Meibomian Gland Dysfunction (MGD)

What is Meibomian Gland Dysfunction?

Meibomian Gland Dysfunction, or MGD, is a condition where the glands within the eyelids (Meibomian glands) become blocked or damaged, and therefore can’t secrete enough oil (meibum) that is required for a healthy tear film. It can therefore result in ‘dry eye’ symptoms as the tears that sit on the front surface of the eye will evaporate at a much faster rate than normal. The condition is very common and is thought to be one of the main causes of ‘dry eye’ disease.

The openings of these glands are near the base of the eyelashes and when the eyes blink, clear oil should secrete out and provide the tears with a lubricating outer layer which serves to protect the watery tears from drying out. With MGD, the oil is often solidified and the blockages can sometimes be seen as small yellow bumps on the eyelid margin.

Causes

Sometimes, there may be no obvious cause as to why the glands have been blocked however, some reasons why these obstructions can occur are due to:

• Age
• Gender
• Ethnicity
• Contact lens wear

Other factors more recently associated with MGD are reduced blink rates and poor blink quality (impartial blinking) due to prolonged use of computer screens and digital devices. Also diets that contain the correct balance of omega- 3 essential fatty acids may help suppress the inflammation associated with MGD and decrease the risk of waxy build-up within the meibomian glands.

Symptoms

In the early stages there may be no symptoms at all. In more severe cases, these include:

• Dryness
• Burning/stinging
• Itching
• Foreign body sensation
• Excessive watering
• Photophobia

Treatments for MGD

MGD can be initially managed with a heat/massage/cleanse routine. Your eye care practitioner will be able to advise when and how often to repeat the routine.

It involves 3 steps:

1. Heat – Applying consistent warmth to the eyes will help melt the solidified oils.
2. Massage – With the eyes closed, apply a gentle massage or manipulation of the lids with the pad of your fingertips along the length of the upper and lower eyelids in a circular motion. The pressure of the fingertips should feel firm but comfortable. Please remember to wash your hands prior to massaging.
3. Cleanse – Using a recommended lid cleansing wipe or solution with cotton pad clean along the lash line of the top and bottom lids to remove any excess oils and debris that can accumulate after the massage.

Often, eye drops are recommended to use on a regular basis to help rebalance the tear film.

For more severe MGD, options are available at dedicated dry eye clinics, which are in-practice treatments performed by the eye care practitioner, designed to be more intensive with longer lasting effects.