Skip to main content
Log in

Meibom-Drüsen

Teil II: Physiologie, Eigenschaften, Verteilung und Funktion des Meibom-Öls

Meibomian glands

Part II: Physiology, characteristics, distribution and function of meibomian oil

  • Leitthema
  • Published:
Der Ophthalmologe Aims and scope Submit manuscript

Zusammenfassung

Das ölige Sekret (Meibum) der Meibom-Drüsen bildet die oberflächliche Lipidschicht des präokulären Tränenfilms und vermindert die Verdunstung der wässrigen Phase. Meibum ist eine komplexe Mischung aus verschiedenen Lipiden sowie kleineren Anteilen von Proteinen und weiteren Bestandteilen der sekretorischen Meibozyten, die bei Körpertemperatur ein klares Öl bilden. Seine Komposition und Funktion sind noch teilweise ungeklärt, speziell die Interaktion der wasserunlöslichen apolaren Lipide mit polaren, partiell wasserlöslichen Lipiden und möglicherweise Proteinen, die zusammen die Verbindung mit der unterliegenden wässrigen Tränenphase herstellen. Meibum wird innerhalb der Drüsen durch den Druck der kontinuierlichen Sekretion sowie durch Muskelkräfte des M. orbicularis oculi und des Riolan-Muskels beim Lidschlag transportiert. Nach der Freisetzung auf den hinteren Lidrand, gelangt das Öl aus dem Lidrandreservoir auf den Tränenmeniskus und wird bei jeder Lidöffnung als dünne Schicht auf dem präokularen Tränenfilm ausgezogen. Beim Lidschluss wird es wieder zusammengeschoben, wobei immer ein kleiner Teil der Lipidschicht des Tränenfilms erneuert wird. Meibum hat auch eine Barrierefunktion gegen das Auslaufen der Tränen über die innere Lidkante und gegen das Eindringen des Hautfettes (Sebum) vom freien Lidrand.

Abstract

The oily secretion (meibum) of the Meibomian glands forms the superficial layer of the pre-ocular tear film and reduces evaporation of the aqueous phase. Meibum is a complex mixture of various lipids and minor protein components as well as other components of the secretory meibocytes, which form a clear liquid at body temperature. The exact composition and functions of meibum are still partly unknown, in particular the interaction of the water insoluble non-polar lipids with the polar, partly water soluble, lipids and potentially with proteins, which altogether interact to maintain the connection with the underlying aqueous tear phase. Meibum is transported within the gland by the force of secretory pressure from continuous secretion and by muscular action of the orbicularis muscle and Riolans muscles during blinking. After delivery of meibum onto the posterior lid margin the oil moves from the posterior lid margin reservoir onto the tear meniscus and is pulled as a thin layer onto the pre-ocular tear film every time the lid opens. During lid closure it is compressed and a small part is continuously renewed. Meibum also has a barrier function against the spillage of tears over the inner border of the lid and against the entry of skin lipids (sebum) from the free lid margin.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Andrews JS (1970) Human tear film lipids. I. Composition of the principal non- polar component. Exp Eye Res 10:223–227

    Article  CAS  PubMed  Google Scholar 

  2. Blackie CA, Korb DR (2009) Recovery time of an optimally secreting meibomian gland. Cornea 28:293–297

    Article  PubMed  Google Scholar 

  3. Blackie CA, Solomon JD, Greiner JV et al (2008) Inner eyelid surface temperature as a function of warm compress methodology. Optom Vis Sci 85:675–683

    Article  PubMed  Google Scholar 

  4. Brewitt H, Kaercher TM, Rüfer F (2008) Trockenes Auge und Blepharitis. Klin Monatsbl Augenheilkd 225:R15–R36

    Article  CAS  PubMed  Google Scholar 

  5. Bron AJ (1988) Eyelid secretions and the prevention and production of disease. Eye 2:164–171

    PubMed  Google Scholar 

  6. Bron AJ, Benjamin L, Snibson GR (1991) Meibomian gland disease. Classification and grading of lid changes. Eye 5:395–411

    PubMed  Google Scholar 

  7. Bron AJ, Tiffany JM (1998) The meibomian glands and tear film lipids. Structure, function, and control. Adv Exp Med Biol 438:281–295

