Dry Eye in Keratoconus

Optimizing the Ocular Surface in Keratoconus: Lid Care and Meibomian Gland Health with Technology

Keratoconus is a progressive eye condition characterized by thinning and swelling of the cornea, leading to visual impairment. While the exact cause of keratoconus remains unclear, research suggests that factors such as eye rubbing, meibomian gland dysfunction and dry eye symptoms may contribute to its progression.

The Link Between Eye Rubbing, Meibomian Gland Dysfunction and Vision Loss:

Eye rubbing is a common habit, but it can have detrimental effects for individuals with keratoconus. The excessive mechanical pressure applied during rubbing can worsen corneal thinning and cause irregular astigmatism, further compromising visual acuity. In addition, rubbing the eyes can exacerbate meibomian gland dysfunction, which impairs healthy tear production.
Meibomian Gland Dysfunction and Dry Eye Symptoms:
The meibomian glands, located in the eyelids, are responsible for producing the oily component of tears that helps lubricate the ocular surface and prevent tears from evaporating. When these glands become blocked or dysfunctional, a condition known as meibomian gland dysfunction (MGD) occurs. MGD can cause insufficient tear film stability, leading to dry eye symptoms such as itching, burning, redness and foreign body sensation.

Technology-Assisted Solutions:

Fortunately, advances in ophthalmic technology have revolutionized the treatment of MGD and dry eye symptoms, thereby benefiting keratoconus patients. Two important technologies are LipiFlow and Mask IPL.

LipiFlow: LipiFlow is an FDA-approved treatment that melts and removes blockages in the meibomian glands by applying a combination of heat and gentle pressure to the eyelids. Performed in a clinical setting, this procedure helps restore normal gland function and improves tear quality, thereby reducing dry eye symptoms and preventing further deterioration of the ocular surface.

Mask IPL: Intense Pulsed Light therapy delivers controlled pulses of light to the eyelids using a special mask. This light energy targets abnormal blood vessels and inflammation associated with meibomian gland dysfunction. By reducing inflammation and improving blood flow, mask IPL helps restore proper gland function and relieve dry eye symptoms.

Benefits of Lid Care and Meibomian Gland Treatment:

By prioritizing lid care and incorporating advanced technologies such as LipiFlow and Mask IPL into the treatment plan, keratoconus patients can reap several benefits:

Stopping Disease Progression: Treating MGD and dry eye symptoms helps prevent keratoconus from worsening by reducing eye rubbing triggers and mechanical stress on the cornea.
Improved Tear Production and Quality: Increasing the function of the meibomian glands promotes the production of natural tears of optimal composition, resulting in better lubrication and protection of the ocular surface.
Alleviation of Dry Eye Symptoms: Addressing the underlying cause of dry eye symptoms with targeted treatments helps relieve discomfort, redness and irritation, improving overall comfort and quality of life.
Reduction in Allergic Reactions: Effective lid care and meibomian gland treatment helps remove particles and debris from the eyelashes, minimizing the risk of allergen build-up and associated allergic symptoms.


In the treatment of keratoconus, optimizing ocular surface health and addressing underlying dry eye symptoms play a crucial role in preventing vision loss and halting disease progression.

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Assoc. Prof. Aylin Kılıç

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