{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:48:24Z","timestamp":1784069304024,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe a clinical entity of upper eyelid margin and meibomian gland inversion (MGI) sequential to meibomian gland dysfunction (<jats:styled-content style=\"fixed-case\">MGD<\/jats:styled-content>), in the absence of eyelash ptosis, trichiasis or manifest marginal entropion. We highlight its clinical features, surgical management and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective analysis of symptomatic <jats:styled-content style=\"fixed-case\">MGI<\/jats:styled-content> cases refractory to conservative management who underwent surgery in our centre over a 4\u2010year period. Anatomical correction, resolution of symptoms and possible complications are reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 21 eyelids of 13 patients (mean age: 68.5\u00a0\u00b1\u00a015.4, range: 32\u201388\u00a0years) were analysed. Symptomatic <jats:styled-content style=\"fixed-case\">MGI<\/jats:styled-content> patients were operated only if they have noted immediate comfort when we corrected the lid margin position with a cotton tip. Those with refractory superior punctate corneal staining (<jats:italic>n<\/jats:italic>\u00a0=\u00a014 eyes), blink\u2010related discomfort (<jats:italic>n<\/jats:italic>\u00a0=\u00a08) and pseudo\u2010blepharospasm (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) reported complete postoperative resolution. Milder symptoms showed partial improvement: gritty feeling (79%), sore eye (80%) and watery eye (86%). However, symptoms of dry eye disease (<jats:styled-content style=\"fixed-case\">DED<\/jats:styled-content>) persisted in 88% of patients. One case recurred in 6\u00a0weeks and was offered revision surgery. Median follow\u2010up was 5 (range: 3\u201312) months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Meibomian gland inversion (<jats:styled-content style=\"fixed-case\">MGI<\/jats:styled-content>) is a subtle clinical entity that can be easily overlooked. Symptoms are often attributed to <jats:styled-content style=\"fixed-case\">DED<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">MGD<\/jats:styled-content> alone. It is likely that <jats:styled-content style=\"fixed-case\">MGI<\/jats:styled-content> represents early upper lid margin anatomical changes secondary to <jats:styled-content style=\"fixed-case\">MGD<\/jats:styled-content> before cicatricial marginal entropion becomes clinically apparent. Recommended treatment is conservative with intensive lid hygiene and topical <jats:styled-content style=\"fixed-case\">MGD<\/jats:styled-content> management. However, refractory symptomatic cases who respond positively to a \u2018cotton\u2010tip test\u2019 (reversal of lid margin malposition with a rolling cotton\u2010tip) may benefit from surgical intervention with favourable anatomical and functional outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14155","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T10:35:23Z","timestamp":1560249323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Meibomian gland inversion: under\u2010recognized entity"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8571-8246","authenticated-orcid":false,"given":"We Fong","family":"Siah","sequence":"first","affiliation":[{"name":"Eye Unit University Hospital Southampton NHS Foundation Trust Southampton UK"},{"name":"Corneoplastic Unit Queen Victoria Hospital NHS Trust East Grinstead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostas","family":"Boboridis","sequence":"additional","affiliation":[{"name":"Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrina","family":"Tan","sequence":"additional","affiliation":[{"name":"Corneoplastic Unit Queen Victoria Hospital NHS Trust East Grinstead UK"},{"name":"Department of Ophthalmology Ng Teng Fong General Hospital National University Health Services Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre S.","family":"Litwin","sequence":"additional","affiliation":[{"name":"Corneoplastic Unit Queen Victoria Hospital NHS Trust East Grinstead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheraz M.","family":"Daya","sequence":"additional","affiliation":[{"name":"Centre for Sight Hazelden Place East Grinstead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raman","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Corneoplastic Unit Queen Victoria Hospital NHS Trust East Grinstead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.72.1.17"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1991.65"},{"key":"e_1_2_6_4_1","first-page":"67","volume-title":"Oculoplastic surgery. 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