Healthy tears consist of a precise mixture of oil, water, and mucus. Meibomian gland dysfunction, also called MGD, is a condition where the meibomian glands do not produce the proper quality or quantity of oil in the outer layer of the tear film. In normal tears, the layer of oil produced by the meibomian glands seals the tear film and helps prevent tears from evaporating too quickly.
In MGD, the glands become blocked and do not produce normal oil due to inflammation. Inflammation can be related to problems with the lid, contact lenses, hormones, or even incomplete or infrequent blinking. When the glands do not produce enough quality oil, tears evaporate more quickly than normal, resulting in dry eye syndrome. MGD is the leading cause of dry eye.
While MGD is not generally sight-threatening, it can have a negative impact on quality of life if left untreated. Symptoms of MGD can include dryness, scratchiness, a burning sensation, and even problems with visual acuity. MGD can also lead to chalazia and infections of the lid margins, which can be painful and unsightly for patients. Lastly, for patients who wear contact lenses, MGD can make wearing lenses very difficult. MGD does not usually go away on its own and requires treatment and follow-up examinations by an eye care professional.
The goal of treating Meibomian gland dysfunction is to ensure that the glands produce oil properly. Clogged glands need to be unclogged, and treatment must be administered to prevent them from blocking up again. The simplest way to do this is to place a warm, moist towel over your eyes for several minutes to melt any thickened oil that may be clogging the gland openings. After removing the warm compress, gently massage your eyelids near the lashes to express the meibomian glands. When this regimen is repeated regularly twice a day, symptoms can drastically improve within a few weeks.
Further treatment is stepwise in approach depending on the severity of the Meibomian gland dysfunction. It is important to control your environment when possible, so, for example, make sure that your computer monitor is positioned at the correct height and distance and that fans are not directed toward your eyes. Your eye care professional may recommend that you increase your dietary intake of omega-3 fatty acids and may also prescribe lubricants and medications that can help the glands produce oil properly.
It is important to understand that MGD is a chronic condition and requires a long-term treatment plan that may change over time as the condition progresses.
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