Meibomian gland dysfunction and dry eye in keratoconus

Area of Science:

• Ophthalmology
• Corneal Diseases
• Ocular Surface Disease

Background:

• Keratoconus is a progressive corneal ectasia often associated with ocular surface abnormalities.
• Meibomian gland dysfunction (MGD) is a common cause of evaporative dry eye.
• The interplay between MGD, dry eye, and keratoconus progression requires further investigation.

Observation:

• A 45-year-old male with keratoconus presented with symptoms of ocular irritation, including burning, tearing, itching, and redness.
• The patient had a history of penetrating corneal transplantation and wore rigid contact lenses.
• Meibography revealed significant meibomian gland dropout in both eyes, despite a normal tear meniscus height.

Findings:

• Severe meibomian gland dropout was observed in a patient with keratoconus and evaporative dry eye symptoms.
• Objective diagnostic tests are vital for accurate dry eye assessment and evaluation of the ocular surface.
• Chronic eye rubbing, potentially linked to underlying inflammation like MGD or blepharitis, may contribute to keratoconus.

Implications:

• Effective treatment of evaporative dry eye and MGD may be essential in managing corneal ectasia.
• Addressing underlying ocular surface inflammation could help prevent the progression of keratoconus.
• Symptom relief in keratoconus patients may be achieved through comprehensive management of associated dry eye conditions.