Lid Margin Debridement

Lid margin debridement, a treatment for blepharitis, entails scraping both the keratinized lid margin (from the mucocutaneous junction to the base of the lashes) and the thickened Line of Marks (the thin line of the eye lid margin that makes contact with the eye, just inside the meibomian glands) to facilitate meibum delivery to the lid margin.

BlephEx is an in-office procedure performed with a handheld device that spins a medical grade micro-sponge along the edge of the eyelids and lashes, removing debris and exfoliating eye lids. The procedure lasts about 6-8 minutes. A numbing drop is usually placed in each eye prior to treatment for increased comfort.

Lid margin debridement may not be without risk.

Lid margin debridement may cause a  loss of gap junctions of the lid margin epithelial cells allowing infiltration of toxic, allergic, and other molecules into the periglandular zones, causing increased inflammation and meibomian gland obstruction. Trauma to the lid margin with repeated debridement may also lead to scarring of the meibomian gland orifices, and obstruction.

References

Epidermal differentiation: the role of proteases and their inhibitors
Zeeuwen PL.
European Journal of Cell Biology
2004 Dec;83(11-12):761-73.
View the full report

Structure and functions of keratin proteins in simple, stratified, keratinized and cornified epithelia
Bragulla HH, Homberger DG.
Journal of Anatomy
Apr;214(4):516-59. doi: 10.1111/j.1469-7580.2009.01066.x.
View the full report