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Everything You Need to Know About Meibomian Gland Dysfunction

Studies indicate 86% of dry eye sufferers show signs of Meibomian Gland Dysfunction (MGD), so if you have dry eye, you likely have MGD.

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What is Meibomian Gland Dysfunction?

Meibomian gland dysfunction is when the meibomian glands, which are essential for optimal eye health, are either not secreting enough meibum (an oil that prevents tears from evaporating too quickly), or are secreting poor quality oil. This condition is often diagnosed and treated by our eye doctor. In many instances, the opening of the glands become clogged, resulting in less secreted oil, which may be granular or otherwise irritating to the eyes.

Patients with meibomian gland dysfunction are often asymptomatic at first, but if not detected and treated in the early stages by our eye care professional, it can both cause and exacerbate dry eye symptoms and inflammation of the eyelids, which can become extremely unpleasant. This is one of the many reasons why routine visits to your local eye care clinic is necessary.

Symptoms

Symptoms

Symptoms of meibomian gland dysfunction may not appear in its early stages. However, as it progresses and less and less of the proper quality oil is secreted into the tear film, it may lead to the following symptoms:

  • Itchy eyes: This is often one of the first signs of MGD. The eyes may feel constantly itchy, which can be quite uncomfortable.
  • Burning sensation: Along with the itchiness, there may also be a burning sensation in the eyes.
  • Dry and irritated eyes: The eyes may feel very dry and irritated as a result of the lack of proper quality oil in the tear film.
  • Foreign body sensation: This can feel as if there is always a grain of sand or dust in the eye, leading to discomfort.
  • Red, irritated, and inflamed eyelids: The eyelids may become inflamed and red, which can cause discomfort.
  • Rough or uneven inner eyelid rim: The inner rim of the eyelid may appear rough or uneven due to the dysfunction of the meibomian glands.
  • Blurry vision: This symptom can be intermittent and often improves upon blinking.
  • Exacerbation due to environmental factors: Certain conditions, such as dry air and prolonged screen time, can worsen these symptoms.

If you are experiencing any of the symptoms above, call your eye doctor to schedule an evaluation.

MGD Complications

MGD Complications

These are some of the complications of meibomian gland dysfunction:

  • MGD is a frequent instigator of dry eye syndrome: This condition is well-known for being one of the primary contributors to dry eye syndrome, a common eye discomfort.
  • MGD can result in blepharitis: This dysfunction can cause inflammation of the eyelids, a condition referred to as blepharitis.
  • Conditions may coincide: It is not uncommon for these conditions - MGD, dry eye syndrome, and blepharitis - to be experienced simultaneously. However, the exact nature of their interrelationship is not fully understood by experts, including the sequence of onset.
  • MGD can complicate eye surgery: If you are living with untreated MGD, undergoing eye surgery may elevate the risk of complications, such as infection and inflammation. These could potentially precipitate cornea disease.
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How is Meibomian Gland Dysfunction Diagnosed?

How is Meibomian Gland Dysfunction Diagnosed?

Meibomian gland dysfunction needs to be diagnosed by our eye care professional. Our optometry clinic is equipped with the necessary tools and resources to diagnose and manage this condition. To check if you have MGD, there are several tests that can be performed.

You’ll be asked to fill out a symptoms assessment form and a dry eye questionnaire, after which points several types of tests may be performed to determine the nature of your dry eye symptoms and whether you have meibomian gland dysfunction. These tests measure the quantity and quality of tears being produced, and some can specifically check the quality of the meibum (the oil produced by the meibomian glands).

These may include:

  • Measure of osmolarity
  • Tear secretion test, such as the Schirmer’s test
  • Measurement of tear volume
  • Tear evaporation rate (Evaporimetry)
  • Corneal and conjunctival staining

Tests to assess ocular inflammation

Additionally, some specialty clinics may use advanced photography utilizing multifunctional corneal topography and digital imaging instruments to obtain accurate looks at the various parts of the eye which may be affected by dry eye.

Based on the results of these tests, the doctor will be able to determine whether you have MGD.

At-Home Care

During the early stages of meibomian gland dysfunction, self-care can be helpful.

