What is Meibomian Gland Dysfunction?
Amongst the different types of eye problems that many people suffer from, Meibomian Gland Dysfunction is probably the most common one. However, it is also one of those problems that many people do not realize or fail to diagnose easily.
Meibomian Gland Dysfunction is a dysfunction or problem of the Meibomian glands that are tiny glands found in both the upper and the lower eyelids. Named after the German doctor Heinrich Meibom, who first discovered these glands, these Meibomian glands secrete oil to the surface of the eyes, so that the water in the eye surface does not dry out or evaporate and help in lubricating the eyes. There are about 25 to 40 Meibomian glands in the upper eyelid and 25 to 30 Meibomian glands in the lower eyelids.
When there is something that is blocking the Meibomian glands or there is an abnormality in the Meibomian glands, the secretion of oil into the eye surface is compromised. This leads to problems like dry eye syndrome as well as eyelid problems like blepharitis and others.
Causes and Risk Factors of Meibomian Gland Dysfunction
There are many reasons behind Meibomian Gland Dysfunction. These include
Age: As people age, they tend to lose some of their Meibomian glands or some of the Meibomian glands lose their activity with time.
Ethnicity: While European people are very less likely to suffer from Meibomian Gland Dysfunction, Asian people are about 3 times more likely to suffer from this condition.
Other Eye Problems: If you have some other eye problems such as damage and inflamed cornea or eyelid, if you have some bacterial infection in your eyes or if you have allergic conjunctivitis, you may also develop Meibomian gland dysfunction.
Medications as a Cause of Meibomian Gland Dysfunction: Certain medicines or drugs, especially the ones that control your hormones, can cause Meibomian Gland Dysfunction. If you are taking certain drugs that reduce androgen or if you are on an oestrogen replacement therapy or even if you are taking some anti-aging creams or medication to control acne or even to treat retinoid, you are more likely to develop Meibomian Gland Dysfunction. Many antibiotics and anti-depressants also lead to this condition.
Other Diseases that can Cause Meibomian Gland Dysfunction: If you have other autoimmune diseases such as lupus, rosacea or Sjögren’s syndrome or even rheumatoid arthritis, you are at a higher risk of developing Meibomian Gland Dysfunction. Many other conditions such as hypertension or psoriasis or even polycystic ovarian syndrome can cause dysfunction of the Meibomian glands.
Symptoms of Meibomian Gland Dysfunction
In the very initial stage, Meibomian Gland Dysfunction is asymptomatic. This means that the condition does not have significant symptoms that can indicate the presence of the condition. This delays the treatment. As the treatment is delayed, the condition worsens and dry eye symptoms or symptoms of inflammation are exacerbated. A thickened secretion of oil from the glands clogs the gland openings and as the glands are unable to secrete anymore oil, the eyes become perpetually dry, changing the tear film. The symptoms at this stage include
- Burning sensation in the eyes
- Dryness in the eyes
- Itchiness in the eyes
- Increased water secretion from the eyes
- Crustiness or stickiness of the eyes
- Redness in the eyes
- Sensitivity to lights
- Blurry vision
- Sensation of foreign body in the eyes.
Diagnosing Meibomian Gland Dysfunction
Diagnosing Meibomian gland dysfunction is initially quite difficult. Since the symptoms of this condition resemble with a lot of other eye problems, in the initial stage, it becomes difficult for the doctor to diagnose if it is Meibomian gland dysfunction or some other condition. In fact, there are no diagnostic tests that can actually tell about the problem.
However, the doctors use a simple, painless and yet very effective clinical test to diagnose Meibomian gland dysfunction. The test is called the Tear Break Up Time Test or TBUT Test. In this test, the doctor will apply a small amount of dye in the tear film of the eyes and wait to check how much time the eyes take to break up the dye by producing tears. He/she will use a cobalt blue light to check for the tears to glow in the light, for proper examination of the time.
Along with this, the doctor will also check if you make enough tears or not, through the Schirmer’s test. In fact, tests that measure how fast your tears evaporate or dry out and also the quality of your meibum or the oil that is secreted from the glands, also help in diagnosing the condition.
Treatment of Meibomian Gland Dysfunction
In the past, hot compress was the only treatment that was recommended to treat Meibomian Gland Dysfunction in which the heat would melt down the clogged Meibomian gland pores. However, it was not a very effective step to treat Meibomian Gland Dysfunction. Nowadays, the doctors prescribe –
- Antibacterial eye drops to treat the condition
- Cyclosporine eye drops to modify the body’s immune response
- Lubricants to moisten the eye surface
- Steroids to reduce the inflammation of the eyes.
Another procedure and treatment method that is proven to be 100% effective for Meibomian Gland Dysfunction is the Meibomian gland probing technique. In this technique, the doctor uses an anaesthetic eye drop at first and then, using hand-held instruments, the doctor dilates and opens up the Meibomian glands. Most of the patients report immediate comfort and all the patients report comfort within a month.
Home Remedies for Meibomian Gland Dysfunction
To help in the treatment procedure for Meibomian Gland Dysfunction, you can try –
- Heat compress at least twice a day for about 5 minutes is one of the best home remedies or Meibomian Gland Dysfunction
- Another useful home remedy for Meibomian Gland Dysfunction is light fingertip massage of the eyelids to promote the oil secretion
- Cleaning the eyelids with a clean and wet cloth, after washing the eyes with non-soap cleanser
- Avoid using beauty products that are chemical rich
- Eat omega 3 fatty acid rich foods to promote oil secretion, improve the quality of meibum and to reduce inflammation of the eyes
- Use a humidifier in the house, if using air conditioning regularly for long periods
- Use disposable daily contact lenses that are high in water gradient, instead of the regular contact lenses.
These will help you to get comfort and relief from the itchiness or dryness and other symptoms.
- American Academy of Ophthalmology. “What is Meibomian Gland Dysfunction?” https://www.aao.org/eye-health/diseases/meibomian-gland-dysfunction
- Cleveland Clinic. “Meibomian Gland Dysfunction (MGD): Symptoms, Causes & Treatment.” https://my.clevelandclinic.org/health/diseases/17658-meibomian-gland-dysfunction-mgd
- All About Vision. “Meibomian Gland Dysfunction (MGD).” https://www.allaboutvision.com/conditions/meibomian-gland.htm
- Tear Film & Ocular Surface Society. “TFOS DEWS II Meibomian Gland Dysfunction Workshop.” https://www.tfosdewsreport.org/report/mgd-workshop/