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Meibomian gland loss, how much do Dr’s know?

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  • Milo007
    replied
    Originally posted by Topher3 View Post
    I understand the common literature on meibomian gland atrophy and loss. And I too believe that it’s true. However I was wondering after seeing a comment on a post on here about how some doctors aren’t too sure that gland loss is as cement fact as most believe. Have they performed meibographies on cadavers and then conducted an analysis of the body? Have doctors seen meibomian gland loss in the flesh? I’m curious, are meibographies as much hard evidence as we need to be certain?
    Hello Topher3

    Good question. I think the point is if meibography doesn't detect the presence of glands (dark empty areas) then it is pretty obvious that there has been a structural change in the glands (provided the instrument used is of very high precision and quality like the lipiview/lipiscan or keratograph 5M and the meibography was done properly).

    Now the second consideration is that if meibography doesn't detect the presence of glands in some areas of the tarsus then it's again not the case that some remnant or altered form of the glands are not present there. This is because we have clear evidence of gland regrowth as recorded by meibography. So the "blank" portions in a meibography (where glands are supposed to be present) is most probably some morphologically altered condition of the atrophied acini that isn't "imaged" by the meibography (technical limitation) but they are very much there. Only some lucky people have witnessed gland regrowth where the structural existence of the atrophied glands were restored to normal.

    What caused the regrowth?

    Probably the activation of some chemical pathway that acted as a trigger for the stem cells to initiate gland regrowth. We all know stem cells have the ability to regrow tissues and meibomian glands do host stem cells.

    So there's definitely a chance of something being present even though meibography does not image the atrophied portions of the glands.

    Hopefully we will have better instruments in future with greater precision that can image the structural modification of the atrophied portions of the glands.

    Leave a comment:


  • deep_dry_eye
    replied
    You bring up great questions! Unfortunately, I don't have any answer to you. I also suspect nobody knows for sure. Unfortunately, dry eye disease does not get a lot of scientific or medical research funding.

    Leave a comment:


  • Topher3
    started a topic Meibomian gland loss, how much do Dr’s know?

    Meibomian gland loss, how much do Dr’s know?

    I understand the common literature on meibomian gland atrophy and loss. And I too believe that it’s true. However I was wondering after seeing a comment on a post on here about how some doctors aren’t too sure that gland loss is as cement fact as most believe. Have they performed meibographies on cadavers and then conducted an analysis of the body? Have doctors seen meibomian gland loss in the flesh? I’m curious, are meibographies as much hard evidence as we need to be certain?
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