Debridement revisited

Debridement of the lid margin is one of the management options for anterior blepharitis that is included in the TFOS DEWS2.¹ Of the few studies cited, all seem to result in symptom alleviation, though ‘larger studies and additional study designs are needed to confirm the mechanisms of action to explain the positive results reported to date’.

One of the primary mechanisms driving obstruction of the meibomian glands (MGs) is hyperkeratinisation of the eyelid margin and duct orifices.² As keratinised material is built up around and within the orifice, the gland is obstructed and meibum cannot be delivered from the gland to the tear film. It is believed that debridement works by mechanically removing accumulated debris and keratinised cells from the eyelid margin to allow increased flow of meibum into the tear film.