About

Meibomian glands are present in the eyelids and provide the oily part of the tear film that slows the evaporation. When they are blocked, the evaporation is higher and dry eye symptoms develop. Meibomian Gland Dysfunction usually appears in older adults. Suggested risk factors are: Asian populations, frequent eye-liner users, and contact lenses.


Causes

Meibomian Gland Disfunction is generally caused by a blockage or some other abnormality of the glands in which they don’t secrete enough oil into the tears, which then evaporate too quickly.
It is a leading cause of dry eye syndrome, resulting in evaporative dry eye associated with eyelid problems such as blepharitis or rosacea, which are chronic conditions that can be controlled well but not immediately cured.


Symptoms 

Symptoms are very similar to dry-eye syndrome: redness, foreign body sensation, itchiness and blurry vision. Eyelid margins may appear red and swollen (blepharitis).


Diagnosis 

Diagnosis is a combination of different techniques to assess the quality, quantity and stability of your tears: gentle pressure of the eyelids and observation of the glands’ secretion, search for lid margin lesions, tear meniscus measurement, staining of ocular surface, Schirmer test and tear break up time.
Some hygienic measures are recommended to melt and express the glands, as application of warm compresses and eyelids margin massage, although the relief is mild. Meibomian glands can also be probed. This procedure opens the glands and it is quite effective although it is somehow tiring for the patient.


Treatment

The typical recommended treatment is applying local hot compresses to the eyelids, followed by massaging and wiping the surface. The goal of this treatment is to melt and express any thickened oil blocking the openings of the meibomian glands, however in some cases this won’t effectively relieve the symptoms.
New treatment options include the pulsed light devices (Intense Pulse Light) or adhesive heating patches (TearCare) that heat the glands and improves secretion flow. Eyelid margins can be exfoliated to remove the inflammatory debris that accumulate in the borders of the eyelids and helps to keep the chronic inflammation (Blefex). Antibiotic eye drops and ointment or tablets such as azithromycin tablet , steroid eye drops, cyclosporine eye drops or Omega-3 supplements are useful in some cases. 

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