How Common is Meibomian Gland Dysfunction?

Doctor diagnosis of dry eyes

Do your eyes itch, sting, look red, or you have a constant feeling of something extreme dryness? You may have a condition called Meibomian Gland Dysfunction (MGD). MGD is “the most underrecognized, underappreciated and undertreated disease in ophthalmic care. It is so common as to be taken as ‘normal’ in many clinical practices,” according to Joseph Tauber, MD. This condition is the leading cause of Dry Eye Syndrome which is caused by lack of sufficient lubrication and moisture on the surface of the eyes. It is one of the most common eye conditions worldwide.

The Three Components Of Tears

Our eyes require an adequate and consistent layer of tears on the surface. This is essential to keep it healthy, comfortable and for good vision.

When you blink, a film of tears spreads over the eye. This keeps the eye’s surface clear and smooth. The tear film is important for good vision.

The tear film is made of three layers. They are:

  1. An oily (lipid) layer
  1. A watery (aqueous) layer
  1. A sticky (mucous) layer

Each layer of the tear film serves a purpose. These three components work together to lubricate and coat our eyes. They keep them moist and comfortable.

The oily layer is the outer part of the tear film. It makes the tear surface smooth and keeps tears from drying up too quickly. This layer is made in the eye’s meibomian glands.

The watery layer is the middle of the tear film. It makes up most of what we see as tears. This layer cleans the eye. It washes away particles that do not belong in the eye. This layer comes from the lacrimal glands in the eyelids.

The mucus layer is the inner layer of the tear film. This helps spread the watery layer over the eye’s surface. It keeps it moist. Without mucus, tears would not stick to the eye. Mucus is made in the conjunctiva. This is the clear tissue covering the white of your eye and inside your eyelids.

Normally, our eyes constantly make tears to stay moist. If our eyes are irritated, or we cry, our eyes make a lot of tears. But, sometimes the eyes don’t make enough tears or something affects one or more layers of the tear film. 

What are Meibomian Glands?

Meibomian glands are named after Hunrich Meibomian, a German doctor. He described and made drawings of them in 1666.

There are about 25 to 40 Meibomian glands in the upper eyelid and 20 to 30 in the lower eyelid. These glands secrete oils onto the surface of the eye. They keep the water component of our tears from evaporating.

Meibomian (oil) glands are the tiny oil glands along the edges of the eyelids where the eyelashes are found. They control the lipids in the eye. They combine with water and mucus in the eye to create a thin film. Meibum is an essential part of our eye’s makeup. It prevents the evaporation of the tear film.

The tear film lubricates and keeps the surface of our eyes healthy. It also affects how clearly we see. Irritation or blurred vision occurs when there is a decrease in the oil layer.

Understanding Meibomian Gland Dysfunction (MGD)

It is a very common eye condition, but many people don’t realize they have it. According to Lemp’s 2012 study, 86% of dry eye has MGD as the underlying cause.

Our eyes need tears to stay healthy and comfortable. MGD is the most common cause of dry eyes. Dry eye occurs when your eyes do not make the right type of tears or tear film.

In  the early stages, patients are often asymptomatic. If left untreated, MGD can cause or worsen dry eye symptoms and eyelid inflammation.

MGD refers to the condition where the  Meibomian glands are not secreting enough oil (meibum) or when the oil they secrete is of poor quality.

Changes in the amount or quality of the oil, or the glands themselves can lead to MGD. Often, the oil glands become blocked with thick secretions. The blocked glands become unable to secrete oil. This results in permanent changes in the tear film and dry eyes.

The oil that comes out of the blocked glands are crusty or abnormal. They can cause irritation to the eye. Meibomian gland dysfunction therapy can provide great relief for dry eyes sufferers.

This condition can be caused by various factors. It makes the tear film evaporate at a quicker rate. As a result, the eyes feel dry and uncomfortable. 

Causes Of Dry Eyes In People

Any condition that changes the oil produced by the Meibomian glands will cause this disorder.  

Due to hormonal changes, people tend to make fewer tears as they get older. This makes them more likely to have this disorder. Both men and women can suffer from dry eyes. 

