Meibomian Gland Dysfunction

Meibomian (pronounced me-bo-me-an) Gland Dysfunction is an eye condition where the oil glands in the eyelids become blocked; which results in poor quality oils and leads to conditions such as dry eye and blepharitis.

What is meibomian gland dysfunction?

Meibomian glands are located in the upper and lower part of the eyelids. They are oil producing glands whose job is to keep your eyes moist. If the glands get blocked, it causes dryness in the eye, which means you’ll have uncomfortable, irritated eyes. If the glands become severely blocked, it can lead to infections. This is called Meibomian Gland Dysfunction (otherwise known as MGD for short).

Meibomian gland dysfunction is a common cause of the well-known eye condition, dry eye. Dry eye syndrome is very common, affecting more than 20% of adults.

Dry eye occurs when the eye can not produce enough tears to lubricate itself, resulting in tears evaporating too quickly from the eye. This often causes the hallmark symptom of watery eyes, which can be confusing as they aren’t dry, but they have dry eye disease.

MGD causes the eye to produce poorer quality of oils, meaning you’ll end up with dry eye symptoms; which can vary from a constant niggle, to severe irritation that can affect your day-to-day activities. This results in dryness, irritation, redness and blurred vision.

What are the symptoms?

Meibomian gland dysfunction symptoms include:

  • Dry eyes
  • Grittiness
  • Sore and red eyes
  • Burning and stinging eyes
  • Styes
  • Watering eyes, especially in windy environments

Symptoms can be different for everyone, and fluctuate due to environmental factors; such as wind, air conditioning, artificial lighting, using your computer or smartphone, air pollution, driving, wearing contact lenses etc.

Dry desert

What causes meibomian gland dysfunction?

Like dry eye, the chance of developing MGD only increases as we get older. Mainly due to the fact that as we get longer in the tooth, the number of meibomian glands we have, decreases. If left untreated, MGD can cause permanent damage to your eyes, so early detection is key. 

Other factors like makeup can contribute to developing MGD. If you do wear makeup, especially eyeliner - this can block the openings of the meibomian glands, even more so if your eye makeup isn’t removed before going to bed. 

Medications, particularly those that treat skin conditions like acne (i.e. accutane), are also a common cause of MGD and dry eye. 

Prevention

As with blepharitis, prevention is key, so practising good eyelid hygiene can be one of the most successful ways of controlling symptoms. This includes washing your face day and night and removing all eye makeup.

Blocked glands

Treatment

Meibomian Gland Dysfunction can be successfully managed through a variety of options. 

To manage symptoms:

Eye drops: There are a variety of eye drops that are used to provide temporary relief of symptoms of MGD.

Warm compresses: are an effective way to ensure that the glands don’t get clogged again, allowing your eye to feel more comfortable.

We recommend our warm compress eye mask for relieving MGD symptoms; they are much more effective than using a face cloth, for example as the heat is sustained for a longer period, allowing more time to remove blockages. They are also more effective than traditional wheat bags as the heat is a moist, humid heat which alleviates any associated dry eye symptoms; whereas a wheat bag can exacerbate any dry eye and allergy symptoms.

Treatment options:

The most effective treatment is to combine both E-Eye IPL and a meibomian gland expression. 

E-Eye IPL: IPL treatment for dry eye is a successful way to both control the symptoms and address the root cause of the condition.

Meibomian gland expression: this is a diagnostic procedure and should not be tried at home. It’s one of the most common forms of treatment for MGD. It can be used to both determine if your glands are blocked and has been proven as an effective therapy for treating MGD.

Having a meibomian gland expression will reduce the symptoms and improve signs of MGD.

What happens during a meibomian gland expression?

An meibomian gland expression involves applying pressure to the eyelids, to both express the glands and squeeze out the oils. Your optometrist will use a tool that looks like tiny forceps to compress the lower and upper eyelids. This is called a Mastrota paddle and is designed to squeeze out the oil from the meibomian glands effectively. 

The optometrist will place the Mastrota between your eye and your inner eyelid and then use a finger or a cotton bud to apply pressure to your outer eyelid. Often a warm compress is applied before the expression, to make it easier to express the hardened oils blocking the glands. They can also apply a topical anaesthetic to both eyes before the procedure. If you need a meibomian gland expression, your optometrist will discuss the procedure with you beforehand.

Meibomian gland expression can also be used alongside eye treatments like IPL (Intense Pulse Light) and Blephasteam.

Here's an example of an IPL treatment:

Danielle Ross demonstrating an IPL treatment 2

FAQs

How do I know if I have MGD? What else could it be? As well as dry eye, MGD is also connected to an eyelid condition called blepharitis. MGD, dry eye and blepharitis all have similar symptoms, like itchy, red, irritated eyes which could have a burning sensation. 

If you think you have dry eye, meibomian gland dysfunction or are experiencing irritation or discomfort in your eyes, please book an appointment to see one of our optometrists. We provide free dry eye consultations.

 

Is there a cure for MGD? Although there is no cure, there are a variety of treatment options (as mentioned above), that control the symptoms of dry eye.

Will MGD affect my vision? While MGD does not directly affect your vision, the symptoms can cause discomfort to your eye. And if left untreated, MGD can cause permanent damage to your eyes, so early detection is key.

If you think you might be suffering from meibomian gland dysfunction or dry eye, book an appointment with our specialised optometrists.

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