Purpose: To look for sex hormone receptor distribution in three structures
contributing to the normal human tear film: the conjunctiva, the accessory
lacrimal glands, and the meibomian glands.
Design: An immunohistochemical study.
Tissues and Controls: Forty-one upper eyelid specimens were collected from
15 male and 26 female patients (age range, 1.5-85 years) during blepharopto
sis surgery via posterior tarsoconjunctival mullerectomy (Fasanella-Servat
or Gavaris). In addition, control sections of histologically normal breast,
prostate, and skin tissue were obtained.
Methods: Immunohistochemical staining using mouse monoclonal antibodies aga
inst estrogen, progesterone, and androgen receptors was performed on all ti
ssues and controls. Quantitation of the receptors was performed and express
ed as percentage nuclear positivity. Specimens were divided into three grou
ps based on the age of the patient: <12 years (n = 9); 18-55 years (n = 1);
>55 years (n = 12).
Results: Forty-one specimens contained conjunctiva. All were negative for e
strogen, progesterone, and androgen receptors. Twenty-four specimens contai
ned accessory lacrimal glands of Wolfring, All were negative for the three
receptors. Twenty-two specimens contained meibomian glands. All were positi
ve for estrogen receptors; one was positive for progesterone receptors and
one for androgen receptors. Using Minitab statistical software (Minitab Inc
. State College, PA), analysis of variation revealed no statistical differe
nce between sexes or between age groups studied. The sebaceous glands of sk
in were uniformly positive for androgen receptors, Sebaceous glands of the
face and scalp (3 of the 15 skin samples) were also positive for estrogen r
eceptors.
Conclusions: Estrogen receptors are present in the meibomian glands of the
upper eyelid. Unlike sebaceous glands elsewhere on the skin, the meibomian
glands lack androgen receptors, Estrogen receptors may play a role in modul
ation of the lipid layer of the tear film, and their activity may be linked
to meibomian gland dysfunction and dry eye syndrome. Ophthalmology 2000; 1
07:180-184 (C) 2000 by the American Academy of Ophthalmology.