Are you aware of any data indicating that ocular surface inflammation (as a result of queous tear deficiency) directly causes MGD? My concern is that lack of tears. i have a low lids retraction ..big opening after eye lids plastic surgery..corneal exposure, contributing to dry eyes that i believe produce inflammation … and in return contribute to MGD. Meibomian gland dysfunction Vladae,
Can Low Lids Retraction After Eye Lids Plastic Surgery Contribute to MGD ?
Doctor Answers 4
Clinical testing is not required to establish a diagnosis of dry eye-that's silly.
MGD meibomian gland dysfunction is complex and is immediately and intimately related to dry eye. The eyelid retraction also contributes because the compromises the windshield wiper function of the eyelids. My own clinical observation is that motor injury to the lower eyelid cause by transcutaneous lower blepharoplasty seems to have some bearing on meibomian gland dysfunction. I suspect that there may be some smooth muscle damage caused by some of these surgeries. Often eyelid reconstruction is necessary in this circumstances to compensate for the compromised eyelids after cosmetic eyelid surgery. This can help but in no way cures the dry eye. There are also a number of medical treatments for these complex MDG/dry eye situations. It can be very helpful to find an oculoplastic surgery or cornea specialist who is interested in treating these conditions.
In my experience, eyes which become dry or exposed after eyelid surgery need more lubrication. In this scenario, your eyes reflexively produce more tears. Since the tears have a mucus and lipid component contributed by the meibomian glands, it stands to reason that there may be some contribution of dry eye to MGD. For patients who have come to me for this problem, I encourage them to use artificial tears at least 4-6 times per day. In general these patients choose to have me perform a surgical correction of their lower eyelid retraction after blepharoplasty.
Meibomian gland dysfunction and ocular surface inflammation often go hand in hand. One does not necessarily cause the other. If you have a poor oil layer to your tear film, then other factors such as lid retraction will become more of a factor.
Please see a cornea specialist and/or an oculoplastics specialist that work together to optimize your outcome.
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A number of tests must confirm your "dry eye" syndrome including a Shirmmer's test, a corneal fluorescein orange dye - blue light test, slit-lamp examination, evaluation for ectropion or entropion, rule out thyroid disorders, diabetes, DCR issues, lacrimal gland studies, past surgeries, etc., etc. May I suggest that you first make an appointment with a trusted ophthalmologist.