on May 24, 2026
If upper eyelid imaging is not part of your current approach, it may be time to reconsider—because the key to reducing dropout could be right above the surface.
Contact lens dropout is frustrating—for both patients and practitioners. But what if we’re missing the most important predictor of success?
Contact lens dropout remains a persistent challenge in eye care, often driven by discomfort that can be difficult to fully explain—or resolve. But emerging insights from the CLASS study group and a recent Cornea review point to a key factor that may be overlooked: the upper eyelid.
To hear Dr. Karpecki’s perspective, watch the short video featured here:
The research shows that upper eyelid gland changes—particularly gland tortuosity—are strongly associated with contact lens intolerance and discontinuation. In contrast, lower eyelid anatomy, even when appearing wider or more robust, does not reliably predict long-term success with lens wear.
This shift in understanding has meaningful clinical implications.
In practice, incorporating upper and lower eyelid meibography when evaluating symptomatic contact lens patients can uncover early signs of mechanical stress. Even when the lower lid appears healthy, significant upper lid tortuosity may indicate a higher risk of discomfort and eventual dropout.
Equally important is how this information is shared. Presenting patients with side-by-side meibography images of their upper and lower eyelids transforms the conversation. It provides a clear, visual explanation for their symptoms and helps reinforce the importance of proactive care.
This often leads to stronger adherence to recommended interventions, including:
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Lid hygiene
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Omega fatty acid supplementation
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Heat or thermal therapies
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Prescription treatments
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Ongoing maintenance strategies
By identifying and addressing upper eyelid gland changes early, clinicians can better manage patient expectations, improve comfort, and extend successful contact lens wear.
Where Meivertor fits in
One of the practical reasons upper lid imaging has lagged behind is the technical challenge of fast, consistent, and comfortable upper lid eversion in a busy clinic. This is where Meivertor becomes especially valuable. Meivertor is a patented, single‑handed eyelid‑eversion instrument designed to make upper and lower lid meibography quick, repeatable, and more comfortable for both patient and provider. Its disposable silicone tips gently grasp the lashes and evert the lid with a simple turning motion, freeing the other hand to stabilize the patient or optimize image focus. See how easy Meivertor is to use.
