Meibomian Gland Disorder
Meibomium Gland Disorder (MGD), sometimes called meibomianitis, is a condition in which the tiny meibomian glands within the eyelids fail to function properly. Under normal circumstances, these glands are responsible for producing small amounts of an oily lipid that helps keep the eyes well lubricated. Without this substance, the watery portion of tears would evaporate very quickly, leaving the eyes feeling very dry and irritated.
Each eye has between 50 to 70 meibomian glands, with the upper eye lids usually having slightly more than the lower eye lids. They are susceptible to becoming blocked or clogged, which then leads to a host of issues. In addition to diminished lubrication of the eyes, the clogged glands can also swell, filling with fluid that is unable to drain. These cysts are called styes, and can become infected easily. They are painful, red bumps that can grow to almost a centimeter in diameter. Sometimes these blockages can drain on their own, or with the application of a warm, damp cloth. Otherwise they may need to be treated by a doctor, who will be able to train them through a very small incision.
Blockages can be caused by dried fluids, dead skin cells, dirt, or even small parasites called demodex mites that live inside the glands. Specialized soap intended for washing the eye lids can help with most of these causes, except the mites, which will require prescription medication to safely and effective eliminate.
Almost all cases of dry eye disease are rooted in MGD, and it affects a surprisingly large number of people in the world. MGD affects nearly 60% of all people, and is much more prevalent in people over the age of 40. However, not all ethnicities are at equal risk. Between 50-70% of the population in countries like Thailand, Japan, and China are affected, compared to only 3-20% of people in the US, Australia, and Canada.
Certain personal hygiene and cosmetic products can also contribute to MGD, especially those used particularly close to the edges of the eyes. Being careful during application, as well as thoroughly removing the products at night will reduce the risk of developing clogged meibomian glands.
Symptoms of Meibomiam Gland Dysfunction
The symptoms of meibomian gland dysfunction are virtually identical to those of dry eye syndrome, red, itchy eyes, blurred vision, and the sensation of a foreign body on the eye. Unfortunately, these symptoms alone aren't enough to diagnose the issue, as they may point to a large number of different eye-related issues. It's best to make an appointment with an eye doctor who can perform an exam and provide an accurate clinical diagnosis.
During the exam, the doctor will likely apply gentle pressure to the eyelid in an attempt to express the fluid within the meibomian glands. Based on the amount and appearance of the secretions, if any, a diagnosis of MGD may be made.
Treating Meibomiam Gland Dysfunction
To treat the condition, either the glands to be unblocked, or the oils that they aren't sufficiently producing need to be supplemented. Both of these approaches are likely to include specialized eye drops, designed to either loosen and relieve the clog, or moisten and lubricate the surface of the eye.
The classic approach of simply applying a warm damp rag will help to melt and loosen the dried, oily clogs, but will far short of being a comprehensive cure. Fortunately, modern medicine has developed far better ways or treating MGD, such as tools designed to probe and dilate the openings of the meibomian glands in order for their fluids to flow properly.
Meibomian gland probing: This is a simple technique performed by your eye doctor to unclog the opening and main duct of your meibomian glands. After anesthetic eye drops are applied to the eye, your doctor uses a hand-held instrument to probe and dilate the openings of your meibomian glands near the base of your eyelashes. This is a highly effective and successful means of clearing blockages and eliminating MGD symptoms, however it does not prevent the condition from developing again in the future.
Because of the risk of infection posed by meibomian gland blockages, antibacterial eye drops may also be prescribed, however they may not be needed, and should only be used under a doctor’s recommendation.
Dietary supplements or modification can help, too, specifically in regards to omega-3 fatty acids. These are found in foods like fish and nuts, and will greatly help with the healthy production of oils within the eyelids, and skin in general. This offers the benefit of not just reducing symptoms now, but helping to prevent future issues as well.
As with any eye-related problem, only your eye doctor will be able to make an accurate diagnosis and prescribe an effective treatment plan. Anyone suffering from dry, irritated eyes should schedule an appointment with an eye care professional today.
Author: John Dreyer Optometrist Bsc(Hons), MCOPTOM, DipCLP
Created: 28 Jul 2017, Last modified: 10 Feb 2020