (TFLE), which correlated with the presence of a superior or central corneal steepening in VKG, were studied. In two of the subjects, careful lid washing reversed either completely or partially this VKG effect, whereas in the last patient the VKG changes after artificially increasing the tear film lipid content is described.


CONCLUSIONS
Meibomian gland lipid secretions may induce mainly superior and occasionally central VKG corneal steepening that is not correlated with any slit-lamp pathologic findings. Computerized corneal topography can help detect such corneal abnormalities, and their reversibility may distinguish them from other pathologic conditions (such as contact lens-induced warpage, eccentric ablations, irregular astigmatism, superior keratoconus).
Markomanolakis
Marinos M
MM
Vardinoyannion Eye Institute of Crete, Crete, Greece.
Kymionis
George D
GD
Aslanides
Ioannis M
IM
Astyrakakis
Nikolaos
N
Pallikaris
Ioannis G
IG
D000328:Adult; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D019781:Corneal Topography; D005141:Eyelid Diseases / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D005260:Female; D006801:Humans; D008055:Lipids / Q000009:adverse effects*; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism*; D008875:Middle Aged; D007507:Therapeutic Irrigation / Q000379:methods
D008055:Lipids