Meibomian Gland Dysfunction during Contact Lens Wear | OOLS |
Dr. May Bakkar, an associate professor and a contact lens(CL) expert begins by stating the need for an eye care practitioner to study CL complications. She elaborates on the SOAPE format for assessing and managing CL related complications. She mentions some of the resources available for students and practitioners to learn more about the complications. She classifies the CL complications based on the frequency of how commonly they are seen among the patients, the reason why patients discontinue, and the mechanism of complication. We learn the definition of Meibomian Gland Dysfunction as defined by current research, the anatomy, and physiology of the glands. We briefly overview the tear film and the function of the meibomian glands in maintaining the tear film integrity. Then Dr. Bakkar, discusses how the tear film changes when a patient is wearing contact lenses leading to dry eye disease. We also discuss how the contact lens actually affects the meibomian glands. This allows us to understand how a patient with meibomian gland disease would present itself and how best can we assess them.
1. Symptoms (16:15)
2. Dry eye assessment (16:42)
3. Signs (17:12)
4. Differential diagnosis (18:40)
5. Meibomian Gland assessment (20:00)
a. Meibomian gland expressibility (20:28)
b. Meibography (21:04)
c. Interferometry (22:00)
d. Blink and lid margin assessment (22:40)
6. Management of meibomian gland dysfunction (23:12)
Lastly, Dr. Bakkar summarizes her talks and the session ends with a Q and A for the live audience.
References:
Papers
Review of contact lens related complications
Lim CHL, Stapleton F, Mehta JS. Review of Contact Lens-Related Complications. Eye Contact Lens. 2018 Nov;44 Suppl 2:S1-S10.
https://pubmed.ncbi.nlm.nih.gov/29373389/
Alipour F, Khaheshi S, Soleimanzadeh M, Heidarzadeh S, Heydarzadeh S. Contact Lens-related Complications: A Review. J Ophthalmic Vis Res. 2017 Apr-Jun;12(2):193-204.
https://pubmed.ncbi.nlm.nih.gov/28540012/
Nagachandrika T, Kumar U, Dumpati S, Chary S, Mandathara PS, Rathi VM. Prevalence of contact lens related complications in a tertiary eye centre in India. Cont Lens Anterior Eye. 2011 Dec;34(6):266-8.
https://pubmed.ncbi.nlm.nih.gov/21795098/
Meibomian gland dysfunction and contact lenses
Nichols KK, Foulks GN, Bron AJ, Glasgow BJ, Dogru M, Tsubota K, Lemp MA, Sullivan DA. The international workshop on meibomian gland dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011 Mar 30;52(4):1922-9.
https://pubmed.ncbi.nlm.nih.gov/21450913/
Arita R, Itoh K, Inoue K, Kuchiba A, Yamaguchi T, Amano S. Contact lens wear is associated with decrease of meibomian glands. Ophthalmology. 2009 Mar;116(3):379-84.
https://pubmed.ncbi.nlm.nih.gov/19167077/
Meibography
Pult H, Riede-Pult BH, Murphy PJ. A new perspective on spontaneous blinks. Ophthalmology. 2013 May;120(5):1086-91.
https://pubmed.ncbi.nlm.nih.gov/23399377/
Websites
2020 IACLE Course
https://iacle.org/programs/iacle-contact-lens-course/
Watch the complete session below:
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