Along the margin of the eyelids, there are the openings of a series of sebaceous glands known as the meibomian glands. It is the dysfunction and inflammation of these glands that constitutes meibomitis. In this condition, the normal oily secretion from these glands becomes thicker and there is less of it. As the normal character of this oily secretion is needed to prevent evaporation of the tear film, meibomitis results in increased tear evaporation and, hence, symptoms of dryness, burning, and irritation. These patients will also complain of grittiness, blurred vision, frequent styes, red eyes, watery eyes, and swollen/red eyelid margins. Over time, chronic meibomian gland dysfunction leads to thickening and blunting of the lid margin, chronic chalazia, superficial punctate keratitis, corneal neovascularization, and scar.
Although the diagnosis of meibomian gland dysfunction is made clinically, a suspect malignant lesion will require biopsy to be sure. Patients with recurrent or dry eye issues should be suspected of having an underlying meibomian gland dysfunction.