Meivertor is a patented, single-handed eyelid-eversion instrument that enables fast, consistent upper and lower lid meibography, as well as secure upper eversion for procedures requiring a free hand. Its disposable silicone tips gently grasp the lashes and evert the lid with a simple turning motion, improving comfort for both patient and provider.
Meivertor also holds the eyelid in place for extended procedures such as foreign body removal, concretion or cyst extraction, scleral lens fitting, and lid wiper assessment.
Meivertor is distributed in the United States, Canada, and select international markets, and is used in optometry, ophthalmology, and emergency-care settings to streamline exams and enhance diagnostic efficiency.
A newly published study in the peer-reviewed journal Cornea reveals that upper eyelid meibography is not just clinically relevant—it may be essential for early detection of ocular surface disease, contact lens dropout risk, post-cataract dry eye, and even systemic autoimmune conditions.
Authored by Preeya K. Gupta, MD, and Paul Karpecki, OD, the paper titled “Comprehensive Assessment of the Meibomian Glands by Meibography: Why the Upper Eyelids Matter,” provides a detailed literature review of research spanning nearly two decades and makes a compelling case for the routine evaluation of the upper eyelid during meibomian gland imaging.
Despite the well-established importance of meibography in diagnosing and managing meibomian gland dysfunction (MGD) and dry eye disease (DED), upper eyelid imaging remains underutilized in clinical practice.
Historically, this has been due to the technical difficulty of consistent upper lid eversion and a lack of workflow-friendly tools.
However, Gupta and Karpecki point out that neglecting the upper eyelid may result in delayed diagnoses and missed opportunities to intervene early in disease progression—particularly in patients at risk for dry eye secondary to contact lens wear, cataract surgery, or autoimmune conditions such as Sjögren’s syndrome or thyroid eye disease.
The study explains that the upper eyelid contains more meibomian glands than the lower lid, and these glands are longer and more delicate. This makes them especially susceptible to early structural changes such as tortuosity and dropout, which may precede symptomatic disease.
The authors present evidence that these early changes can help clinicians identify dysfunction before it becomes advanced, and they emphasize that upper eyelid imaging can reveal morphological features that are not visible in the lower lid.
Notably, Gupta and Karpecki highlight new findings showing that upper eyelid gland dropout is strongly correlated with postoperative dry eye symptoms in patients undergoing cataract surgery—even in individuals who were asymptomatic beforehand.
A separate body of research reviewed in the paper found that upper lid gland tortuosity and meibum quality are major predictors of contact lens dropout. These observations underscore the value of imaging the upper eyelid not just for diagnosis, but also for risk stratification and patient counseling. 1 | Page
The paper also discusses emerging insights into how upper eyelid gland morphology is affected in systemic conditions. In patients with Sjögren’s syndrome, upper lid gland dropout is significantly more severe than in patients with non-Sjögren’s dry eye, providing potential diagnostic value. In cases of thyroid eye disease, researchers have observed greater upper lid gland loss due to altered blinking mechanics and ocular surface exposure, pointing to a clear link between upper lid structure and symptom severity.
Gupta and Karpecki call for clinicians to adopt a more comprehensive approach to meibomian gland evaluation—one that includes both upper and lower lids. While lower eyelid imaging may remain more common due to ease of access, the authors argue that evaluating only the lower lid can offer an incomplete or even misleading clinical picture. Moreover, they point to the need for improved tools and technologies that make upper lid imaging more accessible in routine clinical practice.
The review concludes that integrating upper eyelid assessment into standard imaging protocols could significantly enhance clinicians’ ability to detect disease early, guide treatment, and monitor outcomes across a wide range of ocular and systemic conditions.
With advancements in eyelid eversion technology making upper lid meibography faster and more reliable, Gupta and Karpecki’s findings are expected to influence how eye care providers approach the evaluation and management of MGD and DED going forward.
For more information or to request a copy of the article, contact Sharon Burkart, Hellem Consulting at 404-862-6661 or sharon.burkart@hellemconsulting.com.