title: Emerging strategies for the diagnosis and treatment of meibomian gland dysfunction: Proceedings of the OCEAN group meeting.
abstract: Meibomian gland dysfunction (MGD) is a common and chronic disorder that has a significant adverse impact on patients' quality of life. It is a leading cause of evaporative dry eye disease (DED), as meibomian glands play an important role in providing lipids to the tear film, which helps to retard the evaporation of tears from the ocular surface. MGD is also often present in conjunction with primary aqueous-deficient DED. Obstructive MGD, the most commonly observed type of MGD, is the main focus of this article. MGD is probably caused by a combination of separate conditions: primary obstructive hyperkeratinization of the meibomian gland, abnormal meibomian gland secretion, eyelid inflammation, corneal inflammation and damage, microbiological changes, and DED. Furthermore, skin diseases such as rosacea may play a part in its pathology. Accurate diagnosis is challenging, as it is difficult to differentiate between ocular surface diseases, but is crucial when choosing treatment options. Ocular imaging has advanced in recent years, providing ophthalmologists with a better understanding of ocular diseases. This review presents a literature update on the 2011 MGD workshop and an optimized approach to accurate diagnosis of MGD using currently available methods and tests. It also outlines the emerging technologies of interferometry, non-contact meibography, keratography and in vivo confocal laser microscopy, which offer exciting possibilities for the future. Selected treatment options for MGD are also discussed.
authors.affiliation: Department of Ophthalmology, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany. Electronic address: geerling@med.uni-duesseldorf.de.
authors.forename: Gerd
authors.initials: G
authors.lastname: Geerling
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, University Paris-Saclay, Paris, France. Electronic address: chrbaudouin@aol.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Baudouin
authors.affiliation: Institute of Ophthalmology, Department of Biomedical Sciences, University of Messina, Messina, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Aragona
authors.affiliation: Ocular Surface Centre, ISPRE Ophthalmics, Genoa, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rolando
authors.affiliation: Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Kostas G
authors.initials: KG
authors.lastname: Boboridis
authors.affiliation: Hospital Clínico San Carlos, University Complutense, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Benítez-Del-Castillo
authors.affiliation: Department of Ophthalmology, Bayındır Hospital, Ankara, Turkey.
authors.forename: Yonca A
authors.initials: YA
authors.lastname: Akova
authors.affiliation: Instituto Universitario Fernández-Vega, University of Oviedo, Asturias, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Merayo-Lloves
authors.affiliation: Service d'Ophtalmologie, CHU Bicêtre, APHP, Université Paris-Sud, Le Kremlin-Bicêtre, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labetoulle
authors.affiliation: Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: Steinhoff
authors.affiliation: Department of Ophthalmology, Ludwig Maximilian University, Munich, Germany.
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Messmer
mesh_terms: D005141:Eyelid Diseases; D006126:Group Processes; D006801:Humans; D008537:Meibomian Glands; D011788:Quality of Life; D013666:Tears
keywords: Dry eye disease; Meibomian gland dysfunction