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THE MEIBOMIAN GLANDS: AN INVESTIGATION INTO THE SECRETION AND SOME ASPECTS OF THE PHYSIOLOGY

1961; BMJ; Volume: 45; Issue: 11 Linguagem: Inglês

10.1136/bjo.45.11.718

1468-2079

R.G. Linton, D. H. Curnow, William J. Riley,

VERY little information appears in the literature on the composition of the Meibomian gland secretion or the mechanism whereby it is distributed to the lid margin.The most recent work on ocular biochemistry (Pirie and van Heyningen, 1956) makes no mention of the subject, and the majority of text-books dismiss it with the statement that the secretion is of a sebaceous nature.Duke-Elder (1938), quoting Pes (1897), says that the secretion is rich in fats, fatty acids, and cholesterol.Schiefferdecker (1906) described the glands as being filled with glandular epithelium, the peripheral cells being fat-free and the polygonal central cells being loaded with fat.This is shown in Fig. 1 (opposite), which is a section from a gland obtained post mortem from an adult human and stained with Sudan 3.Buschke and Frankel (1905) investigated the physiology of the glandular action and found that in laboratory animals the secretion was increased by section of the cervical sympathetic.The glands could also be forcibly emptied by subcutaneous injection of physostigmine.We have been unable to find reference to more modem work and the standard text-books make little mention of the question.We therefore considered that the question of the composition of the secretion should be restudied and the means of its controlled excretion in man reconsidered. InvestigationsMaterial.-Clinicpatients, nursing and hospital staff, in-patients and school children, all free of any gland or lid disease, were used as donors.The collection of sufficient secretion proved to be extremely difficult.It was first thought it could be collected in micro-pipettes inserted into the orifices of the glands, but this was defeated by its melting point.It solidified in the mouths of the pipettes, which could not be kept warm enough for it to run up by capillarity.Hence, it was collected (after excluding lid or gland disease) by expression with a glass rod, and was collected, as it solidified, with a Meibomian cyst curette.From 539 persons 200 mg.secretion was obtained.Chemical investigation was carried out on the material and at the same time clinical observations were made on the mechanisms of expression by the lid muscles.