What Is Meibomian Gland Dysfunction?
Meibomian gland dysfunction (MGD) is a condition that affects tiny oil glands in the eyes (Gurnani & Kaur, 2022). Even though MGD is common and often chonic, many people have never heard of it or don’t even realize they have it.
Often associated with dry eye diseases, meibomian gland dysfunction can cause burning, irritation, inflammation, and long-term vision issues.
Here, we’ll explain this common condition, how to recognise MGD, and why it’s important to seek treatment.
What Is Meibomian Gland Dysfunction?
Meibomian gland dysfunction is a condition where the meibomian glands produce insufficient or poor-quality oil.
When there isn’t enough protective oil or if it is of poor quality, the eyes can become irritated and dry. MGD is often one of the causes behind conditions such as blepharitis and dry eye disease.
How MGD Occurs
The meibomian glands are located in the eyelids. These glands make an important oily substance known as meibum. Meibum, mucus, and water combine to form the tear film. This film forms a protective layer to help keep eyes moist.
As a vital component of tear film, meibum helps:
Protect the eyes from particles and microbes
Slow tear evaporation
Preserve the optical surface
Changes to the meibomian glands can cause MGD. Ageing, medication side effects, or certain habits can cause these changes to the glands. This can cause the meibum to change from an olive oil-like consistency to a yellow, cloudier, thicker texture.
If the meibomian glands are clogged or blocked, they cannot secrete the oil needed to make quality tear film. This reduced amount, or poor quality of oil, can result in MGD symptoms.
Without the right balance of oil in the tear film, tears can evaporate too quickly. This contributes to dry eyes, irritation, and discomfort.
How Meibomian Gland Dysfunction Affects the Eye
Meibomian gland dysfunction disrupts the tear film’s oily layer. This can cause dryness and irritation in the eye, leading to burning, redness, inflammation, and blurry vision.
Left untreated, MGD can lead to damage to the surface of the cornea and in severe cases red. Early diagnosis and proper treatment are crucial for reducing symptoms and protecting the eye.
Common Symptoms of MGD
You may not notice any symptoms in MGD’s early stages. Once MGD progresses, you may experience a variety of symptoms due to decreased or poor-quality tear film.
Symptoms of MGD may include:
Foreign body sensation (ie, feeling like a piece of sand or debris is stuck in your eye)
Discharge
Crusting around the eyes
Dryness
Oily eyelids
Periods of increased tears followed by episodes of very dry eyes
Itching
Burning
Redness
Light sensitivity
Watery eyes*
Swelling
Blurry vision
Styes
Decreased ability to read or work at a computer for sustained amounts of time
*Watery eyes, although counterintuitive, are a common symptom of dry eye disease. In cases of meibomian gland dysfunction (MGD), poor-quality tear film leads to increased ocular surface irritation. This irritation stimulates reflex tearing from the lacrimal glands. However, these reflex tears are primarily aqueous and lack sufficient lipid (meibum). Without an adequate lipid layer, the tears evaporate quickly and fail to properly coat and protect the ocular surface. As a result, surface dryness and irritation persist, triggering continued reflex tearing and the paradoxical symptom of watery eyes.
Causes and Risk Factors for MGD
Risk factors and possible causes of MGD include:
Increased and excessive screen time
Ageing, MGD is more prevalent in individuals aged 40 or older (Alghamdi et al., 2016)
Certain hormonal issues
Certain medications
Wearing contact lenses
Certain Immune system disorders
High blood pressure or cholesterol
Eye infections
Wearing eye makeup
Spending excess time in windy or very dry conditions
How to Diagnose MGD
Meibomian gland dysfunction (MGD) is diagnosed through a comprehensive eye examination that may include a combination of the following clinical tests:
Ocular surface staining using fluorescein and lissamine green to assess epithelial damage and surface integrity
Tear film stability assessment, including fluorescein tear break-up time (TBUT) and non-invasive tear break-up time (NIBUT)
Infrared meibomian gland imaging (meibography) to evaluate gland structure, dropout, and atrophy
Slit-lamp biomicroscopy to grade ocular surface and lid margin findings, including hyperaemia, telangiectasia, capped glands, and lid margin irregularity
Meibomian gland expression to assess gland patency and evaluate the quality and quantity of expressed meibum
Tear film analysis, such as tear osmolarity testing, as an indicator of tear film instability and ocular surface inflammation
If you are experiencing symptoms of MGD or dry eyes, schedule a Dry Eyes Treatment Consultation. At For Eyes, we evaluate your vision, eyelid health, tear quality and quantity, and oil glands.
We can develop a treatment plan tailored to your needs, ensuring you experience relief and protect your vision.
Treatment and Management of MGD
At Home MGD Treatments
Your doctor may recommend home MGD treatments (Sabeti et al., 2020), such as:
Drink adequate amounts of water
Avoid excess coffee, alcohol, or tea
Reduce medications that contribute to dry eyes (if possible)
Use warm compresses placed gently over your eyelids for five minutes twice a day to help soothe inflammation and loosen oil
Gentle eyelid massage
Thoroughly remove makeup
Omega-3 supplements as they may help to decrease inflammation
Wear glasses or wraparound sunglasses outside to help protect your eyes
Avoid sleeping or sitting near air conditioning vents or fans
Use a humidifier to increase moisture in your room
Make a point to blink often if you are spending extended time in front of a computer or book
Limit screen exposure
Avoid excess exposure to windy conditions
Gently clean eyelids once a day using medicated lid wipes
Medical MGD Treatments
Medical treatments for MGD and dry eye conditions include:
Prescription eye drops or lubricants
Anti-infective ointments or medications or ointments
Intense-Pulsed Light (IPL) therapy to reduce inflammation and promote improved gland function
Prescription steroid eye drops to reduce inflammation and help promote tear flow
Procedures that help to manually unblock meibomian glands, such as Meiobomian Gland Expression
Lid debridement and treatment for Demodex (if the MGD is related to Demodex mite infestations)
Zest cleaning treatment
Punctal Plugs
Our advanced range of dry eye treatments at For Eyes Optometrist include:
Meibomian Gland Therapy
Intense Pulse Light Therapy
Meibomian Gland Expression
Demodex treatment (Demodex is a mite that is usually harmless. It can infect the meibomian glands or lash follicles and cause inflammation)
A wide selection of quality eye drops and lid cleansers
Zest treatment
Punctal plugs
Personalised Fremantle MGD Treatments
Meibomian gland dysfunction can cause irritation, redness, dry eyes, and long-term vision issues. Fortunately, there is a wide range of MGD specialised treatments that can help relieve symptoms and prevent corneal damage.
The sooner MGD is treated, the better the outcome. The only way to know if you have MGD is with a comprehensive eye exam. If you are experiencing symptoms, contact us to schedule a consult with a dry eye optometrist.
We can perform a comprehensive eye exam and help you restore balance to your eyes with personalised dry eye treatment.
References
Gurnani, B., & Kaur, K. (2022). Meibomian Gland Disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK580474/
Alghamdi, Y. A., Mercado, C., McClellan, A. L., Batawi, H., Karp, C. L., & Galor, A. (2016). Epidemiology of Meibomian Gland Dysfunction in an Elderly Population. Cornea, 35(6), 731–735. https://doi.org/10.1097/ico.0000000000000815
Sabeti, S., Kheirkhah, A., Yin, J., & Dana, R. (2020). Management of meibomian gland dysfunction: a review. Survey of Ophthalmology, 65(2), 205–217. https://doi.org/10.1016/j.survophthal.2019.08.007
