This is the first case report to show the association between Mooren’s Ulcer and Severe Meibomian Gland Atrophy (SMGA). The question is: what came first the SMGA or the Mooren’s Ulcer?
Here is his meibography for the left eye which has the ulcer. He is a stage 3 out of 4 (0 being normal==no gland loss) in his left lower lid.
He has been dealing with this ulcer for 3 months.
His right eye also has severe meibomian gland loss. He used to be a computer programmer. Likely the gland loss started and now something has tipped his immune system over the edge to attack his cornea and lead to this severe melt.
I put a Prokera on him today as his pain got worse after a bandage contact lens was placed for a non-healing cornea. He will come in again in a few days to see how he looks. Saving the meibomian glands are key but very tough.