Photobiomodulation (low-level light therapy) and dry eye disease
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Abstract:
Dry eye disease is one of the most common, chief-complaints presenting in clinical practice, with a prevalence of up to 50%. Evaporative dry eye, as a result of meibomian gland dysfunction, is thought to be the biggest component factor. Treatments for meibomian gland dysfunction aim to restore tear film homoeostasis and include warm compress therapy, eyelid hygiene, in-office meibomian gland expression and lipid-containing, artificial tears. A recent introduction to the in-office treatments available for meibomian gland dysfunction has been low-level light therapy, also known as photobiomodulation. The technique involves applying red, or near infra-red, radiation using low-power light sources and is suggested to promote tissue repair, decrease inflammation, and relieve pain. This work aims to review the available literature on the efficacy and safety of photobiomodulation in meibomian gland dysfunction and dry eye disease, as well as what is currently known about its mechanism of action.Keywords:
Meibomian gland
Artificial tears
Purpose. To investigate the effect on meibomian gland function of super pulse carbon dioxide (CO2) laser excision in the treatment of eyelid tumors at palpebral margin. Methods. 36 patients with 36 and within 1 mm to palpebral margin were recruited in this study. Of which, 16 cases with tumors in the upper eyelid and 20 cases in the lower eyelid were involved. The eyelid tumors of all the patients were treated by super pulse CO2 laser with its power density varied between 0.6 and 21.1 W/mm2 and in repeat mode. The laser spot size ranged from 120 to 200 μm. Ocular surface parameters including tear film break-up time (BUT) and meibograde, meibum expressibility, and meibum quality were evaluated at pretherapy, 1 week, 1 month, and 3 months posttherapy in all 36 patients. Result. All the patients were satisfied with the therapy. No infective complications and recurrence occurred in any of the 36 patients at the following period. The eyelid wound recovered well with nearly normal appearing after 2 to 3 weeks. The morphology of limbi palpebralis, BUT, meibograde, meibum expressibility, and meibum quality of all the 36 patients showed no significant difference before and after the therapy. Conclusions. Super pulse CO2 laser had no effect on meibomian gland function and morphology in the excision of tumors at palpebral margins, which was an efficacy and well-tolerated therapy with lower complications and recurrence.
Meibomian gland
Palpebral fissure
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The sebaceous gland carcinoma is a very rare highly malignant tumour of the eyelid arising from sebaceous glands of the eyelid, such as meibomian glands, glands of Zeis and caruncle. The tumour is more commonly seen in elderly females and more commonly involves the upper lid. We present a rare case of meibomian gland carcinoma of the right upper eyelid in an 80- year-old male who came with a painless slow-growing swelling of the right upper eyelid for the last ten months. There was no enlarged preauricular or submandibular lymph gland. The tumour was excised and the upper lid was reconstructed by Tenzel’s flap procedure and lateral canthotomy. The excised tumour was sent for histopathological examination. Histopathological examination confirmed adenocarcinoma of the meibomian gland.
Meibomian gland
Histopathological examination
Chalazion (fungus)
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Meibomian gland
Closure (psychology)
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To compare the structure and function of the Meibomian gland and eyelid blinking patterns between thyroid eye disease (TED) patients with dry eye and nonthyroidal dry eye (DE) patients.This was a prospective, cross-sectional and observational study. Clinical measurements were performed as follows: (1) external examination, (2) Lipiview® Interferometer (lipid layer thickness, incomplete blinking rate and meibography) and (3) slit-lamp biomicroscopy (corneal staining, tear break-up time (TBUT), meibum expression).The TED and DE groups included 98 and 62 patients, respectively. The meiboscores of the upper eyelid in TED and DE groups were significantly different (1.21 ± 0.76 and 0.94 ± 0.71, respectively, p = 0.046). The rate of incomplete blinking was 53.3 ± 34.5 and 34.6 ± 36.3%, respectively, and was significantly higher in the TED group (p = 0.006). In the TED group, CAS was the only variable affecting the meiboscore of the upper and lower eyelids (p = 0.031, 0.039, respectively). Significantly, active TED patients had more decreased basal tear secretion than inactive TED patients (7.4 ± 2.1 mm versus 8.5 ± 1.5 mm, p = 0.024). Moreover, active TED patients had decreased meibum expression in both upper and lower eyelids compared with inactive TED patients (2.20 ± 0.88 versus 1.08 ± 0.84, p = 0.002 in upper eyelid, 2.10 ± 0.88 versus 1.18 ± 0.88, p = 0.007 in lower eyelid, respectively).In TED patients, incomplete blinking and loss of Meibomian gland structure in the upper eyelid were more prominent than in DE patients. CAS was a factor affecting the structural loss of Meibomian glands in TED individuals.
