What is meibomian gland dysfunction?
Meibomian gland dysfunction is a common eye problem but one that most people have never heard of. The meibomian (“my-BOH-mee-an”) glands are responsible for making an oil called meibum. There are between 25 and 40 of these glands in the upper eyelids and between 20 and 30 in the lower eyelids. The meibum oil combines with mucus and saltwater to make up the tear film that moistens the surface of the eyes. The oil made by the meibomian glands is an essential part of the tear film, the layer that prevents tears from evaporating too quickly. Meibomian gland dysfunction describes a disruption to the quality of the tear film.
What are the symptoms of meibomian gland dysfunction?
In the early stage of meibomian gland dysfunction, there may be no obvious symptoms. As the tear film loses consistency without sufficient oil, the eyes may become dry, itchy, and irritated by a burning sensation. It may feel as though there is dust or a foreign object in the eye. Vision may become blurry but improve with blinking. The eyelid may also look red and irritated.
One of the telltale signs of more advanced MGD is the rough or uneven appearance of the inner rim of the eyelid. However, this symptom does not always occur. Meibomian gland dysfunction may be diagnosed through a comprehensive eye exam.
The symptoms of MGD may worsen in dry environments or as a result of eye strain from using digital devices.
What causes meibomian gland dysfunction?
Meibomian gland dysfunction, often simply called MGD, may result from a blockage in the openings of the glands the prevents sufficient amounts of oil to reach the surface of the eyes. The quality of the oil being produced may also be problematic. In many cases, we see that MGD results from a combination of factors.
Who is at risk for developing meibomian gland dysfunction?
Studies indicate that we become more susceptible to meibomian gland dysfunction after the age of 40. This is because the number of functioning meibomian glands decreases with age. Statistics indicate that people of Asian descent are more likely to develop MGD than other ethnicities. People who wear contact lenses may also have a higher risk.
MGD may relate to certain medical conditions, including:
- Certain autoimmune conditions, such as rosacea and lupus
- Corneal or eyelid damage caused by injury
- Allergic eye diseases
- Viral or bacterial eye infection
- High cholesterol
Meibomian gland dysfunction may also be related to irritation from topical acne or anti-aging creams or long term oral anti-acne medication.
How is meibomian gland dysfunction diagnosed?
The symptoms of meibomian gland dysfunction provide clues that the tear film may be changing. An eye doctor may conduct a simple exam in which gentle pressure is applied to the eyelid in the area of meibomian glands. This should produce secretions that can be observed for signs of irregularity. Because MGD affects the tear film, testing often involves some type of evaluation of the tear film. For example, a tear breakup time test may be conducted to determine how quickly the tear film destabilizes. The test is painless and takes only a few minutes.
What are the treatment options for meibomian gland dysfunction?
When meibomian gland dysfunction is detected in an earlier stage, symptoms may improve without the need for medical intervention.
- A humidifier can be placed in rooms to combat the drying effects of indoor heating and air conditioning.
- A warm, wet washcloth or gel pack can be placed over the eyes for 5 minutes. This loosens the oil to unblock gland openings. After removing the heat, use a finger to lightly massage the eyelid. The upper eyelid can be massaged by rolling the finger from the upper lid to the lash line. The lower eyelid can be massaged by rolling the finger upward to the lash line. This can be done twice a day.
- People who wear contacts may want to switch to “water gradient” disposable lenses.
- Some people experience improved eye lubrication through supplementation with omega-3 fatty acid products (fish oil or flaxseed oil). This can take several weeks to see improvement.
- Lubricating eye drops or prescription eye drops may be used as directed.
- For more severe dryness and irritation, medical treatment may be performed in a clinical setting. Patients can visit our med spa for a brief laser treatment that may help improve oil quality and secretion.
- Rarely, minor surgical procedures are needed to unblock the most severe cases of MGD in selected patients
What happens if meibomian gland dysfunction goes untreated?
The most common problem related to untreated meibomian gland dysfunction is dry eye disease (or dry eye syndrome). Eyelid inflammation called blepharitis may also occur, affecting the rim of the eyelids.