TESTING FOR "low meibum production" and "poor meibum quality"

[Ariel]

Rebecca mentioned the following on a three-year-old post:

" How many people with chronic lid margin disease (that probably describes a lot of us here) have clear freely running meibum that just needs the orifice punctured? Seems to me like poor meibum production and/or poor consistency meibum are the problems most of us have. For those that have hardened caps which don't respond to warm compresses or gentle at-home lid massage, they can typically be expressed by an ophthalmologist with a 'paddle'. And if the glands are atrophied... that's yet another ballgame...."

I've been under the impression that all that could be wrong with the meibomian glands was their being temporarily obstructed or permanently atrophied. So I believed that whenever the MGs were temporarily clogged, unless there was a problem with tear production or with the mucin layer, periodically opening the orifices was all that was needed to restore the chemical composition of a healthy tear.

Rebecca mentioned in the enclosed posting the problem can also be "low meibum production" or "bad maibum quality" so if you have your meibomian glands examined and they are not clogged or inflamed, you may think they are fine and you'll be completely wrong.

I've prepared a list of tests I would like to have done by my opthalmologist so that my DE condition can be properly studied and diagnosed, which hasn't happened yet. I imagine the tear film osmolarity test will detect a meibum production or quality problem.

● Schirmer's I
● Tear Breakup time
● Tear Meniscus height
● Fluorescein staining
● Rose Bengal staining
● Tear film osmolarity
● Impression cytology
● Brush cytology
● Tear lactoferrin
● mucin layer
● goblet cell density
● blepharitis (visual inspection)
● meibonian glands (visual inspection)
● skin disorders (dermatitis, rosaceat, etc.)
● demodex
● H Pylory


Is low meibum production or poor meibum quality always a chronic condition for everyone?

[sanna]

I have haerd that it can sometimes be stress that cause this (a lot of bad stress!)
and when you are less stressed it can go away.

I do not know if everyone that has MGD has dry skin but when you are stressed you could have dry skin also.

(I have also heard of women having dryeyes when they are pregnant but when the baby is born the eyes start to feel better).

The bad thing about this is that the dry eyes usually makes you feel more stressed.