    CAS  PubMed  Google Scholar 

  8. Bron AJ, Tiffany JM (2003) The tear film lipid layer forms a pleated sheet on eye closure. Ophthalmic Res 35 (Suppl 1):112

    Google Scholar 

  9. Bron AJ, Tiffany JM (2004) The contribution of meibomian disease to dry eye. Ocul Surf 2:149–165

    CAS  PubMed  Google Scholar 

  10. Bron AJ, Tiffany JM, Gouveia SM et al (2004) Functional aspects of the tear film lipid layer. Exp Eye Res 78:347–360

    Article  CAS  PubMed  Google Scholar 

  11. Butovich IA, Uchiyama E, Di Pascuale MA, McCulley JP (2007) Liquid chromatography-mass spectrometric analysis of lipids present in human meibomian gland secretions. Lipids 42:765–776

    Article  CAS  PubMed  Google Scholar 

  12. Butovich IA, Millar TJ, Ham BM (2008) Understanding and analyzing meibomian lipids. A Review. Curr Eye Res 33:405–420

    Article  CAS  PubMed  Google Scholar 

  13. Chew CK, Hykin PG, Jansweijer C et al (1993) The casual level of meibomian lipids in humans. Curr Eye Res 12:255–259

    Article  CAS  PubMed  Google Scholar 

  14. Chew CK, Jansweijer C, Tiffany JM et al (1993) An instrument for quantifying meibomian lipid on the lid margin: the Meibometer. Curr Eye Res 12:247–254

    Article  CAS  PubMed  Google Scholar 

  15. Collins MJ, Iskander DR, Saunders A et al (2006) Blinking patterns and corneal staining. Eye Contact Lens 32:287–293

    Article  PubMed  Google Scholar 

  16. Cope C, Dilly PN, Kaura R, Tiffany JM (1986) Wettability of the corneal surface: a reappraisal. Curr Eye Res 5:777–785

    Article  CAS  PubMed  Google Scholar 

  17. Craig JP, Blades K, Patel S (1995) Tear lipid layer structure and stability following expression of the meibomian glands. Ophthalmic Physiol Opt 15:569–574

    Article  CAS  PubMed  Google Scholar 

  18. Dana MR (2004) Corneal antigen-presenting cells: diversity, plasticity, and disguise the cogan lecture. Invest Ophthalmol Vis Sci 45:722–727

    Article  PubMed  Google Scholar 

  19. Foulks GN, Bron AJ (2003) Meibomian gland dysfunction: a clinical scheme for description, diagnosis, classification, and grading. Ocul Surf 1:107–126

    PubMed  Google Scholar 

  20. Gilbard JP, Rossi SR, Heyda KG (1989) Tear film and ocular surface changes after closure of the meibomian gland orifices in the rabbit. Ophthalmology 96:1180–1186

    CAS  PubMed  Google Scholar 

  21. Glasgow BJ, Abduragimov AR, Gasymov OK, Yusifov TN (2002) Tear lipocalin: structure, function and molecular mechanisms of action. Adv Exp Med Biol 506:555–565

    CAS  PubMed  Google Scholar 

  22. Goto E, Yagi Y, Matsumoto Y, Tsubota K (2002) Impaired functional visual acuity of dry eye patients. Am J Ophthalmol 133:181–186

    Article  PubMed  Google Scholar 

  23. Goto E, Endo K, Suzuki A et al (2003) Tear evaporation dynamics in normal subjects and subjects with obstructive meibomian gland dysfunction. Invest Ophthalmol Vis Sci 44:533–539

    Article  PubMed  Google Scholar 

  24. Gouveia SM, Tiffany JM (2005) Human tear viscosity: an interactive role for proteins and lipids. Biochim Biophys Acta 1753:155–163

    CAS  PubMed  Google Scholar 

  25. Green-Church KB, Nichols KK, Kleinholz NM et al (2008) Investigation of the human tear film proteome using multiple proteomic approaches. Mol Vis 14:456–470

