Everything You Need to Know About Meibomian Gland Dysfunction
If your eyes itch, burn, sting, look red, or you have a constant feeling of something being lodged in your eye, you may have a condition called Meibomian ("my-BOH-mee-an") Gland Dysfunction, or MGD. This condition is the leading cause of Dry Eye Syndrome.
Patients from throughout the Toronto area suffering from Meibomian Gland Dysfunction. If you suffer from any of these symptoms or think you might have MGD, contact the Yonge Eyes Optometry Dry Eye Center. Dr. Sophia Awadia can help you with the long-term relief you need.
What is Meibomian Gland Dysfunction?
Our tears are made up of three components: the lipid (oil) layer, aqueous (water) layer, and the mucus (sticky) layer. These components work in unison to lubricate and coat the eyes, keeping them moist and comfortable.
Your meibomian glands control the lipids in the eye (meibum) which combine with water and mucus in the eye area to create a thin film that consistently lubricates your eyes. Meibum is an essential part of your eye’s makeup as it prevents the evaporation of the eye's tear film.
Meibomian Gland Dysfunction occurs when the meibomian glands fail to provide enough meibum. This can be triggered by various factors and causes the tear film to evaporate at a quicker rate, leading the eyes to feel dry and uncomfortable.
What Are the Symptoms of Meibomian Gland Dysfunction?
Depending on your specific case, your symptoms may be mild or severe, quick or long-lasting.
The most common symptoms of MGD include:
- Blurry vision
- Burning and dry sensation
- Difficulty wearing contact lenses
- Watery eyes
- Red, sore and gritty eyes
- Crusty or sticky or eyelids
The increased use of air conditioning or heating systems in the summer and winter months may intensify symptoms. Humid climates, extreme temperatures, and dusty and windy conditions may aggravate eye dryness and itchiness as well.
What are the Causes of Meibomian Gland Dysfunction?
- Age: MGD tends to manifest in older people, particularly in women during and after menopause
- Taking certain medications: particularly retinoic acid (acne treatment), HRT (hormone replacement therapy for menopausal women), antidepressants, antihistamines, anti-androgen medication (used to treat prostatic hypertrophy).
- Endocrine disorders
- Wearing contact lenses for an extended period of time.
- Immune system disorders: atopic rosacea, psoriasis, rheumatoid arthritis and Sjogren’s syndrome.
Excessive screen time has also been linked to the development of MGD. Staring at a screen on your TV, smartphone, computer or tablet, causes you to blink less frequently. Blinking naturally moisturizes your eyes, and by doing so, clears any small particles that may have accidentally lodged in your eye. Less frequent blinking results in dryer eyes, which can harm the long-term ability of your meibomian glands to function properly.
How is Meibomian Gland Dysfunction Diagnosed?
Because MGD affects the stability of the tear film, your optometrist will test for the quality, quantity and stability of your tears.
Tear breakup time (TBUT) is a painless test where a small amount of dye is applied to the tear film on the surface of the eye. The doctor then examines the eye using a cobalt blue light, which causes the tears to glow and exposes the rate at which your tear film loses its stability on the eye.
TearLab Osmolarity System is also a quick and painless diagnostic tool used to measure the osmolarity of tears in patients suspected of having these MGD or Dry Eyes. It is typically used in conjunction with other methods of clinical evaluation.
LipiScan® is a medical device that captures high-definition images of the meibomian glands. This gives the eye doctor a close view of your meibomian glands, allowing for a faster and more accurate diagnosis. Both lower eyelids can be completed in 60 seconds.
What are the Solutions for Meibomian Gland Dysfunction?
Treatments for Meibomian Gland Dysfunction range from self-administered or practitioner-administered treatments and typically involve a few methods, such as artificial tears, heat application, and manual gland expression. Dr. Sophia Awadia usually suggests applying warm compresses over your eyelids as a first course of action. This gently opens the clogged glands and loosens the oil that may have accumulated. Warm compresses, such as the Bruder Mask, can provide temporary relief.
Further therapies used to manage MGD include omega-3 supplementation, topical antibiotics, oral tetracyclines to reduce the level of pro-inflammatory cytokines, corticosteroids, or topical cyclosporine.
People with MGD commonly purchase over-the-counter eye drops to lubricate their eyes. Unfortunately, these drops tend to provide only transient relief, because, without an adequate layer of Meibomian Gland oil, the liquid from the drops simply evaporate off of the eye. Dr. Sophia Awadia at Yonge Eyes Optometry Dry Eye Center can recommend the appropriate eye drops or treatment for your dry eye case to improve your eye comfort levels.
What are the Medical Technologies Used to Treat Meibomian Gland Dysfunction?
Meibomian Gland Dysfunction manifests differently and to varying degrees of severity. Some may need mild treatment while others may require more intense care. Our eye doctor can determine the right choice for your condition to get you the best possible results.
The latest treatment options for Meibomian Gland Dysfunction are listed below.
Intense Pulsed Light, or IPL, heats the skin around the eye area and dislodges the oil buildup. Once this happens, the glands can once again secrete the oils naturally and resume their moisturizing effects. It is quick and painless and requires a series of at least 3 treatments to be effective. Results are usually immediate and cumulative
LipiFlow® is an advanced device, which applies warmth and gentle pressure directly to the meibomian glands, liquefying the blockage. The LipiFlow is a painless 12-minute in-office treatment session.
iLUX is a relatively new an in-office treatment for MGD which uses a portable, hand-held LED-based heat source to warm the inner and outer surface of the eyelids in order to melt waxy secretions trapped inside the meibomian glands.
Mibiflow or MiBo ThermoFlo® is a medical device that gently messages the margins of the eyelids and uses controlled heat to unclog the meibomian glands. By liquefying the secretions blocking these glands, complex oils can again flow freely, restoring a healthier, more balanced tear film, thus preventing tears from evaporating too rapidly.
Mibiflow is a painless 12-minute treatment (per eye).
TearCare is an in-office treatment for MGD made up of single-use adhesive heating patches that are applied to the external eyelids for about 12-minutes. After removing the heating patches, the eye doctor drains the clogged meibomian glands.
Blephex is a treatment typically used for blepharitis that has been shown to reduce the symptoms of meibomian gland dysfunction. The hand-held instrument gently and precisely spins a medical-grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris, while exfoliating your eyelids. This removes an inflammation-causing biofilm that can form on the eyelids leading the meibomian glands to clog. The treatment usually lasts under 10 minutes.
Depending on your case of MGD, the doctor may suggest a combination of treatments to ensure the most successful outcome.
Think You Have MGD? We Can Help
If you are suffering from any of the above symptoms or conditions, then reach out to the Yonge Eyes Optometry Dry Eye Center. Based on the degree of your condition, symptoms, and lifestyle, Dr. Sophia Awadia will recommend the best course of treatment for you.
Yonge Eyes Optometry Dry Eye Center serves patients from in and around Toronto, Bedford Park, Rosedale, and Yonge and Lawrence and throughout Ontario.
“I went to the Yonge Eyes Optometry Dry Eye Center and everyone there was professional and courteous. Dr. Sophia Awadia did a thorough evaluation and treatment. I’m happy to say that my eyes feel comfortable and my vision is back to how it was before the condition began.”
Jennifer P. Craig, Yen-Heng Chen, Philip R. K. Turnbull; Prospective Trial of Intense Pulsed Light for the Treatment of Meibomian Gland Dysfunction. Invest. Ophthalmol. Vis. Sci. 2015;56(3):1965-1970. doi: 10.1167/iovs.14-15764.