Meibomian Gland Dysfunction
Meibomian Gland Dysfunction (MGD) is a common condition also known as Evaporative dry eye disease.
The meibomian glands are little pumps located along the edges of the eyelids. These glands produce the oily component of the tear film, known as meibum. Every time we blink, we pump this oil, meibum, into our eyes. This oil layer is crucial for preventing tears from evaporating too quickly and for keeping the eyes lubricated.
What Happens in MGD:
In MGD, the meibomian glands become clogged or inflamed, leading to reduced oil production or altered quality of the meibum. This can result in a thickening or blockage of the gland’s ducts, preventing the proper release of oil onto the eye’s surface.
Causes:
MGD can be caused by various factors, including prolonged digital screen use, makeup, hormonal changes, aging, certain medications, and conditions like blepharitis or acne. Ocular rosacea, like Rosacea on the cheeks, can cause irritation to the meibomian glands.
Symptoms:
MGD can cause a range of symptoms, including dryness, irritation, a gritty or burning sensation, blurred vision, and redness. It often leads to evaporative dry eye, where the tears evaporate too quickly due to the lack of an adequate oil layer.
Treatment:
Treatment for MGD aims to restore proper gland function and may include:
Warm Eye Mask: Applied to the eyelids for 10 minutes at night. This is to help loosen and release blockages. A warm washcloth does not work, because it does not stay hot long enough.
Mybo Clean: Regular cleaning of the eyelid margins to reduce inflammation and remove debris. This product uses manuka honey, which has antibacterial properties and has shown to be effective against Demodex.
Other Lid Wipes: OcuSoft and Optase are both good at cleaning the eyelid margin to reduce inflammation and remove debris.
Medications: Including oral antibiotics or antibiotic eye drops and ointments.
In-Office Procedures: Such as intense pulsed light (IPL) and low level light therapy (LLLT) to treat and manage MGD more effectively.
The meibomian glands are like pumps within the eyelids. They pump oil into the eyes.
The oil should look like olive oil similar to this picture here.
When the glands are blocked the oil becomes hardened and solid.
If we warmed up clogged glands and did expression it would look like thick cheese or toothpaste material coming out of the gland, instead of a clear oil.
This is important because the meibomian glands release the oil into the tear film which helps slow down the evaporation of our tears. If your glands are blocked your tears are evaporating, leaving the eye, too fast.
You can think of your glands similar to teeth. You are born with a set of them and if you do not take care of them they will go away. Picture A shows nice healthy meibomian glands. Picture B shows some loss of glands and unhealthy glands. Picture C shows a complete loss of the meibomian glands. Picture C patient would have to be using many different eyedrops and prescription eye drops to treat and make their eyes feel better. They would not be able to wear contacts comfortably, if at all.
A warm eye mask offers several benefits by applying consistent heat directly to your eyelids. This heat helps to soften and melt the oil in your meibomian glands, which can improve the stability of your vision, enhance eye comfort, and make wearing contact lenses more comfortable. Unlike a washcloth, which cools down too quickly, a warm eye mask provides sustained heat for about 10 minutes, which is crucial for effectively loosening blocked oil. However, if the warm eye mask alone isn't sufficient to clear the glands, we may need to consider additional in-office treatments such as Intense Pulsed Light (IPL) therapy or Low-Level Light Therapy (LLLT).