Eye-Lid Debridement


Regular in-office maintenance treatments such as manual lid margin debridement are beneficial for meibomian gland dysfunction. Meibomian glands located along the edge of the eyelids where the eye lashes are found in a part of the eye lid known as the "line of Marx". The meibomian glands make the oil that is an essential part of healthy tears. The oil is what prevents the eyes from drying out too quickly. When the lands are not working properly because they are blocked, dry eye disease is often the result.


Lid margin debridement can effectively remove accumulated debris and skin cells that that block the the meibomian glands. Similar to dental plaque, gland-blocking debris can re-accumulate over time. Thus treatments such as lid margin debridement should be performed on a regular basis. “Lid cleanings” at regular intervals are standard practice for some dry eye patients just like teeth cleaning. 


A study published in the October 2013 issue of the medical journal, Cornea, confirms the effectiveness of debridement-scaling of the line of Marx (LOM) and keratinized lid margin. The procedure stimulates the functioning of the meibomian glands (which are located under the eyelid and and play a critical role in maintaining a healthy tear film).


The study took 28 patients with evaporative dry eye (16 test patients who had the procedure and 12 controls who did not have the procedure), who also had anteroplacement and a thickened LOM. The studies methods were described as follows:

Symptoms were evaluated with the Standard Patient Evaluation of Eye Dryness questionnaire. The MG function was evaluated with the standardized MG function evaluator. The LOM was stained with lissamine green (Odyssey Medical, TN) for evaluation. For the test group only, the stained LOM and the entire width of the keratinized lower lid margin were debrided-scaled using a stainless steel, foreign body, golf club spud (Hilco Wilson Ophthalmics, Plainville, MA). All the patients were monitored for change in symptoms and MG function approximately 1 month later.

The researchers found a significant improvement in dry eye symptoms and functioning of the meibomian glands one month following the debridement-scaling procedure.  The controls were just as badly off as before.


The conclusion was that debridement-scaling of the Line of Marx and lower lid margin provides statistically significant relief from dry eye symptoms and improves the function of the meibomian glands. This procedure can be used in patients who have dry eye caused by meibomian gland dysfunction and evaporative dry eye.


Note that there are many different types of dry eye disease and different treatment options available for different variations of the disease. Not all treatments work for every patient and and an eye doctor must be consulted prior to treatment.



Debridement-Scaling: A New Procedure That Increases Meibomian Gland Function and Reduces Dry Eye Symptoms Cornea 2013 Oct 17;[EPub Ahead of Print], DA Korb, CA Blackie


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