Meibomian Gland Dysfunction: It’s Risk Factors And Treatment Methods

There are many common eye problems that people haven’t heard of before, meibomian gland dysfunction is one such eye problem. Meibomian is a particular gland in the eyelids.  This gland was named after “Heinrich Meibom.” He was a German doctor who first got to know about this form of dysfunction and made drawings of it way back in 1666.

The upper eyelids consist of around 25 to 40 Meibomian glands while the lower eyelids consist of 20 to 30 meibomian glands.  These glands are responsible for the secretion of oil onto the surface of the eye. The oil secreted from these glands helps to keep the tears from evaporating quickly.

Any abnormality or a blockage of the meibomian gland, which halts the secretion of enough oil in the eye is known as meibomian gland dysfunction. This dysfunction is associated with dry eye syndrome.

This dysfunction can also be known as “Meibomianitis”. Meibomian gland dysfunction can also be connected with another eye problem called Blepharitis.

Risk factors 

There are many factors that can increase the risk of dysfunction of the Meibomian Gland.

The risk of this condition can increase with age. People in the age group of the early 40s have a greater risk of developing meibomian gland dysfunction as compared to young adults or teenagers. It can also be the fundamental cause of dry eyes.

Ethnic background also plays an important role in developing meibomian gland dysfunction. In some studies, it was found, that up to 69% of the Asian population living in Thailand, Japan, and china have meibomian gland dysfunction.

Wearing a lot of eye make-up is another cause for the development of meibomian gland dysfunction. Eye make-up can block the opening of the meibomian glands. Hence, it is important to thoroughly clean the eyelids and remove any sign of eye make-up before going to sleep.

There are many researchers who believe that wearing eye lenses can be another cause for the development of meibomian gland dysfunction. Although it is still unclear whether wearing an eye lens can cause this dysfunction or not, as there are many researchers who do not support this statement. Thus, further study is required to clear the proclamation.

How is “Meibomian Gland Dysfunction” detected?

Some of the symptoms of meibomian gland dysfunction include “redness in eyes, itchiness in the eyes, blurred vision, etc.” Only through an eye exam by a trusted ophthalmologist, can it be stated whether someone has meibomian gland dysfunction or not.

An easy technique used by ophthalmologists to see whether someone has meibomian gland dysfunction is by applying pressure on their eyelids.  The ophthalmologist then observes the secretion and determines if the patient has meibomian gland dysfunction or not.

Another test that an ophthalmologist conducts to determine the dysfunction is the “Tear breakup time (TBUT) test.” This is an easy and painless procedure that includes a little amount of dye on the front surface of the eye. The ophthalmologist then examines the eye with a cobalt blue light to see how quickly the patient’s tears dry up.

Treatments 

Previously, the treatment recommended was to apply a warm compress to the eyelids. The objective of this treatment was to melt any thickened eye clogging.

Another treatment was to probe and dilate the meibomian glands. In this treatment, the ophthalmologist applies numbing eye drops in the eyes and then uses the end of the hand-held instrument to probe and then dilate the openings of the meibomian glands. Although this procedure is effective, still it is tedious and uncomfortable.

Some of the new treatment techniques which are now used are:

1.Lipiflow

This is an in-office medical device known as a “Lipiflow thermal pulsation system.”  It helps to apply sufficient heat to the eyelids to melt the waxy deposits in the meibomian gland.  At the same time, this device helps to apply pulsed pressure to the eyelids to open and thoroughly express the contents of the glands.

In a twelve minutes treatment session, the Lipiflow device attaches itself to the eyelids. The device is designed in a way so that there is no transfer of heat or pressure from the eyelids to the eyeballs. According to research, a single Lipiflow treatment can significantly improve the secretion by the meibomian glands and can reduce dryness in the eyes for up to three years.

2.iLUX

Tear film innovations came up with a new in-office treatment for meibomian gland dysfunction which is marketed by Alcon.

The treatment system is known as iLUX. This is a hand-held LED-based heat source that is used to warm the inner and outer surface of the eyelids to melt the secretion which is stuck inside the meibomian glands.

Once the ophthalmologist has applied sufficient heat to melt the secretion, then he/she applies compression to the eyelids to express the blocked meibomian glands. This system is a time-saving treatment as it can treat the dysfunction in less than eight minutes.

Recent studies have shown significant results through the iLUX system. The system has shown improvement in the signs and symptoms of meibomian gland dysfunction and dryness in the eyes within two to four weeks of the treatment.

The iLUX system was also awarded at the 2019 medical design excellence awards.

3.Tearcare

Developed by sight sciences, this in-office treatment uses adhesive heating patches that are applied to the external eyelids. The heating period for this device is around twelve minutes. After that, the ophthalmologist uses expression forceps to squeeze the eyelids to open and drain the blocked meibomian glands.

Adjunct meibomian gland therapies

Many ophthalmologists suggest a combination of treatments. The following are the therapies that might be suggested for use with treatments mentioned above:

1.Intense pulsed light (IPL)

For years dermatologists have used this treatment to cure acne rosacea.  Recently, it has been proven to be effective to also cure meibomian gland dysfunction. In this treatment, an intense pulse of visible and infrared light is applied to the eyelids for around 20 minutes. This treatment reduces the inflammation in the eyelids.  IPL treatment has shown many promising results in the past three years.

2.Lid Debridement

In this treatment, the ophthalmologist uses a handheld instrument to de-scale keratin and other debris which adhere to the margins of eyelids and block meibomian gland openings. This treatment provides statistically great relief from dryness in the eyes.

3.Antibacterial Eye Drops

Many ophthalmologists suggest antibacterial eye drops as they easily help resolve meibomian gland dysfunction.

4.Omega-3 Supplements

Many ophthalmologists recommend nutritional supplementation with omega-3 fatty acids as an adjunct therapy to cure meibomian gland dysfunction.  The omega-3 rich diet helps to decrease the risk of meibomian gland dysfunction.  According to studies, omega-3 fatty acids help to subdue inflammation linked with meibomian gland dysfunction and also decrease the risk of waxy build-up within the meibomian gland.

5.Blephex

This is an in-office treatment that helps to reduce the symptoms of MGD. In this treatment, a hand-held instrument gently decreases the margins of the eyelids. This action later removes inflammation which can form on the eyelids causing the meibomian glands to clog.

The best way to treat your eyes is to visit your eye care professional and get your eyes checked regularly. He will be able to assess the best method of treatment for your eye ailment.

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