The Dry Eye Zone

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Abstract: OMGD, AKA MRKC (LOL)

Do you remember when the term "Non Obvious MGD" emerged?

Well, here's a new term for its counterpart. Dr. Suzuki of Kyoto Pref. U. has coined the elegant, dignified term Meibomitis Related KeratoConjunctivitis (MRKC). Though personally I'd prefer to stick with what I've always used: Obvious MGD. Kind of a nice ring to it, wouldn't you say?

I can just hear the conversations now.

"Well," (snickers the patient during a visit to his fifth ophthalmologist) "I guess my first doctor was right all along. I really do have NO MGD."

"Oh my God" (exclaims the optometry student) "Just look at that OMGD!"

Et cetera.

Meibomian gland inflammation, "meibomitis," is associated with ocular surface inflammatory diseases. However, these diseases are poorly defined clinically, making effective treatment difficult. Herein, we propose a new disease subset, termed meibomitis-related keratoconjunctivitis (MRKC). The ocular surface features of MRKC include: meibomitis with redness and swelling of the eyelid margin and palpebral conjunctiva; superficial vascularization and granulomatous nodules in the cornea; and conjunctival hyperemia, similar or identical to that observed in phlyctenular keratitis. The characteristics of MRKC patients include a significantly higher prevalence in women, multiple history of chalazia, close association with meibomitis, the presence of specific human leukocyte antigen association, high Propionibacterium acnes detection rates in meibum culture, and the effectiveness of systemic antimicrobial therapy targeting P. acnes. MRKC may share many clinical features with ocular rosacea, especially during childhood. The clinical effectiveness of systemic antimicrobial agents in treating both diseases suggests the importance of focusing on the elimination of bacteria such as P. acnes.

Cornea. 2012 Nov;31 Suppl 1:S41-4. doi: 10.1097/ICO.0b013e31826a04dd.
Suzuki T.
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.