What are the symptoms of meibomian gland dysfunction (MGD)? What causes MGD? How is MGD diagnosed and treated?

Understanding Meibomian Gland Dysfunction (MGD)

Meibomian Gland Dysfunction (MGD) is a common eye condition that affects the tiny oil glands located in the eyelids. These glands, known as meibomian glands, produce an oil called meibum, which is a crucial component of the tear film that keeps the eyes moist and lubricated. When there are problems with the amount or quality of this oil, it can lead to various eye-related issues.

Symptoms of Meibomian Gland Dysfunction

In the early stages of MGD, you may not experience any symptoms. However, as the condition progresses and the tear film becomes affected, various symptoms can arise. These include:

• Burning, itching, or irritated eyes
• Feeling like there is a grain of sand or dust in the eye
• Red, inflamed eyelids
• Uneven or rough inner rims of the eyelids (a classic sign of MGD)
• Moments of blurred vision that improve with blinking
• Worsening of symptoms when using digital screens for extended periods or in dry environments

Causes of Meibomian Gland Dysfunction

MGD can be caused by a combination of factors, including:

1. Age – The number of meibomian glands decreases over time.
2. Ethnicity – Asian people are about three times more likely to develop MGD than those with European ancestry.
3. Contact lens wear – Wearing contact lenses increases the risk of developing MGD.
4. Underlying medical conditions – High cholesterol, allergic conjunctivitis, eyelid/cornea inflammation, bacterial infections, and autoimmune diseases like rosacea, lupus, rheumatoid arthritis, and Sjögren’s syndrome have all been linked to MGD.
5. Certain medications – Estrogen replacement therapy, drugs that reduce androgen, and retinoids (used for acne or anti-aging) can also contribute to MGD.

Diagnosing Meibomian Gland Dysfunction

There is no single test that can definitively diagnose MGD. Your eye doctor will examine your eyelids closely to inspect the gland openings and may perform tests such as:

• Schirmer’s test to check for adequate tear production
• Measurements to assess the quality of your meibum and the rate of tear evaporation

The combination of these findings will lead to a diagnosis of MGD.

Treatment for Meibomian Gland Dysfunction

The treatment for MGD depends on the stage of the condition and any underlying health issues. Initial self-care measures may include:

• Applying warm compresses to the eyelids to help loosen the oil
• Gently massaging the eyelids to help unblock the gland openings
• Using a non-soap cleanser to clean the eyelid margins
• Using a humidifier to counter the drying effects of air conditioning or heating
• Considering daily disposable contact lenses with a “water gradient” design for improved comfort
• Avoiding products with retinoids near the eyes
• Taking omega-3 fatty acid supplements to help improve meibum quality

For more advanced cases or if underlying health conditions are present, your doctor may prescribe additional treatments, such as:

• Lubricating eye drops or sprays
• Antibiotic eye drops or ointments to treat infections
• Cyclosporine eye drops to suppress the immune system
• Steroid eye drops or creams to reduce inflammation
• In-office procedures to open blocked meibomian glands and improve oil flow

Complications of Meibomian Gland Dysfunction

If left untreated, MGD can lead to several complications, including:

• Increased risk of eye infections and inflammation after eye surgery
• Development of dry eye syndrome (also known as dry eye disease)
• Eyelid inflammation, known as blepharitis
• In advanced cases, corneal disease

It’s important to work closely with your eye care provider to manage MGD and prevent these potential complications.

Preventing and Maintaining Meibomian Gland Health

While some factors that contribute to MGD, such as age and ethnicity, cannot be controlled, there are steps you can take to help prevent and maintain the health of your meibomian glands:

• Adopt a daily eyelid hygiene routine, including warm compresses and gentle massage
• Use a humidifier to combat the drying effects of air conditioning and heating
• Avoid products with retinoids near the eyes
• Consider taking omega-3 fatty acid supplements
• Manage any underlying medical conditions that may contribute to MGD
• Discuss the use of contact lenses with your eye care provider

By understanding the symptoms, causes, and treatment options for Meibomian Gland Dysfunction, you can take proactive steps to maintain the health of your eyes and prevent or manage this common eye condition.