    CAS  PubMed  Google Scholar 

  26. Greiner JV, Glonek T, Korb DR et al (1996) Phospholipids in meibomian gland secretion. Ophthalmic Res 28:44–49

    CAS  PubMed  Google Scholar 

  27. Greiner JV, Glonek T, Korb DR, Leahy CD (1996) Meibomian gland phospholipids. Curr Eye Res 15:371–375

    Article  CAS  PubMed  Google Scholar 

  28. Harrison WW, Begley CG, Liu H et al (2008) Menisci and fullness of the blink in dry eye. Optom Vis Sci 85:706–714

    Article  PubMed  Google Scholar 

  29. Haworth KM, Nichols JJ, Thangavelu M et al (2009) Examination of human meibum collection and extraction techniques. Invest Ophthalmol Vis Sci 50:2544

    Google Scholar 

  30. Henriquez AS, Korb DR (1981) Meibomian glands and contact lens wear. Br J Ophthalmol 65:108–111

    Article  CAS  PubMed  Google Scholar 

  31. Holly FJ (1973) Formation and stability of the tear film. Int Ophthalmol Clin 13:73–96

    Article  CAS  PubMed  Google Scholar 

  32. Holly FJ (1973) Formation and rupture of the tear film. Exp Eye Res 15:515–525

    Article  CAS  PubMed  Google Scholar 

  33. Hykin PG, Bron AJ (1992) Age-related morphological changes in lid margin and meibomian gland anatomy. Cornea 11:334–342

    Article  CAS  PubMed  Google Scholar 

  34. Isenberg SJ, Del Signore M, Chen A, Wei J (2002) The lipid layer and stability of tears in human newborns. Adv Exp Med Biol 506:401–404

    CAS  PubMed  Google Scholar 

  35. Isreb MA, Greiner JV, Korb DR et al (2003) Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer’s test. Eye 17:79–83

    Article  CAS  PubMed  Google Scholar 

  36. Kaercher T, Brewitt H (2004) Blepharitis. Ophthalmologe 101:1135–1147

    Article  CAS  PubMed  Google Scholar 

  37. Kaercher T, Honig D, Mobius D (1993) Brewster angle microscopy. A new method of visualizing the spreading of Meibomian lipids. Int Ophthalmol 17:341–348

    Article  PubMed  Google Scholar 

  38. Kaercher T, Mobius D, Welt R (1992) Biophysical characteristics of the Meibomian lipid layer under in vitro conditions. Int Ophthalmol 16:167–176

    Article  CAS  PubMed  Google Scholar 

  39. Kaercher T, Mobius D, Welt R (1994) Biophysical behaviour of the infant Meibomian lipid layer. Int Ophthalmol 18:15–19

    Article  CAS  PubMed  Google Scholar 

  40. King-Smith PE, Fink BA, Hill RM et al (2004) The thickness of the tear film. Curr Eye Res 29:357–368

    Article  PubMed  Google Scholar 

  41. King-Smith PE, Fink BA, Nichols JJ et al (2009) The contribution of lipid layer movement to tear film thinning and breakup. Invest Ophthalmol Vis Sci 50:2747–2756

    Article  PubMed  Google Scholar 

  42. Knop E, Knop N (2003) Augen-assoziiertes lymphatisches Gewebe (EALT) durchzieht die Augenoberfläche kontinuierlich von der Tränendrüse bis in die ableitenden Tränenwege. Ophthalmologe 100:929–942

    Article  CAS  PubMed  Google Scholar 

  43. Knop E, Knop N (2005) Influence of the Eye-associated Lymphoid Tissue (EALT) on inflammatory ocular surface disease. Ocul Surf 3:S180–S186

    PubMed  Google Scholar 

  44. Knop E, Knop N (2009) Conjunctiva immune surveillance. In: Dartt DA, Edelhauser HF (eds) Encyclopedia of the Eye. Elsevier, Oxford

  45. Knop E, Knop N, Brewitt H (2003) Das trockene Auge als komplexe Fehlregulation der funktionellen Anatomie der Augenoberfläche. Neue Impulse zum Verständnis des trockenen Auges. Ophthalmologe 100:917–928

    Article  CAS  PubMed  Google Scholar 

  46. Knop E, Knop N, Claus P (2008) Local production of secretory IgA in the eye-associated lymphoid tissue (ealt) of the normal human ocular surface. Invest Ophthalmol Vis Sci 49:2322–2329

    Article  PubMed  Google Scholar 

  47. Korb DR, Donald R, Korb OD (2008) Interview. Ocul Surf 6:56–58

    PubMed  Google Scholar 

  48. Korb DR, Baron DF, Herman JP et al (1994) Tear film lipid layer thickness as a function of blinking. Cornea 13:354–359

