Meibomian therapy in problematic contact lens wear

Utilizing the principal diagnostic criterion of an absent or cloudy Meibomian gland secretion upon repeated expression, patients with Meibomian gland dysfunction (MGD) were selected to participate in a study of the efficacy of lid scrubs and massage in the treatment of MGD. Twenty-one patients with contact lens intolerance unrelated to lens, care system, or health factors were randomly assigned to treatment of one eye with common clinical therapy for MGD. After 2 weeks of treatment, gland expression, biomicroscopy, staining, comfort, and fluorescein breakup time were assessed in a masked manner. Analyzed using a paired-data t-test, the results indicated a significant increase in mean tear film breakup time (BUT) in the treated eye at follow-up compared to baseline (mean increase = 4.0 s, p = 0.0001). The control eye demonstrated no significant change (mean increase = 0.2 s, p = 0.5955). These objective results were corroborated by reports of improved subjective comfort with contact lens wear after therapy.