Meibomian Gland Dysfunction


Meibomian glands are oil-producing glands located in both the upper and lower eyelids. They number about 30 on both the top and bottom lid. Normal glands slowly release specialised oils into the tear film which helps to prevent the tears from evaporating, causing dry eyes and the resultant ocular pathology that follows. Sometimes this oil becomes slightly thicker than normal which leads to blockages in the narrow ducts from the glands to the tear film. As this abnormal oil production continues, the glands swell and overfill, changing the shape of the eyelid margin and causing ocular surface pathology. Severe blockage can lead to much enlarged glands (cysts) and even infections like styes. Corneal inflammations and infections are also more common.

Predispositions to meibomian gland dysfunction include skin type, age, sun exposure, certain drugs, contact lens wear and many cosmetics are also implicated.

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It is important to firstly unclog the blocked glands and secondly to prevent them from blocking up again. A program of daily eyelid hygiene, as recommended. This goes a long way in controlling the symptoms and severity of the resultant blepharitis and should ideally be kept up on an ongoing basis. The most critical factor in the successful treatment of your symptoms is your diligence in keeping this regimen up.

The treatment requires regularly heating the glands with a warm compress. This is applied directly to the closed eyelid, to melt and to mobilise the secretions. Gentle massaging of the lids help to express this afterwards. Daily eyelid cleansing is also required to remove debris, crusts and toxins from the eyelid margin. These greatly add to lid inflammation if not regularly controlled. Ocular lubricants are also important to relieve symptoms associated with dry eye syndrome and to keep the tear chemistry wholesome. Antibiotics may also need to be prescribed to control secondary infections and stabilise the microbial flora of the eyelid margin; or steroids to get inflammation under control.

It’s important to know that in some cases, it may take a long time for you to notice a significant improvement in your symptoms and ongoing treatment is often necessary to keep this condition under control. In severe cases of meibomian gland dysfunction a course of oral medication might be necessary to get the dysfunctional glands under control.

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        Normal Glands                Dysfunctional Glands

1. Warm Compresses

1.1. The first part of unblocking the glands is to liquefy the thickened oil in the glands. This is achieved by gently applying heat to the eyelids. Then, having liquefied the oils with this warming, press with one finger firmly on your lower eye lid, up close to the lashes.
1.2. Next gently press the edge of the eyelid upward, using a clean fingertip or cotton bud, to express the oil up into the tear film.
1.3. Do this a several times over the entire extent of lower eyelid. For the upper eyelids use a downward rolling motion.
1.4. Repeat the entire procedure for the other eye.

This will help to unclog the blocked glands. Your eyes may initially feel more uncomfortable afterwards for a short time afterward. This is normal and will improve over time and you’ll soon notice a more moist and comfortable eye.

2. Lid Scrubs

We recommend that you scrub your lid margins with Sterilid (Theratears).

3. Lubrication

Lubricate your eyes immediately after doing compress and massage. We recommend that you use Systane Balance.

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