Management options for Meibomian gland dysfunction

Background Meibomian gland (MG) dysfunction is a chronic, diffuse abnormality of the MGs. At the end stage, it is characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretions. This may result in alterations of the tear film. Patients and methods This is a prospective randomized study that included two groups of patients;, with 40 eyes in each group. The first group (group I) received oral azithromycin for 5 days (500 mg in the first day and then 250 mg/day for 4 days), whereas the second group (group II) received oral doxycycline for 1 month (100 mg/twice daily). The patients were evaluated by the symptoms, signs, and special tests (Schirmer’s and tear break-up time tests) of dry eye. The patients were followed up at two main visits: at day 12 and at day 36 from the start of therapy. Results There was no significant difference between group I and group II regarding age, sex, or presence of diabetes mellitus. At the first post-treatment visit, group I had significant improvement in itching (P=0.002), foreign body sensation (P=0.001), and ocular surface staining (P=0.01) compared with group II. At the second post-treatment visit, group I had significantly better results regarding foreign body sensation (P=0.05), eyelid swelling (P=0.04), and ocular surface staining (P=0.03). Conclusion Both oral azithromycin and oral doxycycline had beneficial effects in patients with MG dysfunction. Azithromycin group was proved to have better results regarding symptoms, signs, and special tests with lower rates of adverse effects.