What is Meibomian Gland Dysfunction?
Meibomian Gland Dysfunction (MGD), also known as meibomian gland disease, is a common condition in which the oil-producing glands in the eyelids become blocked or do not function properly. These glands are essential in maintaining a healthy tear film, which keeps the surface of the eye moist and comfortable.
When the glands are not functioning correctly, the tear film becomes unstable and evaporates too quickly. This can lead to dry, irritated, or uncomfortable eyes. This condition is particularly common in older adults, but it can also affect individuals of any age.
At Moorfields Eye Hospital Dubai and Abu Dhabi, we offer advanced diagnostic tools and evidence-based treatment options to help manage Meibomian Gland Dysfunction and improve your long-term eye comfort and vision
What are the causes and risk factors of Meibomian Gland Dysfunction?
The underlying cause of MGD is often a blockage or abnormality in the meibomian glands. While the precise cause is not always known, several factors contribute to the development of dysfunctional meibomian glands:
- Aging: As we age, the meibomian glands naturally produce less oil, increasing the risk of the condition.
- Hormonal changes: Hormonal fluctuations, particularly during menopause, can affect gland function.
- Chronic blepharitis: Blepharitis, an inflammation of the eyelids, often present alongside MGD, can worsen symptoms.
- Environmental factors: Prolonged exposure to dry or windy conditions, air conditioning, and excessive screen time can contribute to the development of MGD.
- Contact Lens use: Wearing contact lenses can interfere with the normal functioning of the meibomian glands.
- Makeup use: Frequently using eye makeup like eyeliner.
Individuals with certain underlying conditions, such as rosacea or other inflammatory skin disorders, are also at a higher risk of developing meibomianitis, a specific form of MGD characterised by inflammation of the meibomian glands.
What are the symptoms of Meibomian Gland Dysfunction?
The symptoms of meibomian gland dysfunction are very similar to those of dry eye syndrome and include:
- Itchy and red eyes
- A persistent feeling of dryness or grittiness in the eyes
- Blurry vision, particularly after prolonged use of digital devices
- Swollen, red eyelid margins (blepharitis)
These symptoms may fluctuate throughout the day and can worsen in certain environments, such as air-conditioned rooms or outdoors on windy days.
How is Meibomian Gland Dysfunction diagnosed?
Accurate diagnosis of meibomian gland dysfunction is essential for effective treatment. Eye care professionals use various diagnostic procedures to assess the function of the meibomian glands:
- Meibography: This imaging scan allows the visualisation of the meibomian glands to assess their structure and function.
- Tear film analysis: Evaluating the tear film’s composition can help identify abnormalities caused by MGD.
- Expression Testing: The doctor may apply gentle pressure to the eyelids to evaluate the quality and quantity of oil secretion from the glands.
- Slit lamp examination: Checking your eyelid structure with a special light called a slit lamp
These diagnostic tools provide a comprehensive understanding of the condition and guide the most appropriate treatment plan.
Various treatments for meibomian gland dysfunction are available, ranging from simple home care measures to advanced medical therapies. The treatment approach depends on the severity of the condition and the patient’s specific needs.
Basic treatments: Warm Compresses and Medications
- Warm Compresses: Applying a warm compress for 5-10 minutes to the eyelids can help to melt the blocked oils within the meibomian glands. After warming, gently massaging the eyelids can further help, promoting natural secretion and relieving symptoms.
- Medications: In some cases, doctors may prescribe medications, such as antibiotics, steroid eye drops, or even omega-3 supplements to help relieve symptoms.
These treatments are typically the first line of defence and can effectively manage mild to moderate cases of blocked meibomian glands.
Advanced Treatments: LipiFlow and Other Therapies
For more severe cases, advanced treatments are available:
- LipiFlow®: A specialised and a state-of-the-art treatment that combines heat and gentle pressure to unclog blocked meibomian glands. This procedure effectively restores normal gland function and provides long-term relief.
