Table 4.

Inclusion and Exclusion Criteria

Ref.	First Author	Evidence Level	Title	Inclusion Criteria	Exclusion Criteria
17	Perry HD	I	Efficacy of Commercially Available Topical Cyclosporine A 0.05% in the Treatment of Meibomian Gland Dysfunction	Adult patients with slit lamp diagnosis of meibomian gland dysfunction, with an OSDI score of >12.	Contact lens wear, active ocular disease other than blepharitis, surgery within past 3 months, active ocular allergy, used isotretinoin within the past 6 months, or have autoimmune disease requiring treatment.
21	Schechter BA	I	Efficacy of Topical Cyclosporine for the Treatment of Ocular Rosacea	Adult patients with rosacea-associated eyelid and corneal changes.	Eyelid defects, lagophthalmos, active ingredient sensitivity, pregnant/nursing mothers.
26	Yoo SE	I	The Effect of Low-Dose Doxycycline Therapy in Chronic Meibomian Gland Dysfunction	Adult patients with newly diagnosed chronic meibomian gland dysfunction with grade 2 or worse meibomian gland destruction or meibomian gland orifice obstruction, and whose symptoms failed to improve despite warm compression, lid massage, lid scrub, and topical eye drops or ointment therapy for more than 2 months.	Topical therapy within 2 weeks before the beginning of the study.
8	Goto E	I–II	Low-Concentration Homogenized Castor Oil Eye Drops for Noninflamed Obstructive Meibomian Gland Dysfunction	Consecutive series of adult MGD patients nonresponsive to conventional therapy, which could include lid hygiene and topical artificial tears, antibiotics (oral/topical), and/or corticosteroids.	Anterior blepharitis of more than moderate severity, infectious conjunctivitis, MGD with acute inflammation, seborrheic MGD. No patients wore CLs; unclear if this was an exclusion criterion.
20	Rubin M	I–II	Efficacy of Topical Cyclosporin 0.05% in the Treatment of Posterior Blepharitis	Consecutive adult patients presenting with posterior blepharitis defined as lid erythema and MG telangiectasia.	Current punctal plugs, doxycycline, steroids, women of childbearing age with no contraception.
10	Luchs J	II	Efficacy of Topical Azithromycin Ophthalmic Solution 1% in the Treatment of Posterior Blepharitis	Adult patients with a diagnosis of poster blepharitis by a qualified ophthalmologist; patients must have a grade of at least 2 of lid redness/swelling and gland plugging.	Eyelid structural abnormalities, active inflammation, fungal or viral infection, ocular surgery in the past 90 days, including LASIK or glaucoma surgery.
12	Matsumoto Y	II	The Evaluation of the Treatment Response in Obstructive Meibomian Gland Disease by in Vivo Laser Confocal Microscopy	Consecutive adult patients with severe obstructive MGD associated with lid inflammation.	History of Sjögren's syndrome; Stevens-Johnson syndrome; chemical, thermal, or radiation injury; or any ocular surgery or procedure that would create an ocular surface problem. History of contact lens use.
15	Olson MC	II	Increase in Tear Film Lipid Layer Thickness Following Treatment with Warm Compresses in Patients with Meibomian Gland Dysfunction	Consecutive adult patients with symptoms of ocular dryness were enrolled with the following criteria: (1) subjective dry eye status determined by a score of ≥6 on dry eye symptoms questionnaire; (2) meibomian gland obstruction determined by SLE; (3) TFLLT baseline of ≤90 nm; as well as fluorescein tear breakup time and Schirmer results of ≤10 mm/5 min.	Exclusions were not defined other than evidence of ocular disease.
16	Paugh JR	II	Meibomian Therapy in Problematic Contact Lens Wear	Consecutive adult contact lens wearers with (1) minimal or transient symptoms of dryness, (2) cloudy or absent MG secretions, and (3) CL intolerance not related to lens or solution parameters.	History of ocular trauma or surgery, use of tear-influencing medications, systemic connective tissue disease, ocular conditions (blepharitis, meibomitis, or any anterior segment disease), contact lens intolerance due to poor lens fit, deposits, care system hypersensitivity.
18	Pinna A	II	Effect of Oral Linoleic and Gamma-Linolenic Acid on Meibomian Gland Dysfunction	Group 4 and 5 of McCulley Classification system for MGD (McCulley et al. Classification of chronic blepharitis.27	Infectious keratoconjunctivitis, inflammatory disease unrelated to MGD, Schirmer I test result <10 mm/5 min, concomitant ocular disease, previous ocular surgery, alterations of the lacrimal drainage system, concomitant topical ophthalmic medic ations, topical ophthalmic steroids taken during the 4 weeks before the study; treatment with systemic drugs affecting.
