Stenosed gland orifices in a case of meibomian gland dysfunction.

Meibomitis may sometimes simulates malignant lesion.

Meibomitis

Inflammation of meibomian glands together with meibomian gland dysfunction is commonly seen in patients with acne rosacea. Clinical features: Lid margin vascular engorgement and stagnantion of meibomian gland secretion. The gland orifices may become stenosed and when pressure is applied to the lid margin, oil secretion can be expressed through the stenosed orifices. Chronic meibomitis may lead to the thickening and blunting of the lid margin, which causes gland orifices obliteration. This may progress to chronic granuloma infection (chalazion). In a later stage of the gland dysfunction, subsequent superficial punctate keratitis, corneal neovasculatization and scar may result. Diagnosis is usually made clinically, however in a particular case where the lesion simulates malignant lesion and clinical differentiation is difficult, biopsy confirmation is required. Treatment: Lid hygiene. Warm compress. Topical or systemic antibiotic. Possible surgical incision to enhance drainage.

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Dilated, meibomian orifice containing accumulated meibomian secretion is seen at lid margin.