• dry eyes

What is Meibomian Gland Dysfunction?

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.
January 8th, 2019|Comments Off on What is Meibomian Gland Dysfunction?

About the Author:

Born in Connecticut and raised in Upstate New York , Dr. Stetson graduated Cum Laude from Colgate University in New York, and then earned an MD degree with honors at the University of Vermont College of Medicine. He distinguished himself again in residency at the Albany Medical Center, where he obtained the highest percentile in the Ophthalmology Knowledge Assessment Examinations. Dr. Stetson has performed more than 50,000 refractive surgeries and has been on staff at Diamond Vision since 2004, before becoming Medical Director in 2006.


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