19	Romero JM	II	Conservative Treatment of Meibomian Gland Dysfunction	Adult patients with (1) a chief complaint of MGD (ocular discomfort assessed by questionnaire) and (2) diagnosis of MGD with two or more of the following: redness or thickening of the lid margin, telangiectasia, reduced or no secretions, poor quality secretions, gland capping.	Current use of treatments for blepharitis, current use of topical or systemic steroids, topical or systemic antibiotics, or topical or systemic antimetabolites, history of contact lens wear, history of eyelid surgery, presence of any ocular disease provoking dry eye syndrome and
24	Souchier M	II	Changes in Meibomian Fatty Acids and Clinical Signs in Patients with Meibomian Gland Dysfunction after Minocycline Treatment	Adult patients with chronic posterior blepharitis defined by redness, thickening, or irregularity of the lid margin, telangiectasia, reduced or no secretions, poor-quality secretions, gland capping, and/or MG metaplasia.	Smokers, contact lens wearers, and diabetic patients.
25	Yalcin E	II	N-Acetylcysteine in Chronic Blepharitis	Adult clinic patients with chronic posterior blepharitis.	Eye disorders that could affect the ocular surface (e.g. infectious conjunctivitis), excessive meibomian lipid secretion, ≤10 mm by Schirmer II, and contact lens use.
14	Mori A	II–III	Disposable Eyelid-Warming Device for the Treatment of Meibomian Gland Dysfunction	Short term efficacy study: adult patients with TBUT ≤5 s and dry eye symptoms. Therapeutic study: adult patients with TBUT ≤5 s, MGD (not defined), and dry eye symptoms.	Exclusions were not defined.
1	Albietz JM	III	Effect of Antibacterial Honey on the Ocular Flora in Tear Deficiency and Meibomian Gland Disease	Consecutive adult dry eye patients subsequently classified into four groups: non-Sjögren's tear deficienc y, Sjögren's tear deficiency, MGD (posterior lid margin thickening, irregularity, telangiectasia, gland loss, plugging and capping, and abnormal MG secretions), and MGD plus tear deficiency.	Contact lens wear, eye surgery, punctal occlusion, and use of eye drops other than artificial tears within the past 3 months, ocular infection, pregnancy/nursing, changes in systemic medications altering the tear film, uncontrolled systemic disease.
2	Blackie CA	III	Inner Eyelid Surface Temperature as a Function of Warm Compress Methodology	Healthy adult individuals.	Ocular adnexal disease that would interfere with warm compress application.
3	Cetinkaya A	III	Pediatric Ocular Acne Rosacea: Long-Term Treatment with Systemic Antibiotics	Rosacea patients younger than 12 years of age, with or without obvious skin involvement, who were having active inflammation with ocular discomfort, photophobia, and red eyes, despite topical steroid, antibiotic or	Exclusions were not defined.
4	Dougherty JM	III	The Role of Tetracycline in Chronic Blepharitis: Inhibition of Lipase Production in Staphylococci	Isolates from patients with meibomian keratoconjunctivitis and staphylococcal blepharitis; patients not clinically defined.	Exclusions were not defined.
5	Epstein GA	III	Combined Excision and Drainage with Intralesional Corticosteroid Injection in the Treatment of Chronic Chalazia	Adult and pediatric patients undergoing surgical excision of chronic chalazia; patients not clinically defined.	Exclusions were not defined.
6	Goto E	III	Improvement of Tear Stability Following Warm Compression in Patients with Meibomian Gland Dysfunction	Consecutive adult patients with noninflamed obstructive MGD.	Anterior blepharitis of more than moderate severity, infectious conjunctivitis, MGD with acute inflammation, meibomitis, seborrheic MGD.
7	Goto E	III	Treatment of Non-Inflamed Obstructive Meibomian Gland Dysfunction by an Infrared Warm Compression Device	Consecutive adult patients with MGD unresponsive to conventional treatment, which could include lid hygiene and topical artificial tears, antibiotics (oral/topical) and/or corticosteroids.	Anterior blepharitis of moderate or greater severity, infectious conjunctivitis, occluded punctum, contact lens wear, best corrected acuity <1.0 logMAR, “obvious” eyelid skin abnormalities (atopic dermatitis).
9	Ishida R	III	Tear Film with “Orgahexa EyeMasks” in Patients with Meibomian Gland Dysfunction	Adult patients with simple MGD defined as (1) occluded MG orifices, (2) cloudy secretions, (3) keratinization and/or mucocutaneous junction displacement, and (4) noninflamed lid margins.	Exclusions were not defined.
11	Matsumoto Y	III	Efficacy of a New Warm Moist Air Device on Tear Functions of Patients with Simple Meibomian Gland Dysfunction	Adult patients with simple MGD defined as (1) occluded MG orifices, (2) cloudy secretions, (3) keratinization and/or mucocutaneous junction displacement, and (4) noninflamed lid margins.	Exclusions were not defined.
13	Meisler DM	III	Oral Erythromycin Treatment For Childhood Blepharokeratitis	Children with chronic lid margin inflammation (lid redness and thickening).	Exclusions were not defined.
22	Shine WE	III	Minocycline Effect on Meibomian Gland Lipids in Meibomianitis Patients	Patients were selected based on clinical appearance and categorized as having acne rosacea with or without meibomianitis, or seborrheic blepharitis alone.27	Exclusions were not defined.
23	Song CH	III	Enhanced Secretory Group II PLA2 Activity in the Tears of Chronic Blepharitis Patients	Adult patients with the presence of one or more of the signs and symptoms of blepharitis for more than 6 months, categorized into six blepharitis groups.27	Exclusions were not defined.