Upper eyelid meibography: underused but clinically valuable

This Optometric Management article addresses a growing gap between clinical best practices and real-world adoption of upper eyelid meibography. Despite variability in diagnostic protocols across practices, the consensus emerging from multiple studies is clear: simultaneous evaluation of both eyelids produces a more complete and clinically useful assessment.

A key insight from the article is that the upper and lower eyelids reveal different types of meibomian gland pathology. The upper eyelid tends to show more morphological changes such as tortuosity, while the lower eyelid is more prone to gland dropout. These distinct patterns mean that evaluating only one lid risks missing diagnostically significant findings present in the other.

The article positions upper eyelid meibography as an underutilized but clinically valuable tool — one that clinicians can incorporate into their existing workflows with the right instruments and a small shift in protocol.