Meibomian gland
Basal (medicine)
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Artificial tears
Palpebral fissure
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Meibomian gland
Mucocutaneous zone
Margin (machine learning)
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The sebaceous gland carcinoma is a very rare, highly malignant tumour of the eyelid arising from sebaceous glands of the eyelid such as meibomian glands, glands of Zeis, and caruncle. The tumour is more commonly seen in elderly females and more commonly involve the upper eyelid. We present a rare case of meibomian gland carcinoma of the left lower eyelid in a 59-year-old female who came with a history of a slow growing painless swelling of the lower eyelid. Histopathological examination confirmed poorly differentiated meibomian gland carcinoma.
Meibomian gland
Histopathological examination
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The state of the ocular surface and visual functions depends on ocular adnexal tissues. Involutional changes of the eyelids and meibomian glands occur with age. There is a lack of information about possible relationship between involutional lower lid malposition and meibomian gland dysfunction. Purpose. To evaluate meibomian glands dysfunction in patients with lower eyelid malposition. Methods. Two groups of patients were enrolled: 26 patients (52 eyelids) with involutional lower eyelid malposition and a control group of 22 patients (44 eyelids) without eyelid malposition. Groups were comparable by age and sex. The clinical examination included general eye examination; evaluation of the degree of the eyelids laxity, signs of retractors dehiscence and clinical score of meibomian gland’s dysfunction (The International Workshop on Meibomian Gland Dysfunction, 2011). Results. Atonic eyelid changes and meibomian gland dysfunction were significantly more expressed in patients with involutional eyelid malposition (р 0,05). Conclusion. Our study showed an age-independent clinical relationship between involutional lower eyelid malposition and dysfunction of meibomian glands.
Meibomian gland
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Meibomian gland carcinoma (MGC) is a rare but highly malignant slow growing tumor of the eyelid. MGC usually arises from meibomian gland located in the tarsal plate although rarely it can originates in the gland of zeis, sebaceous gland of caruncle, and periocular skin. MGC is more common in cases of elderly females. Upper eyelid is more commonly affected where the meibomian glands are more. Early diagnosis is very important but in most of the cases the diagnosis is delayed as it mimics chalazion or blepharo-conjunctivitis. This leads to inappropriate treatment and increase in morbidity and/or mortality. Special feature of this carcinoma is that it spread intra-epithelial and causes skipped lesions.
Meibomian gland
Chalazion (fungus)
Tarsus (eyelids)
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Eyelid tumors can be diagnosed using various diagnostic techniques. However, capability of existing methods for determining the type and margins of the tumor at the preoperative stage remains insufficiently studied.To improve the noncontact infrared meibography technique and determine its diagnostic capabilities for studying structural changes in meibomian glands in malignant eyelid tumors of epithelial origin.The study included 49 people (66 eyelids), among which 21 (21 eyelids) with malignant eyelid tumors, 11 - with benign eyelid tumors (11 eyelids), and 17 (34 eyelids) comprised the control group. The mean age of patients was 64.8±1.56 years. Meibomian glands of the lower eyelids were photographed in infrared light. Receiver-operating characteristic (ROC) curves were constructed to estimate the sensitivity and specificity of the method.Modified meibography showed 100% sensitivity and 90% specificity in the differential diagnosis of malignant and benign eyelid tumors in 32 patients. Unlike other methods, the modified meibography technique can clarify the margins of tumor growth, which is considered when planning the resection volume.Modified meibography can indicate the margins of tumor invasion; it can be successfully used in the differential diagnostics of malignant eyelid tumors of epithelial origin and benign eyelid tumors.Введение. Для диагностики опухолей век применяются различные методы исследования. Однако ценность существующих методов для определения типа и границ опухоли на дооперационном этапе остается недостаточно изученной. Цель исследования - усовершенствовать метод бесконтактной инфракрасной мейбографии и определить ее диагностическую ценность для исследования структурных изменений мейбомиевых желез при злокачественных новообразованиях век эпителиального происхождения. Материал и методы. В исследование были включены 49 человек (66 век): 21 пациент со злокачественными новообразованиями век (21 веко), 11 - с доброкачественными новообразованиями век (11 век), 17 (34 века) - контрольная группа. Средний возраст пациентов составил 64,8±1,56 года. В инфракрасном свете проводили фоторегистрацию мейбомиевых желез нижних век. Строились ROC-кривые для оценки чувствительности и специфичности метода. Результаты. В 32 случаях показаны 100% чувствительность и 91% специфичность в дифференциальной диагностике злокачественных и доброкачественных новообразований век по данным модифицированной мейбографии с возможностью уточнения невизуализируемых другими методами границ опухолевого роста, что учитывалось при планировании объема резекции. Заключение. Данные модифицированной мейбографии могут указывать на границы опухолевой инвазии и успешно применяться в дифференциальной диагностике злокачественных новообразований век эпителиального происхождения и доброкачественных новообразований.
Meibomian gland
Chalazion (fungus)
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