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Kallosum > MGD > Flashcards

MGD Flashcards

1
Q

Meibum consists of

A

lipids containing wax and cholesterol esters

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2
Q

upper eyelid: average length and how many meibomian glands

A

Average length 5mm

25-40 meibomian glands

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3
Q

Lower eyelid: average length and how many meibomian glands

A

Avg length 2mm

20-30 glands

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4
Q

Meibum is produced by

A

Acinus- terminal structure of the ducts

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5
Q

Meibium moves through

A

Small ductules to the central duct then towards the orifice/opening.

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6
Q

Blinking facilities

A

the meibum secretion and circulation

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7
Q

Normal blink rate

A

15 blinks/min. In front of computer avg 5 blinks/min

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8
Q

Role of healthy meibum

A

Reduced evaporation, enhance stability and spreading, provides smooth optical surface for the cornea.
Tear film breaks up uniformly and the most power across the ocular surface is 0.1D. In irregular tear film, power changes of up to 1.3D can occur with high order aberrations.
Prevents contamination of tear film by sebum, prevents spillover, seals the apposing lid margins.

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9
Q

MGD

A

Chronic, diffuse abnormality of the meibomian glands, characterized by terminal duct obstruction and qualitative/quantitative changes in the glandular secretion.

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10
Q

MGd may result in

A

Alteration of tear film, Symptoms of eye irritation: discomfort, redness, excessive tearing, gritty/burning sensations, ocular pain, vision problem. Clinically apparent inflammation, Ocular surface disease.

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11
Q

Typical changes in MGD

A

Obstruction, dilation, cystic changes of mg ducts, and stagnant secretion leads to:
Loss of function, morphological changes, atrophy, gland drop out.

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12
Q

Evaporative stress results in broad spectrum of ocular surface mods

A

Lack of lubricity, eyelid morphological changes, increased osmolarity, ocular surface inflamation, corneal hyperalgesia, neuropathic pain.

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13
Q

Risk factors for MGD

A

Age, ethnicity, hormonal changes, immune and skin diseases, meds, environmental factors.

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14
Q

Ant. Blepharitis

A

Ant. Bleph is chronic inflammation of the ant eyelid margin and eyelashes, associated with irritation, burning sensation, redness and itchiness of the eyelids, crusting.

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15
Q

Ant. Blepharitis and MGD

A

Associated with staphylococcus, demodex mite.
Risk factors: seborrheic dermatitis, rosacea, eczema.
Complications: eyelid hypertrophy, mg ducts blockage, scarring.

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16
Q

Post. Blepharitis

A

Chronic inflammation of the inner eyelid, associated with symptoms of dry eye: irritation, burning, fbs, excessive tearing. Worse as the day goes on.

17
Q

Post. Bleph and MGD

A

Associated with MGD.
Risk factors : Systemic immune disorders.
Complications: Fibrosis of meibomian glands, with loss of function

18
Q

Demodex

A

Mite infestation of the eyelids, giving rise to chronic blepharitis.
Itching, burning, fbs, crusting, and lid margin redness.

19
Q

Demodex and MGD

A

Cause by:
Demodex folliculorum which tends to cluster to the root of the lashes leading to ant. bleph.
Demodex brevis which attacks sebaceous and meibomian glands leading to MGD and keratoconjunctivitis.
Risk factors: Age and rosacea.
Complications: Blepharoconjunctivitis, keratoconjunctivitis, corneal mods (neo, infiltrates, opacities, scarring).

20
Q

Rosacea

A

Long term skin condition that typically affects the facte and results in redness, swelling, and dilated superficial blood vessels.

21
Q

Rosacea and MGD

A

Periocular and ocular forms are reported.
Majority of patients with acne rosacea complain of ocular symptoms. Rosacea is associated with sebaceous gland hypertrophy and meibomian glands are also affected.
Eyelid changes represent up to 90% of cases, ant. bleph. present in %50.

22
Q

Dry Eye

A

Multifactorial disease of ocular surface characterized by loss of homeostasis of tear film, Ocular symptoms in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities.

23
Q

DE and MGD

A 
Aqueous deficient DE (autoimmune disease, disorder of lacrimal functional unit)
Evaportative DE (MGD, deformities of lacrimal functional unit)
Mixed DE
24
Q

Cl and MGD

A

Some recent studies have suggested Cl wear may be associated with adverse change in: Meibomian gland morphology/structure and condition of the lid margin and meibum.

25
Q

Cl wearers complain of ocular symptoms that could be attributed to:

A

Diminished aqueous or mucin layer of tear film. Changes in tear protein concentration. Altered meibomian gland structure or function.

26
Q

Long term meds and MGD

A

Preservatives.
Benzalkonium cholride (BAK) cytotoxic effects- deleterious effects on comfort and vision.
Active ingredient prostaglandins can be the irritating element.

27
Q

Meiboscopy

A

Visualisation of the meibomian glands

28
Q

Meibography

A

Imaging evaluation of the meibomian glands morphological structure.
Assess and look for shortening, distortion, and dropout through obstruction.

29
Q

Meibometry

A

Lid margin reservoir

30
Q

Meibomian gland transillumination (Meiboscopy)

A

Meiboscopy and the transmitted IR rays are captured with a camera. Can be seen through slit lamp and meibomian gland evaluator.
8 central glands are observed.
Meibomian gland drop out score.

31
Q

Meibum described as

A

Clear, light, yellow - Normal

Cloudy, cloudy with debris, thick or paste like, or no expression.

32
Q

MGD treatment protocol Stage 1

A

Pt asymptomatic, minimal MGD clinical signs

Inform; educate patient in dietary and lifestyle changes and eyelid hygiene

33
Q

MGD treatment protocol Stage 2

A

Pt Minimal symptoms, minimal to mild MGD clinical signs, limited staining
Non preservative AT, topical Ab (azithromycin), consider oral AB (tetracycline)

34
Q

MGD treatment protocol Stage 3

A 
Pt moderate symptoms, Moderate MGD clinical signs, mild -moderate staining
Oral AB (tetracycline), lubricant ointment at bedtime, consider anti inflammatory therapy (short term steroids and/or restasis)
35
Q

MGD treatment protocol Stage 4

A

Pt marked symptoms, Severe MGD clinical signs, increase staining, signs of inflammation
Anti inflammatory therapy (short term steroids and/or restasis)

36
Q

While A.T. are valuable and important treatment

A

Supplementing tears without properly treating meibomian glands will lead to therapeutic failure.

37
Q

Demodex treatment

A

Combination of lid scrubs and removal of eyelash collarettes in the office, followed by lid cleaning and rigorous treatment at home.
Tea tree oil based and non tea tree oil (hypochloric acid and okra based formulas).

Kallosum (3 decks)

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