The lipid components of meibomian gland excreta were evaluated in rabbits after they received 2% topical epinephrine dropped into their eyes daily for a period of 6 months to a year to induce meibomian gland dysfunction (MGD). Changes were compared to excreta obtained from seven age-matched, untreated control rabbits. Comparison of the lipids from MGD lids with lipids obtained from control rabbits revealed, for clinically evident MGD, a marked increase in the lipids that are uniquely characteristic of epidermal tissue. These epidermal lipids are free sterols (large amounts) and a group of seven types of ceramides. The data are consistent with the hypothesis that the initiating factor of rabbit MGD is hyperkeratinization of the ductal epithelia. For clinically apparent MGD some hydrolysis of the sterol esters of the meibomian gland lipids also seems to have occurred. This was evidenced by the formation of an 8-fold increase in a cluster of anteiso fatty acids with chain lengths longer than C20 in the free fatty acid fraction. This group of free fatty acids was the same as the acids esterified to the sterol esters. We could detect no change in the lipid excreta obtained from rabbits that developed only subclinical MGD, consisting of orifice plugging and dilation of the duct.