    Article  CAS  PubMed  Google Scholar 

  49. Korb DR, Blackie CA (2008) Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location. Cornea 27:1142–1147

    Article  PubMed  Google Scholar 

  50. Korb DR, Greiner JV (1994) Increase in tear film lipid layer thickness following treatment of meibomian gland dysfunction. Adv Exp Med Biol 350:293–298

    CAS  PubMed  Google Scholar 

  51. Korb DR, Henriquez AS (1980) Meibomian gland dysfunction and contact lens intolerance. J Am Optom Assoc 51:243–251

    CAS  PubMed  Google Scholar 

  52. Korb DR, Herman JP, Greiner JV et al (2005) Lid wiper epitheliopathy and dry eye symptoms. Eye Contact Lens 31:2–8

    Article  PubMed  Google Scholar 

  53. Lemp M, Holly FJ, Shuzo I, Dohlman C (1970) The precorneal tear film. 1. Factors in spreading and maintaining a continuous tear film over the corneal surface. Arch Ophthalmol 83:89–94

    CAS  PubMed  Google Scholar 

  54. Linton RG, Curnow DH, Riley WJ (1961) The meibomian glands: an investigation into the secretion and some aspects of the physiology. Br J Ophthalmol 45:718–723

    Article  CAS  PubMed  Google Scholar 

  55. Mathers WD (1993) Ocular evaporation in meibomian gland dysfunction and dry eye. Ophthalmology 100:347–351

    CAS  PubMed  Google Scholar 

  56. Mathers WD, Lane JA (1998) Meibomian gland lipids, evaporation, and tear film stability. Adv Exp Med Biol 438:349–360

    CAS  PubMed  Google Scholar 

  57. McCulley JP, Shine W (1997) A compositional based model for the tear film lipid layer. Trans Am Ophthalmol Soc 95:79–88

    CAS  PubMed  Google Scholar 

  58. McCulley JP, Shine WE (2001) The lipid layer: the outer surface of the ocular surface tear film. Biosci Rep 21:407–418

    Article  CAS  PubMed  Google Scholar 

  59. McDermott AM, Perez V, Huang AJ et al (2005) Pathways of corneal and ocular surface inflammation: a perspective from the Cullen symposium. Ocul Surf 3:S131–S138

    PubMed  Google Scholar 

  60. McDonald JE (1968) Surface phenomena of tear films. Trans Am Ophthalmol Soc 66:905–939

    CAS  PubMed  Google Scholar 

  61. Mishima S, Maurice D (1961) The oily layer of the tear film and evaporation from the corneal surface. Exp Eye Res 1:39–45

    Article  CAS  PubMed  Google Scholar 

  62. Nagymihalyi A, Dikstein S, Tiffany JM (2004) The influence of eyelid temperature on the delivery of meibomian oil. Exp Eye Res 78:367–370

    Article  CAS  PubMed  Google Scholar 

  63. Nagyova B, Tiffany JM (1999) Components responsible for the surface tension of human tears. Curr Eye Res 19:4–11

    Article  CAS  PubMed  Google Scholar 

  64. Nicolaides N, Kaitaranta JK, Rawdah TN et al (1981) Meibomian gland studies: comparison of steer and human lipids. Invest Ophthalmol Vis Sci 20:522–536

    CAS  PubMed  Google Scholar 

  65. Norn M (1985) Meibomian orifices and Marx’s line. Studied by triple vital staining. Acta Ophthalmol (Copenh) 63:698–700

    Google Scholar 

  66. Norn M (1987) Expressibility of meibomian secretion. Relation to age, lipid precorneal film, scales, foam, hair and pigmentation. Acta Ophthalmol (Copenh) 65:137–142

    Google Scholar 

  67. Norn MS (1979) Semiquantitative interference study of fatty layer of precorneal film. Acta Ophthalmol (Copenh) 57:766–774

    Google Scholar 

  68. Olami Y, Zajicek G, Cogan M et al (2001) Turnover and migration of meibomian gland cells in rats‘ eyelids. Ophthalmic Res 33:170–175

