What is Meibomitis, Causes, Sign & Symptoms, Treatment

1. What is Meibomitis

• Meibomitis, a chronic inflammatory condition of the meibomian glands.

• This condition is closely related to Meibomian Gland Dysfunction (MGD) and is a major cause of evaporative dry eye disease.

2. What are Meibomian Glands?

• Definition: Meibomian glands are specialized sebaceous glands located in the eyelids.

• Function: They secrete meibum, an oily substance that forms the outer lipid layer of the tear film.

Importance:

• Prevents rapid evaporation of tears.

• Maintains tear film stability.

• Provides smooth optical surface for clear vision.

• Acts as a barrier against microbes and irritants.

3. Location of Meibomian Glands

• Found in tarsal plates of the eyelids (both upper and lower).

• Number of glands:

• Around 25–40 in upper eyelid.

• Around 20–30 in lower eyelid.

• They open at the lid margin, just behind the eyelashes.

4. Structure of Meibomian Glands

• Long, vertical tubular glands embedded in the tarsal plate.

Each gland has:

Acini (glandular units): produce the meibum (lipid secretion).

Central duct: collects and carries meibum.

Orifice at lid margin: releases oil into the tear film.

Controlled by holocrine secretion (the whole cell breaks down to release oil).

5. Importance of Meibomian Glands

Tear Film Balance: They form the lipid layer of the tear film.

Prevents Dry Eye: By reducing tear evaporation.

Maintains Corneal Health: By providing smooth refractive surface and protecting ocular surface.

Defense: Prevents contamination by bacteria and foreign substances.

6. Meibomitis (Pathophysiology)

Definition: Chronic inflammation of the meibomian glands.

Causes:

Inflammation & blockage of gland ducts.

Bacterial overgrowth (commonly Staphylococcus).

Altered composition of meibum (thick, waxy, turbid).

Association with blepharitis and ocular rosacea.

Result: Poor quality lipid secretion → unstable tear film → evaporative dry eye.

7. Symptoms of Meibomitis

Itchy, gritty, or sore eyes.

Redness along eyelid margins.

Blurry or fluctuating vision.

Dry eye sensation, especially in evening.

Burning or stinging.

Tired eyes and discomfort.

8. Complications

Chronic dry eye syndrome.

Recurrent chalazion.

Secondary blepharitis.

Corneal epithelial damage and keratitis.

9. Treatment of Meibomitis

A. Home Care

Warm compresses: Softens blockages, improves oil flow.

Lid hygiene: Cleaning with diluted baby shampoo or commercial lid scrubs.

Lid massage: Helps express meibum.

B. Medications

Antibiotics: Oral tetracyclines (e.g., doxycycline, azithromycin) for bacterial control.

Topical antibiotics/antiseptics in severe cases.

Steroid drops: To reduce acute inflammation.

C. Professional Treatments

In-office procedures: thermal pulsation devices, intense pulsed light (IPL), meibomian gland probing.

D. Supplements

Omega-3 fatty acids: Improve lipid quality of meibum.

Adequate hydration & nutrition.

Meibomian glands are crucial for ocular surface health and tear film stability.

Meibomitis is a chronic condition that leads to discomfort, dry eye, and visual problems if untreated.

Early diagnosis, proper lid hygiene, and appropriate therapy can control the disease and preserve eye comfort and vision.

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What is Meibomitis, Causes, Sign & Symptoms, Treatment