What is Meibomian Gland Dysfunction?

Dry Eyes

We’ve all seen the ads on TV: an impossibly good-looking eye doc saves the day for her patient with dry eyes. Even more, at least one of those attractive eye doctors uses the prescribed medication to treat their own eyes.

And while the doc’s treating a very specific dry eye problem — dry eye syndrome — medication of choice also eases one of its causes, meibomian gland dysfunction.

What Is a Meibomian Gland?

Meibomian glands lie just over and under the eyelashes. Each eye has 20 to 30 of these glands on the lower eyelid and 40 to 50 on the upper lid. They secrete meibum, an oily substance that keeps the eye surface clean and lubricated.

Each time we blink, we spread meibum over the eye. It mixes with tears to enhance refraction on the eye surface to maintain consistent visual input to the brain.

Meibomian Gland Dysfunction Is a Type of Meibomian Gland Disease

Meibomian gland disease is defined as a broad range of disorders that affect meibomian glands, including meibomian gland dysfunction. Other types of meibomian gland diseases include neoplasia (uncontrolled cell growth) and congenital eye diseases.

Meibomian gland dysfunction occurs when the glands are blocked or develop some kind of abnormality that prevent them from creating and discharging meibum. This diminishes tear quality and quantity, causing symptoms similar to dry eye syndrome: eyes that feel dry or gritty, itchy, and blurred vision.

It can also cause blepharitis, where the eyelids become red and sore, leaving crust on the eyelashes. Blepharitis is also caused by bacteria inside the eyelid, which can make problems in the meibomian glands.

Meibomian gland dysfunction is diagnosed with tools that measure the amount of force needed for the glands to push out the oils, and how quickly tears lose stability and break upon the eye.

Meibomian Gland Dysfunction Is a Common Eye Problem

Meibomian gland dysfunction is pretty common. Most researchers think it’s caused by bacteria, either started in the glands or spread from other parts of the eye. It’s a kind of bacterial conundrum. It’s also been noted in patients with skin conditions like rosacea and seborrheic dermatitis.

Here are some other contributing risk factors:

  • Wearing contact lenses. Contact lenses may disturb the glands’ functioning. In addition, poor handling can introduce bacteria to the eyelids that lead to meibomian gland problems.
  • Wearing eye makeup. Eye makeup can be a killer on these delicate glands. They can easily be clogged by eyeliner and mascara, particularly if the products are more than a few months old and are more likely to have been exposed to bacteria. Improper or incomplete makeup removal is another risk factor.
  • Age. Everything begins to dry up after 40, including meibomian glands.
  • Asian ethnicity. Researchers have discovered that nearly 70% of people from Thailand, Japan, and China have had meibomian gland problems compared to perhaps 20% of Caucasians in Australia and the U.S.

Eye Drops Heal Most Meibomian Gland Problems

Those doctors/actors in the TV commercials aren’t lying: certain eye drops formulated for dry eye work on meibomian gland dysfunction as well, even if they can’t actually advertise this until they prove its effectiveness to the FDA.

Standard treatments include oral antibiotics and cyclosporine eye drops that attack bacteria, and down-regulate inflammation which unchecked will worsen MGD. Warm compresses to the eyelids also improve Meibum flow but can be difficult to be consistent with.
More definitive in-office procedures include Lipiflow and intense pulsed light (IPL) both of which are offered at Diamond Vision, are painless, and take only 15 minutes to perform. Lipiflow simultaneously warms the blocked oil while gently compressing the glands from the bottom up to release the blockages and restore the proper flow of meibum oil. IPL creates deep warmth in the subdermal tissues while stimulating restoration and normalization of blocked, regressed, and even previously defunct or shortened Meibomian glands. Literally bringing them back to life!
Studies have shown both these interventions to be extremely effective and provide long term support to MGD sufferers. Meibomian gland probing by an ophthalmologist is another effective treatment. The physician applies anesthetic eye drops and uses a tool to clean out the glands. Some studies show 100% improvement within a day.

For more information or to schedule an appointment for Lipiflow or IPL, please call us or set up an office visit online. Lipiflow is available at our New York office and IPL is available at our Atlanta office.

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