Meibomian gland dysfunction(MGD) is the leading cause of dry eye through out the world. Lid hygiene is the mainstay of the clinical treatment of MGD. Tea Tree Oil(TTO) derived from the leaves of Melaleuca alternifolia, has antibacterial, antifungal, antiviral and anti-inflammatory properties. It has been used for Demodex blepharitis treatment, topically. In this study, we compared its effects on recovery of MGD signs and symptoms with baby shampoo.

40 patients with MGD were included in this study. They were treated by daily lid scrubbing with TTO in one eye and baby shampoo in other one. Solutions were prepared in same bottles and each bottle was mareked for one eye. Patients and physician weren’t informad about bottles content. Other medicatinos were same in two eyes. At first and then after 1 and 3 months, patients were exammed by slitlamp biomicroscopy and asked about their symptoms, in each eye, separately. At the end of the study, after analyzing data, we informed about bottle content. Baby shampoo was used for right eye and left eye was treated with TTO.

Plugging and capping of meibomian gland orifices, foamy tear, glands expressibility, ocular surface disease index(OSDI) and tear breakup time(TBUT) were improved significantly in both eyes(all variables P value was less than 0.001). Recovery of above variables in left eye was more than right eye(capping P =0.05, other variables P less than 0.001). Scores of meibum quality, conjunctival hyperemia, corneal and conjunctival staining and schirmer test value were improved significantly in both eyes(all variables P value was less than 0.001). But there was no considerable difference between eyes.Lid margin telangectasia resolved in left eye, only(P less than 0.001). lid margin thickening and notching, trichiasis and distichiasis and lash loss changed in neither right and nor left eye(P=1). Ocular surface irritation during scrubbing was more in left eye(P=0.002).

TTO controlled MGD signs and symptoms better than baby shampoo, but ocular surface irritation during its application was more.