  • Placing a warm, wet washcloth or a heat back over your eyelids twice a day for 5 minutes, can help loosen the oil. You can follow this with a light fingertip massage of the eyelids.
  • To massage the upper lids, look downward and then gently roll one side of your finger from the top of the eyelid to the lash line. To massage the lower lid, stare upward as you roll a finger up to the lash line.
  • Using a non-soap cleanser can help unblock gland openings, and a humidifier can counteract the drying effect of air conditioning and heating.
  • It is also advised to avoid the eye areas when you use beauty products that contain retinoids.
  • If you wear contacts, water gradient daily disposable lenses may be more comfortable.

Additionally, consult with a doctor about taking omega-3 fatty acid supplements, as they have anti-inflammatory properties and can improve meibum quality.

Symptoms
MGD Complications

Medical Treatment

More advanced MGD requires medical treatment. Steroids (either topical, spray, eye drops or pills), can be prescribed to help decrease inflammation.

In the office, the doctor may use medical devices specially designed to unblock meibomian glands to improve symptoms. Some of these, such as Systane iLux, Tearcare, Lipiflow, and Mibo Thermoflo, emit heat from the devices directly to the target area to melt buildup and allow the glands to be unclogged via expression of the glands. Intense Pulse Light therapy (IPL), works similarly, but utilizes light to generate the necessary heat to melt the obstructions.

Being consistent with whatever treatment is recommended to you is vital to keep your MGD from getting worse, and in-office treatments such as those mentioned above are capable of providing much longer-lasting relief than at-home treatments like warm compresses.

How Can I Find An Eye Doctor Near Me?

If you don’t already have a trusted optometrist, you could start your online search by typing in phrases such as "eye doctor near me," "optometrist near me," or "Dry eye specialist near me."

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Common Questions

Depends on the severity of the meibomian gland dysfunction (MGD). We have meibomian glands on our upper and lower lid margin that help to produce oil, which contributes to the outermost oil layer of our tears and prevents our tears from evaporating. MGD is when the glands don’t work properly. If these glands are blocked, they do not secrete the oils necessary to maintain a healthy tear film, and can eventually die off resulting in various symptoms such as dry eyes, burning, itching, irritation, tearing, foreign body sensation etc. If the glands have already atrophied then there is no way of getting the glands back. However, if the glands are still present but just truncated or tortuous, then there is still a chance to allow the glands to start working properly again with various MGD treatment options.
Meibomian Gland Dysfunction (MGD) is a common condition that can significantly affect a person's quality of life if left untreated. It's a primary contributor to dry eye syndrome, which can cause discomfort, irritation, and in severe cases, potential vision issues. MGD might begin as a minor irritation, but if undiagnosed or untreated, it can exacerbate other eye-related issues, affecting the overall ocular health. It's vital to seek assistance from a trusted eye care provider who can assess, diagnose, and provide the necessary treatment to manage this condition.
Several factors can exacerbate MGD. Environmental conditions such as dry or windy climates, high altitude, and air-conditioned environments can worsen symptoms. Prolonged screen time without regular breaks can contribute to the condition, as well. Lifestyle habits like poor diet and inadequate hydration can also negatively impact MGD.
MGD can be managed with a combination of home treatments and medical interventions. Home remedies include warm compresses and lid massages to stimulate oil production and relieve blockages. Additionally, maintaining a healthy diet rich in Omega-3 fatty acids can improve the quality of the meibum. Prescription treatments or office procedures like IPL, Lipiflow, or meibomian gland expression can also help.
Given the chronic nature of MGD, the term "cure" may not be the best descriptor. It's more about managing the symptoms and improving the quality of life for the patient. The length of treatment and its success can vary widely depending on individual factors, including the severity of the condition, the patient's overall health, and their adherence to the prescribed treatment regimen.
Everything You Need to Know About Meibomian Gland Dysfunction
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Summary

Meibomian gland dysfunction is a very common problem which can cause dry eye. While in its early stages it can be managed at home, if it gets more severe proper medical care is vital to help relieve symptoms and improve your quality of life. If you’re suffering from dry eye symptoms, you can reach out to your nearest Amplify EyeCare practice either via a call or in-person visit. Our team of eye care professionals is ready and equipped to provide you with the care you need.

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