Meibomian gland

睑板腺
  • 文章类型: Practice Guideline
    睑板腺功能障碍(MGD)引起的蒸发性干眼(EDE)是眼科常见的临床问题之一。它是干眼病(DED)和眼病的主要原因。在EDE中,由睑板腺产生的脂质的数量或质量不足导致眼前泪膜的更快蒸发以及DED的症状和体征。尽管结合临床特征和特殊诊断测试结果进行诊断,该疾病的治疗可能具有挑战性,因为通常很难将EDE与DED的其他亚型区分开来.这是至关重要的,因为DED的治疗方法是通过识别潜在的亚型和原因来指导的。MGD的传统治疗包括热敷,盖子按摩,改善盖子卫生,所有旨在缓解腺体阻塞和促进泪液流出的措施。近年来,出现了新的EDE诊断成像模式和治疗方法,例如矢量热脉动和强脉冲光疗法。然而,众多的管理选择可能会混淆治疗眼科医生,这些患者需要定制的而不是通用的方法。这篇综述旨在提供一种简化的方法来诊断MGD引起的EDE,并为每位患者提供个性化治疗。该综述还强调了改变生活方式和适当咨询的作用,以便患者能够有现实的期望并享受更好的生活质量。
    Evaporative dry eye (EDE) due to meibomian gland dysfunction (MGD) is one of the common clinical problems encountered in ophthalmology. It is a major cause of dry eye disease (DED) and of ocular morbidity. In EDE, inadequate quantity or quality of lipids produced by the meibomian glands leads to faster evaporation of the preocular tear film and symptoms and signs of DED. Although the diagnosis is made using a combination of clinical features and special diagnostic test results, the management of the disease might be challenging as it is often difficult to distinguish EDE from other subtypes of DED. This is critical because the approach to the treatment of DED is guided by identifying the underlying subtype and cause. The traditional treatment of MGD consists of warm compresses, lid massage, and improving lid hygiene, all measures aimed at relieving glandular obstruction and facilitating meibum outflow. In recent years, newer diagnostic imaging modalities and therapies for EDE like vectored thermal pulsation and intense pulsed light therapy have emerged. However, the multitude of management options may confuse the treating ophthalmologist, and a customized rather than a generalized approach is necessary for these patients. This review aims to provide a simplified approach to diagnose EDE due to MGD and to individualize treatment for each patient. The review also emphasizes the role of lifestyle modifications and appropriate counseling so that patients can have realistic expectations and enjoy a better quality of life.
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