Several factors can increase your risk of getting Meibomian gland dysfunction. Some factors are:

  • Entropion (when eyelids turn in); ectropion (eyelids turn outward)
  • Being in a smoky, windy or very dry climate
  • Looking at a computer screen for a long time, reading and other activities that reduce blinking
  • Having refractive eye surgery, such as LASIK
  • Taking certain medicines, such as:
    • Diuretics (water pills) for high blood pressure
    • Beta-blockers, for heart   problems or high blood pressure 
    • Allergy and cold medicines (antihistamines)
    • Sleeping pills
    • Anxiety and antidepressant medicines
    • Heartburn medicines

In some cases, there’s no known cause of dry eyes. This condition is not contagious. It’s more common in adults than children.

Symptoms Of Meibomian Gland Dysfunction

Depending on the specific case, symptoms may be mild or severe, quick or long-lasting. Here are some of the symptoms of MGD:

  • You feel like your eyes are stinging and burning.
  • Occasional blurred vision, especially when reading.
  • There is a scratchy or sandy feeling like something is in your eye.
  • There are strings of mucus in or around your eyes.
  • Your eyes are red or irritated. This happens when you are in the wind or near cigarette smoke.
  • Light sensitivity
  • Foreign body sensation
  • It is painful to wear contact lenses.
  • You have lots of tears in your eyes.

This might sound odd. Do you know that your eyes make more tears when they are irritated?

The increased use of air conditioning or heating systems in the summer and winter months increases the symptoms. Humid climates, extreme temperatures, and dusty and windy conditions may worsen eye dryness and itchiness.

Treatment options for people with MGD

The goal of Meibomian gland dysfunction therapy is to improve the flow of oil in the eye.

When you are diagnosed with MGD, there are several treatment options your doctor may recommend. It involves methods such as:  artificial tears, manual gland expression and heat application.

Clean your eyelids regularly with a warm washcloth to reduce symptoms of MGD. This treatment may be the only method for controlling symptoms in some cases.

Your doctor might recommend artificial tears if you experience dry eyes as a result of the condition.

If you wear contact lenses, you may need to stop using them during treatment. If you wear eye makeup, your doctor may recommend that you stop using it during and following treatment.

If you have an underlying cause, such as acne or rosacea, your doctor may prescribe medications to treat these disorders.

Your doctor might also perform a meibomian gland expression procedure. It will clear the oil and crust from your meibomian glands. Your doctor will massage the eyelids to unblock them.

The eyelid skin is extremely delicate, so you should be very gentle when clearing off the build up.

Self- care Treatment for MGD

Warm Compress

It provides temporary relief. It involves the  use of a warm wet washcloth to apply heat on the eyelids for four minutes.

It warms the oil and allows it to flow more freely. It should be done two times in a day, when there are active symptoms. 

Lid Scrubs

This helps to remove oil and bacteria that block the oil gland openings. You can use your fingers, or a warm washcloth on the tips of your fingers. Gently scrub the lash line on the top and bottom eyelids.

It can be done once in a day.

Massage

This can be done while applying the warm compress. Apply light pressure with your fingertips to the lid edges just above the eyelashes. 

Excessive rubbing of the lids can cause additional irritation. Massage of the eyelid provides a  partial and temporary relief of the meibomian glands. 

Omega- 3 Fatty Acid

In addition to the above treatments, some people benefit from supplementing their diets with omega-3 fats. Omega- 3 fatty acids improve the quality and viscosity of the oil produced by the Meibomian glands.

Flax seed oil and fish oil are excellent sources of omega- 3 fatty acids. Do not take these oils  with blood-thinning medication or blood-sugar lowering medication.

For more advanced cases, the Meibomian gland dysfunction therapy prescribed will depend on your other health issues. Your doctor may prescribe antibiotics or steroids to treat your condition. 

Antibiotics may be in the form of eye drops or creams applied directly to your eyelids. They may also be in pill form. Steroids may help reduce inflammation.

People with MGD commonly purchase over-the-counter eye drops to lubricate their eyes. Unfortunately, these eye drops  provide only a brief relief. 

This is because the layer of Meibomian gland oil is not adequate. The liquid from the drops will dry up.

Although there’s no cure for MGD, dry eyes sufferers can benefit from Meibomian gland dysfunction therapy. 

A visit to an eye clinic to get  the appropriate eye drops or treatment for your dry eye can  improve your eye comfort levels. You can benefit from this great treatment.

If you are suffering from any of the above symptoms or conditions, please reach out  to an eye clinic. The best course of treatment will be recommended for you based on the degree of your symptoms.


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