- Intense Pulsed Light (IPL) Therapy: A light therapy that helps treat moderate-to-severe chronic dry eye disease and MGD. It works by heating the meibomian glands and liquifying the oils, reducing inflammation and redness
- BlephEx®: This treatment involves thoroughly cleaning the eyelids to remove debris and bacterial buildup that can contribute to MGD.
Managing Meibomian Gland Dysfunction
Managing MGD is an ongoing process. Patients are encouraged to:
- Maintain daily eyelid hygiene using warm compresses and eyelid cleansers
- Use prescribed treatments consistently
- Limit environmental triggers when possible
- Attend regular follow-ups with their eye care provider
With the right care plan, symptoms can be effectively managed, and long-term eye health preserved.
Meibomian Gland Dysfunction Specialists
Dr. Miguel Morcillo
Consultant Ophthalmologist in Cornea, Cataract and Refractive vision correction surgery
Dr. Miguel Morcillo is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive (Vision Correction – LASIK, LASEK, TransPRK) Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Miguel holds a Spanish Degree in Medicine from the Universitat de Valencia. He completed his Residency in Ophthalmology under the MIR (Medico Interno Residente) system of the Spanish Ministry of Health. He has more than 25 years of experience, most of which was attained in Spain. He also worked in Italy and finally moved to the UAE in 2017 and has been practising in the UAE since that time. Dr. Miguel started his career working with Clinica Baviera, the largest private ophthalmology group in Europe, in Madrid and Valencia. He helped develop many of the refractive treatments offered today, such as LASIK, LASEK, ICLs and multifocal IOLs, in addition to collaborations with other hospitals to provide high-quality cataract and refractive surgery to patients. Dr. Miguel trained in cornea surgery at NIIOS Eye Institute (Rotterdam) and, since then became an experienced educator for other surgeons in the fields of the anterior segment and refractive surgery.
He has been a member of “Surgical Eye Expeditions International” since 1999, an American non-government organisation that arranges eye camps worldwide. Dr. Miguel has assisted several eye charity camps in numerous countries of Africa, in addition to Peru, Panama and India, providing free eye care and performing surgeries to those who could not afford it in less developed areas.
His research efforts include surgical topics and outcomes such as Ultrathin LASIK, Keratoconus screening, ICLs, and multifocal IOLs, among others. He has presented various papers in national and international congresses and journals and organised educational courses on refractive surgery for peers and opticians.
He is a member of Sociedad Española de Oftalmologia (SEO), the Panamerican Association of Ophthalmology (PAAO) and the European Vitreoretinal Society (EVRS).
He is also the recipient of the Dr. P C Mahendra Memorial ACOIN International Award in India in recognition of his charitable work with people in need.
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Dr. Nadim Habash
Consultant Ophthalmologist in Cornea and Ocular Surface Diseases
Dr. Nadim Habash is an American Board-Certified Consultant Ophthalmologist specialising in Cornea, Ocular Surface Diseases, and General Ophthalmology at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Nadim undertook his speciality training at George Washington University in Washington D.C., U.S.A., where he also served as Chief Resident. He then acquired an additional Cornea and External Disease Fellowship at the University of Florida, Gainesville, U.S.A.
Dr. Nadim is a Diplomate of the American Board of Ophthalmology and a Fellow of the Royal College of Surgeons of Canada FRCS(C).
Over the past 40 years, Dr. Nadim has had extensive experience in Corneal transplantation and Anterior Segment Diseases in several countries, including the United States of America, the Kingdom of Saudi Arabia and the United Arab Emirates.
Dr. Nadim has worked and held leadership and academic positions in prestigious institutions, including the University of Ohio at Toledo, Ohio, U.S.A., the King Faisal Specialist Hospital and the King Khaled Eye Specialist Hospital in Saudi Arabia, and at the American Hospital Dubai, where he held key positions including Chief of Medical Staff, Assistant Chief Medical Officer and Director of Ophthalmology.
