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When patients come to us for dry eye disease, there are special things we do that are not part of a regular eye exam.
In dry eye patients, one thing we play close attention to is the meibomian glands.Meibomian glands are found at the rim of the eye lids and they are responsible for the supply of meibum, an oily substance that prevents evaporation of the tear film. When the meibomian glands are not working properly they do no secrete enough meibum, causing tears to evaporate too quickly, which results in dry eyes.
For these reasons, an evaluation of the meibomian glands is a key part of the dry eye examination. We look closely at the meibomian glands and we try to make them secrete the oily meibum that they are made for. Meibum is an essential component of a healthy tear film. This process is called gland expression and it is usually done with Q-tips, the doctor's finger tips or specially designed squeezers.
We typically grade the quality and quantity of the the secretions and look to see how easy it is to apply pressure to the glands to make the secretions visible at the eye lid margin.
An assessment of the meibomian glands gives doctors a good idea of whether a patient has an evaporative dry eye or an aqueous-deficient dry eye, or a combination of both. Knowing the latter points the way to selecting a proper treatment for the patient.