    Article  CAS  PubMed  Google Scholar 

  69. Purslow C, Wolffsohn JS (2005) Ocular surface temperature: a review. Eye Contact Lens 31:117–123

    Article  PubMed  Google Scholar 

  70. Shimazaki J, Sakata M, Tsubota K (1995) Ocular surface changes and discomfort in patients with meibomian gland dysfunction. Arch Ophthalmol 113:1266–1270

    CAS  PubMed  Google Scholar 

  71. Shine WE, McCulley JP (1991) The role of cholesterol in chronic blepharitis. Invest Ophthalmol Vis Sci 32:2272–2280

    CAS  PubMed  Google Scholar 

  72. Shine WE, McCulley JP (2003) Polar lipids in human meibomian gland secretions. Curr Eye Res 26:89–94

    Article  PubMed  Google Scholar 

  73. Siemasko KF, Gao J, Calder VL et al (2008) In vitro expanded CD4+CD25+Foxp3+ regulatory t cells maintain a normal phenotype and suppress immune-mediated ocular surface inflammation. Invest Ophthalmol Vis Sci 49(12):5434–5440

    Article  PubMed  Google Scholar 

  74. Stern ME, Pflugfelder SC (2004) Inflammation in dry eye. Ocul Surf 2:124–130

    PubMed  Google Scholar 

  75. Sullivan DA, Yamagami H, Liu M et al (2002) Sex steroids, the meibomian gland and evaporative dry eye. Adv Exp Med Biol 506:389–399

    CAS  PubMed  Google Scholar 

  76. Tiffany JM (1978) Individual variations in human meibomian lipid composition. Exp Eye Res 27:289–300

    Article  CAS  PubMed  Google Scholar 

  77. Tiffany JM (1979) The meibomian lipids of the rabbit. I. Overall composition. Exp Eye Res 29:195–202

    Article  CAS  PubMed  Google Scholar 

  78. Tiffany JM (1985) The role of meibomian secretion in the tears. Trans Ophthalmol Soc U K 104:396–401

    PubMed  Google Scholar 

  79. Tiffany JM (1986) Refractive index of meibomian and other lipids. Curr Eye Res 5:887–889

    Article  CAS  PubMed  Google Scholar 

  80. Tiffany JM (1987) The lipid secretion of the meibomian glands. Adv Lipid Res 22:1–62

    CAS  PubMed  Google Scholar 

  81. Tiffany JM (1995) Physiological functions of the meibomian glands. Prog Retin Eye Res 14:47–74

    Article  CAS  Google Scholar 

  82. Tiffany JM, Dart JKG (1981) Normal and abnormal functions of meibomian secretion. R Soc Med Int Congr Symp Ser 40:1061–1064

    Google Scholar 

  83. Tiffany JM, Marsden RG (1986) The influence of composition on physical properties of meibomian secretion. The preocular tear film in health, disease and contact lens wear. Dry Eye Institute, Lubbock TX, pp 597–604

  84. Tiffany JM, Nagyova B (2002) The role of lipocalin in determining the physical properties of tears. Adv Exp Med Biol 506:581–585

    CAS  PubMed  Google Scholar 

  85. Torens S, Berger E, Stave J, Guthoff R (2000) Darstellung der Mikroarchitektur und Dynamik der Aufreißphänomene des präkornealen Tränenfilms mit Hilfe der Laser-Rastermikroskopie. Ophthalmologe 97:635–639

    Article  CAS  PubMed  Google Scholar 

  86. Tsai PS, Evans JE, Green KM et al (2006) Proteomic analysis of human meibomian gland secretions. Br J Ophthalmol 90(3):372–377

    Article  CAS  PubMed  Google Scholar 

  87. Yokoi N, Bron AJ, Tiffany JM, Kinoshita S (2000) Reflective meniscometry: a new field of dry eye assessment. Cornea 19:S37–S43

    Article  CAS  PubMed  Google Scholar 

  88. Yokoi N, Takehisa Y, Kinoshita S (1996) Correlation of tear lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol 122:818–824

    CAS  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. Knop.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Knop, E., Knop, N. & Schirra, F. Meibom-Drüsen. Ophthalmologe 106, 884–892 (2009). https://doi.org/10.1007/s00347-009-2019-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-009-2019-9

Schlüsselwörter

Keywords

Navigation