Lid expression is an important part of meibomian gland disease (MGD) treatment, and how you perform it matters, according to a new study. Researchers recently demonstrated that tear break-up time (TBUT) was significant higher in a plate expression group compared with digital expression and no lid expression. The researchers suggest that the improvement is due to better expression and removal of the inflamed meibum from the eyelids by the mechanical expression.

The prospective clinical study divided 17 eyes into three groups: no lid expression, lid expression from moderate digital pressure and lid expression from a plate expressor. Each group also underwent the same routine MGD treatment for one month. Though all three groups showed improvement in tear stability, meibum expressibility and corneal staining scores from the routine treatment, the plate expression group showed a statistically significant improvement of TBUT after treatment among all groups. The fluorescein staining score was not statistically significantly different among the group, and dry eye–related quality of life scores improved in all groups.

The study did note that the sustainability and duration of the effects of lid expression need further exploration. The researchers believe their findings justify similar but larger trials that compare MGD treatment with other expression techniques.

Aketa N, Shinzawa M, Kawashima M, et al. Efficacy of plate expression of meibum on tear function and ocular surface findings in meibomian gland disease. Eye Contact Lens. 2019;45(1):19-22.