Meibomian Gland Disorder
Meibomian 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 evaporates very quickly, leaving the eyes feeling very dry and irritated.
Each eye has between 60 to 80 Meibomian glands, with the upper eyelids usually having slightly more than the lower eyelids, approximately 20 to 30 Meibomian glands are on the lower lid and 40 to 50 on the upper lid. 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 centimetre 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 drain 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 eyelids can help with most of these causes, except the mites, which will require prescription medication to safely and effectively 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 Meibomian Gland Dysfunction
The symptoms of Meibomian gland dysfunction are virtually identical to those of dry eye syndrome,
- Red eye or eyes
- Itchy eyes
- Blurred vision
- 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 Meibomian Gland Dysfunction
There is no uniform treatment for Meibomian gland dysfunction, but rather a diversity of options. To treat the condition your Optometrist or eye doctor needs to determine whether it is caused by blocked glands or insufficient oil production. Both of these causes 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 cloth will help to soften and loosen the dried, oily clogs, but is not 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 anaesthetic 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 modifications to your diet can help, too, specifically in regard 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.
These small plugs are inserted into the tear ducts, they effectively block the duct and prevent drainage therefore keeping the tears in the eye
A warm (not too hot) compress placed over the affected eye will soften the dried matter and may help the natural oils flow more freely.
These products are designed to loosen and remove debris from the eyelashes and around the lids and delicate skin surrounding the eye.
A pharmacist may be able to suggest some over the counter eye drops that can relieve your symptoms but not necessarily treat the condition.
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: 3 Jan 2023