Comprehensive assessment of the meibomian glands by meibography: why the upper eyelids matter

Published in Cornea, one of the leading peer-reviewed journals in ophthalmology, this study makes a compelling case for why the upper eyelid should be part of every meibomian gland evaluation. The authors found that upper lid assessment is critical for detecting and managing a range of ocular conditions early, including meibomian gland dysfunction (MGD), dry eye disease (DED), and complications related to contact lens fitting and post-cataract surgery outcomes.

The research highlights that upper eyelid evaluation becomes especially important in patients with systemic conditions such as Sjögren syndrome or thyroid eye disease, where early morphological changes in the upper meibomian glands can serve as a diagnostic indicator that lower-lid-only imaging would miss entirely. 

For clinicians, this study reinforces a clear message: comprehensive meibomian gland assessment requires imaging both lids. Relying solely on the lower eyelid risks overlooking early-stage changes that could inform treatment decisions and improve patient outcomes.