title: In vivo examination of meibomian gland morphology in patients with facial nerve palsy using infrared meibography.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of orbicularis oculi weakness on meibomian gland morphology using infrared meibography.
  
  
  METHODS
  This was a cross-sectional study. Patients were recruited from the University of Iowa Hospitals and Clinics. Inclusion criteria required the patient to be at least 18 years of age and have a unilateral facial nerve palsy. A total of 32 affected eyelids from 20 patients were studied. The aforementioned participant group was examined using infrared video meibography. The contralateral unaffected eyelids served as control. Eyelids with previous surgery were excluded. Data collected included age and gender in addition to laterality, duration, and cause of the palsy. Each eyelid was assigned a "meibograde" based on morphological changes of the meibomian glands.
  
  
  RESULTS
  The main outcome measure was the "meibograde" based on infrared morphology of the meibomian glands. Fourteen upper and 18 lower eyelids affected by facial nerve palsies of various durations were examined. Mean patient age was 57.6 years (range 20-86). The affected lower eyelid meibograde (n = 12) was significantly different than the control (p = 0.001) in patients with weakness for more than 3 months. No difference was found in the upper eyelids at less than (n = 6) or more than (n = 8) 3 months duration. Similarly, the lower eyelids affected for less than 3 months (n = 6) showed no statistically significant difference.
  
  
  CONCLUSIONS
  Over time, weakness of the orbicularis oculi is associated with morphological changes in the lower lid representing increased meibomian gland dysfunction. This may represent an overlooked cause of ocular surface disease in patients with facial nerve weakness.
authors: Department of Ophthalmology & Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
authors: Conley B
authors: CB
authors: Call
authors: Ryan J
authors: RJ
authors: Wise
authors: Marlan R
authors: MR
authors: Hansen
authors: Keith D
authors: KD
authors: Carter
authors: Richard C
authors: RC
authors: Allen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005154:Facial Nerve / Q000503:physiopathology; D005158:Facial Paralysis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007259:Infrared Rays; D008297:Male; D008537:Meibomian Glands / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D018908:Muscle Weakness / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009801:Oculomotor Muscles / Q000294:innervation; D011859:Radiography; D055815:Young Adult