Over the last few years, dry eye has become a focus for eye doctors and patients alike. However, there’s one term that many dry eye sufferers may be unfamiliar with — meibomian gland dysfunction.
While this term isn’t quite as cut-and-dry as “dry eye disease,” it amounts to the same thing in some ways. But what does it mean if you’re diagnosed with meibomian gland dysfunction?
Let’s discuss what this condition is, how it affects your eye health, and what your options are if you have it.
How Your Tears Are Supposed to Work
Before we dive into meibomian gland dysfunction, we need to talk a little bit about your tears and what they’re made of.
The first layer is called the mucin layer. This mucusy substance helps your tears stick to the surface of your eye.
The middle layer is called the aqueous layer. This section of your tear film is the liquid that helps hydrate your eyes and keep them clean.
Finally, we have the lipid layer. This outermost layer sits on the surface of the tear film to prevent your tears from evaporating too quickly. Your lipid layer is made of an oil called meibum, which is produced by your meibomian glands. You can find these tiny glands on your lid margins between the surface of your eyeball and your lash line.
If your tear film doesn’t have a healthy lipid layer, your tears will evaporate too quickly, which leaves your eyes feeling dry and irritated.
What Is Meibomian Gland Dysfunction?
Meibomian gland dysfunction is not technically just one condition–it’s a term that describes a group of conditions that impact the meibomian gland’s ability to produce meibum.
The most common form of MGD is known as obstructive MGD, which occurs when the glands are blocked and unable to excrete oil properly. These blockages can be caused by inflammation, build-up inside the gland, or a combination of these and other factors.
When meibomian glands are out of commission, your eyes don’t receive enough meibum to prevent tears from evaporating. As a result, MGD leads to evaporative dry eye disease.
Symptoms of MGD
MGD can come with a range of symptoms, including:
- Dry, itchy, or gritty eyes
- Swollen and sore eyelids
- Red eyes
- Excessive tears
- Blurry vision
- Foreign body sensation in the eye
Risk Factors of MGD
As we age, our meibomian glands can atrophy and stop producing meibum. Approximately 95% of MGD sufferers are over the age of 60.
Certain medications can increase your risk of developing MGD. These medications may include:
- Hormone replacement therapy
- Testosterone blockers
- Acne medications
- Medicines for an enlarged prostate
Contact Lens Use
Research indicates that wearing contact lenses could lead to meibomian gland dysfunction for a few reasons. Unfortunately, there is conflicting evidence from multiple studies, so the link between contacts and MGD is still somewhat unclear.
Several systemic conditions and autoimmune diseases can increase the likelihood of developing meibomian gland dysfunction. Some of these conditions include:
Getting an MGD Diagnosis
You’ll most likely be able to determine whether you’re suffering from dry eye based on symptoms alone. However, your symptoms won’t tell you whether you’re suffering from aqueous deficiency dry eye or MGD (evaporative dry eye.) This distinction is important because both types of dry eye are treated differently.
You’ll need to visit an optometrist that focuses on dry eye diagnosis and treatments. They’ll most likely have special diagnostic technology that evaluates your meibomian gland health or tear volume and quality.
For example, our practice uses LipiScan. LipiScan is a special piece of imaging equipment that allows us to look closely at the state of your meibomian glands. These high-definition images make it easy for us to determine whether your dry eye symptoms result from MGD.
There are several treatment options available for meibomian gland dysfunction. Perhaps one of the most promising options is a relatively non-invasive in-office treatment called LipiFlow.
LipiFlow uses precise applications of heat and pressure to eliminate blockages within your meibomian glands.
The specially-designed activators are placed over your eyes. Once they’re in place, they will heat up to a comfortable temperature that is just high enough to liquefy some of the meibum that has hardened within your glands.
At the same time, the activators gently massage your eyes, which helps express any blockages in your meibomian glands and stimulates the flow of the meibum.
Some of the other treatment options include:
- Anti-inflammatory medications
- Warm compresses
- Gland expression
- Lid debridement
- Lid hygiene
- Intraductal probing
- Intense pulsed light
Help Is Available
Meibomian gland dysfunction is a frustrating problem to have, but you are certainly not alone. Finding an optometrist who focuses on dry eye will allow you yet the appropriate diagnosis, and by extension, the best treatment option for your unique needs.