REFERAT

“MEIBOMIAN GLAND
DYSFUCNTION”
Stase Ilmu Penyakit Mata
Fakultas Kedokteran Universitas Kristen Indonesia
Periode 1 Oktober – 3 November 2018
Meibomian Gland Dysfunction
1. Definisi dan Prevalensi Meibomian Gland Dysfunction
2. Klasifikasi dan Etiologi Meibomian Gland Dysfunction
3. Faktor Risiko Meibomian Gland Dysfunction
4. Manifestasi Klinis Meibomian Gland Dysfucntion
5. Patofisiologi Meibomian Gland Dysfunction
6. Diagnosis Meibomian Gland Dysfunction
7. Diagnosis Banding Meibomian Gland Dysfunction
8. Tatalaksana Meibomian Gland Dysfunction
DEFINISI DAN PREVALENSI
MEIBOMIAN GLAND
DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
Definisi Meibomian Gland Dysfunction
Meibomian Gland Dysfunction merupakan
abnormalitas yang bersifat kronik pada kelenjar
meibom, sering ditandai dengan obstruksi pada
muara duktus dan/atau perubahan
kualitas/kuantitas sekresi dari kelenjar meibom.
Prevalensi Meibomian Gland Dysfunction
• Geografis : Asia 60% populasinya mengalami MGD dan
Kaukasia 20%

• Usia :
• 33% pasien yang menderita meibomian gland dysfunction
berumur kurang dari 30 tahun
• pasien yang mengalami Meibomian gland dysfunction yang
berumur ≥ 60 tahun adalah sebanyak 72%.
 KLASIFIKASI DAN
ETIOLOGI MEIBOMIAN
GLAND DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
 FAKTOR RISIKO
MEIBOMIAN GLAND
DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
 Oftalmik:
Aniridia, blefaritis kronis,
lensa kontak, tato kelopak
mata, giant pupillary
conjungtivitis, ikhtiosis,
trakhoma

Sistemik lain:
Faktor Resiko Hormon seks, Sjogren,
hipertensi, menopause, Penuaan
Meibomian Steven-Johnson
Syndrome, Turner
syndrome, diabetes

Gland DKM
Dysfunction

Medikasi: Lingkungan:
Isotretinoin, antiandrogen,
Geografi Temperatur.
antidepresan, antihistamin,
Kelembaban, kerja visual
antihiperplasia prostat
MANIFESTASI KLINIS
MEIBOMIAN GLAND
DYSFUCNTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
Manifestasi Klinis Meibomian Gland Dysfunction
• Pada kasus MGD kadang sering kali simptomatik maupun
asimptomatik.
• MGD sering kali dihubungkan dengan gejala okular yang disebabkan
karena dry eye dan kerusakan permukaan mata.
• Gejala yang paling sering ditemukan adalah :
• Mata terasa mengganjal
• Mata kering
• Rasa terbakar
• Rasa seperti disengat dan gatal di mata
• Kemerahan dan memar pada kelopak mata
• Dapat ditemukan gangguan visus.
 Clinical Symptoms
• Dryness • Eyelid redness
• Redness • Eyelid itching
• Watering/tearing • Crust on lids/lashes, especially in
mornings
• Burning/stinging
• Eyelids stuck together, especially in
• Eye irritation mornings
• Itchy eyes • Puffy eyelids
• Gritty/sandy • Sensitivity to light
• Sticky sensation • Increased glare
 PATOFISIOLOGI
MEIBOMIAN GLAND
DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
Patofisiologi Meibomian Gland Dysfunction
DIAGNOSIS MEIBOMIAN
GLAND DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
Testing Category Specific test(s) Tests for a general clinic Tests for a specialized unit
Symptoms
Questionnaires McMonnies, Schein, OSDI, McMonnies, Schein, OSDI,
DEQ, OCI, SPEED, and DEQ, OCI, SPEED, and
others others
Signs
Meibomian function Lid morphology Slit lamp microscopy Slit lamp microscopy,
confocal microscopy
Meibomian gland mass Meibography
Gland expressibility, expressed oil Slit lamp microscopy Slit lamp microscopy
quality and volume
Lid margin reservoir Meibometry
Tear film lipid layer, thickness, Interferometry, slit lamp Interferometry, slit lamp,
spread time, spread rate video interferometry
Evaporation tears Evaporimetry Evaporimetry
Osmolarity Osmolarity TearLab device, other TearLab device, other
Testing Category Specific test(s) Tests for a general clinic Tests for a specialized unit
Signs
Stability Tear film TFBUT, ocular protection TFBUT, ocular protection index
index
Tear film lipid layer Spread time Interferometry, spread rate, pattern
Indices of volume Tear secretion Schirmer 1 Fluorophotometry/fluorescein clearance rate
and secretion
Tear volume Not available Volume by fluorophotometry
Tear volume Meniscus height Meniscus radius of curvature, meniscometry

Tear clearance Tear film index Tear film index

Ocular surface Ocular surface staining Oxford scheme, Oxford scheme, NEI/industry scheme
NEI/industry scheme
Inflammation Biomarkers Flow cytometry, bead arrays, microarrays,
mass spectrometry, cytokines and other
mediators, interleukins, matrix
metalloproteinases
DIAGNOSIS BANDING
MEIBOMIAN GLAND
DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
Diagnosis Banding Meibomian Gland
Dysfunction
 TATALAKSANA
MEIBOMIAN GLAND
DYSFUNCTION
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
DAFTAR PUSTAKA
Referat Meibomian Gland Dysfunction
Stase Ilmu Penyakit Mata FK UKI
Periode 1 Oktober – 3 November 2018
 DAFTAR PUSTAKA
• Schaumberg DA, Nichols JJ, Papas EB, Tong L, Uchino M, Nichols KK. The International
Workshop on Meibomian Gland Dysfunction: Report of the Subcomittee on the Epidemiology
of, and Associated Risk Factors for MGD. Invest. Opthalmol. Vis. Sci. 2011;52(4):1994-2005.
• Rahman A, Yahya K, Ahmed T, Sharif-Ul-Hasan K. Diagnostic value of tear films tests in type 2
diabetes. J Pak med Assoc (JPMA) 57:577;2007.
• Wald ER. Periorbital and orbital infections. Infect Dis Clin North Am. 2007;21(2):393–408.
• Carlisle RT, John D. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2015
Jul 15; 92(2): 106–112.
• Turgut B, Çatak O, Demir T. Meibomian gland dysfunction: an overlooked eyelid disease. Adv
Ophthalmol Vis Syst. 2018;8(3):168‒172.
• Geerling G, Baudouin C, Aragona P, et All. Emerging strategies for the diagnosis and treatment
of Meibomian gland dysfunction: Proceedings of the OCEAN group meeting. The Ocular Surface
15. 2017: 179-192.
• Baudouin C, Messmer EM, Aragona P, et al. Br J Ophthalmol 2016; 100: 300–306.