Meibomian Gland Dysfuction (MGB) - pronounced "my-BOH-mee-an" - refers to the glands around the eyelid not functioning well.
These glands play a crucial role in producing the oils to make healthy tears. The oils from the Meibum prevent the tears from evaporating.
In MGD, the glands are either blocked or not functioning correctly. This means they cannot produce adequate amounts of oils. As a result, tears become more 'watery' and dry up quicker.
To compensate for the poorer quality tears, more 'watery' tears are produced. Unfortunately, these fail to adequately lubricate the eye and symptoms worsen.
Studies estimate that 70% of dry eye sufferers have MGD
Symptoms of MGD include:
Constant watery eyes (excessive tearing)
Feeling like something is inside your eyes (foreign body sensation)
You can see these are identical to dry eye syndrome.
What Causes Meibomian Gland Dysfunction
The exact cause of MGD is unknown but researchers believe the following risk factors may play a role.
- Age - The likelihood of having MGD increases with age. 70% of people over 60 years of age are thought to have MGD. As we get older the glands around our eyelids don't function as well. This means they are unable to produce adequate amounts of oil, causing MGD.
- Medications - Taking certain medications, such as for acne, antidepressants, anti-histamines can cause MGD. These dry out the skin and prevent the glands from producing enough oils.
- Blepharitis - Longstanding inflammation of the eyelid (Blepharitis) can lead to glands becoming blocked, or damaged. MGD can result as a complication of untreated Blepharitis
- Contact Lens - Wearing contact lens over a period of years can disturb the eyelid glands. Researchers have developed a link, but cannot exactly state why.
- Eye makeup - Eyeliner, mascara and eye-shadow, when not properly removed can directly interfere with the eyelid glands.
- Skin disorders - Acne, rosacea, psoarisis have all been associated with MGD.
Many of these causes are associated with Blepharitis. This highlights the importance of having functioning Meibomian glands for good eye health.
How Is MGD Diagnosed?
Since there is much overlap between Dry Eye Syndrome, only an Eye Doctor can diagnose MGD.
This may involve expressing the glands and observing the secretions (like popping a pimple). These secretions may have an abnormal composition (e.g. cloggy) which could reveal MGD.
An Eye Doctor may also test the quality of tears. One test, called the Tear Breakup Time involves applying a painless dye to the eyes and observing how fast it breaks up. In MGD, the stability of tears is reduced so a quick dispersion of dye may indicate MGD.
What is Treatment for MGD?
Since MGD is often a multi-factorial condition, a holistic approach to treatment is required.
An Eye Doctor will be able to determine the best treatment, based on what has caused your MGD.
Meibomian Gland Probing is an in-office procedure that uses an instrument to open the ducts of the glands. Research has reported this can lead to a faster recovery and even resolution of MGD symptoms.
A warm compress can help by raising the temperature, turning cloggy oils around the eyelid into liquid. This uses the body's natural cleaning mechanism (tears and oils) to flush out debris.
Eyelid massage by a healthcare professional can also assist in allowing the free flow of oils.
Lipiflow is an in-office procedure that applies heat directly to the eyelid glands. This melts away any blockages while also applying pressure. Think of the Lipiflow like a warm compress and eyelid massage on steroids.
Adding in Omega 3s to your diet has been proven to enhance quality of tears and reduce eyelid inflammation. This could help prevent future episodes of MGD.
What about the eye drops?
Eye drops are great for short term relief if you have true dry eye (a lack of tears). However, if you have MGD, eye drops with preservatives will make the condition worse. These should be avoided until the underlying cause (e.g. blocked glands) are treated.