Dr. Nadim published several papers about Corneal transplantation, chaired many scientific conferences and symposia, and participated actively in teaching medical students and Ophthalmology residents.
Throughout his career, Dr. Nadim held memberships in several scientific organisations, including a fellowship of the American College of Surgeons, the American Academy of Ophthalmology membership, and many regional and local societies
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Dr. Osama Giledi
Consultant Ophthalmologist in Cataract, Cornea and Refractive Vision Correction SurgeryGCAA Approved Specialist Aeromedical Examiner
Associate Professor Of Ophthalmology (Adjunct)
Dr. Osama Giledi is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Osama is skilled in managing ocular surface problems, including severe dry eye and Stem cell deficiency. He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr. Osama’s expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed over 23,000 refractive surgeries, including Lasik, LASEK, Intralase LASIK and Trans PRK, and phakic IOLs. He delivers the latest treatment for keratoconus, including Intracorneal ring segments, corneal cross-linking and complex laser treatment.
Dr. Osama graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed two years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery in 2003 at the prestigious Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital. Dr Osama has 22 years of experience in the UK, providing services for anterior segment, Cornea, Refractive and cataract surgery.
In addition to his clinical commitments, Dr. Osama has extensive experience in teaching and training; he is a noted presenter at national and international meetings and has extensive research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.
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Dr. Alia Issa
Aesthetic Oculoplastic Surgeon
Dr. Alia Issa is an Aesthetic Oculoplastic Surgeon, specialising in surgical and non-surgical aesthetic eye treatments at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Alia is a German board-certified ophthalmologist who completed her medical school and residency training at leading institutions in Germany. She also holds a PhD in Ophthalmology from the University of Dresden, Germany.
She went on to expand her expertise and subspecialise in Aesthetic Oculoplastics by completing a Fellowship training in London at the Ezra Clinic and an Honorary Fellowship in Oculoplastics at the world-renowned Moorfields Eye Hospital in London.
Dr. Alia has over 13 years of regional and international experience in Ophthalmology, including in Germany, the United Kingdom, and the United Arab Emirates.
In her career, she has practised in leading medical institutions such as Moorfields Eye Hospital London, and Schlosspark Hospital Berlin, an academic hospital of the Charite University Hospital Berlin, Gemrany.
She is a member of the German Ophthalmic Society.
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Dr. Esmaeil Arbabi
Medical Director and Consultant Ophthalmologist in Corneal transplant, Cataract & Refractive Surgery
Dr. Esmaeil Mohammad Arbabi is a Consultant Ophthalmologist with excellent surgical experience including all types of corneal transplants (DMEK, DSAEK, PDEK, DALK, PKP), ocular surface reconstruction, complex cataract and laser refractive surgery.
Prior to joining Moorfields Eye Hospital Center, he was Consultant Ophthalmic Surgeon (Cornea, Cataract & Laser Refractive Surgery) and the Lead for Refractive Services at Royal Liverpool University Hospital, Liverpool, United Kingdom.
Dr. Esmaeil holds several prestigious degrees and certifications in the field of cataract and refractive surgery including MSc in Cataract and Refractive Surgery, Certificate in Laser and Refractive Surgery (CertLRS) from Royal College of Ophthalmologist and Fellow of European Board of Ophthalmology Subspecialty Diploma in Cataract and Refractive Surgery (FEBOS-CR).
He is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, European Board of Ophthalmology, UK Cross-Linking Consortium, EYE -LAW CHAMBERS - Medicolegal Expert and Expert, Association of Personal Injury Lawyers (APIL).
He is instrumental in high quality papers in various peer reviewed journals and numerous scientific and ophthalmology publications. He is also an examiner for the University of Leeds and the University of Liverpool and for the European Board of Ophthalmologist (FEBO exam).
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