There are oil glands at the bottom and top of our eyelid margins. These meibomian glands, which are also known as oil glands, are responsible for producing meibum, which is the oil and it’s the outermost layer of our tears. This oil layer helps to protect our tears from evaporating.
When the meibomian glands don't secrete enough of this oil, whether they're blocked or clogged or producing a poor quality of this oil, this results in meibomian gland dysfunction, which can lead to different symptoms.
What are the symptoms of a dysfunctional meibomian gland?
One of the symptoms can be dry eyes, because your tears evaporate faster now without the protective layer of oil on the outer surface of your tears. This can lead to:
How is meibomian gland dysfunction diagnosed?
There are several different ways that our eye doctors diagnose Meibomian gland dysfunction. In order to measure how severe their symptoms may be, we ask our patients to fill out a symptom survey first. Take the assessment on our website.
Our eye doctors then examine the eyelid margin under the slit lamp. They examine the lid margins, both the upper and lower lid margins, under our microscope. The eye doctor wants to make sure that it is not uneven or scalloped. In addition, they look at the oil glands, making sure none of them are blocked or clogged. Several dyes are also injected into the patient's eyes in order to observe how quickly their tears evaporate. The eye doctor then looks at the tear volume. Our office also has a multifactorial corneal topographer, which can take an image of the interior of your meibomian glands and show us if they've shrunk, atrophied, or are healthy and intact.
What are the different treatment options available for meibomian gland dysfunction?
There are several treatment options we would recommend to our patients. If my meibomian gland dysfunction is caught early on, we may notice signs before the patient exhibits any symptoms. It's vital to treat the meibomian gland dysfunction, so that eventually the patients won't experience symptoms from the meibomian gland dysfunction. Furthermore, if you fail to treat meibomian gland dysfunction early on, the meibomian glands may end up atrophying, which means you can never have that meibomian gland back. Our goal is to preserve as much of the meibomian gland as possible.
- Eye masks - First and foremost, the main treatment is to apply heat to your eyes. Dr. Pinkhasov, typically recommends bruder eye masks or any generic eye mask that you can put in the microwave. You can also boil up gel beads or masks that you can place over your eyes if you don't have a microwave at home. If the condition is moderate to severe, you hold it over your eyes for up to 10 minutes. It will provide constant heat over your eyes.
- Massage your eyelid margins - After that, it's important to really massage your eyelids. You'll massage your lower lids while you're looking upward. You'll start at the bottom of your eyelid and then roll upward until you reach your lash line. Additionally, you should massage the top of your eyelid margins. You will look downward, start at the top of your eyelid, and work your way all the way down to your eyelid margin.
- Lid scrubs - Following that, it may be necessary to use a lid scrub to remove any excess oils. After this procedure, you may experience a little bit of blurry vision since oil is being released from the oil gland. If you use artificial tears to help flush out your eyes, you can help solve this problem.
- Eye drops - Additionally, we may recommend various other treatment options, such as different artificial tears, or different prescription eye drops.
- In-office procedure - If we notice that even after applying the warm compresses and even after scrubbing your eyes, the glands don't seem to be improving as much, there are different office procedures we can apply as well. These include a variety of heating techniques in order to be able to properly heat up both the inside and outside of the oil glands and get them up to a certain temperature. There are machines that can express meibomian glands for you or we can manually express those glands so that the oil can drain and start functioning the way it is supposed to.
