Meibomian gland dysfunction is a condition when the meibomian glands can’t produce enough meibum to keep the ocular surfaces well lubricated. Meibomian glands (also called tarsal glands) are the tiny oil glands in the eyelids located along the margin (rim) of the eyelids.
There are approximately 25-40 meibomian glands in the upper eyelid and 20-30 in the lower eyelid. The major function of the meibomian glands is to secrete oil (called meibum) into the tears and hence prevent the water component of the tears from drying out. They keep the ocular surface clean, healthy and well lubricated.
Meibomian Gland Dysfunction
Meibomian Gland Dysfunction is basically a blockage in the meibomian glands due to which they fail to secrete enough oil (meibum) that could prevent the water component of the tears from drying out. Changes in the amount or quality of the oil secreted by the Meibomian gland can lead to this dysfunction. The condition is similar to that of the dry eye. The only difference between the two is that the dry eye syndrome is caused due to the lack of tears whereas the meibomian gland dysfunction is caused due to the lack of oil secretion into the tears.
Causes Of Meibomian Gland Dysfunction
Meibomian gland dysfunction can be the result of a number of causes. The most common cause is when the openings of the glands get clogged due to various reasons and hence the meibum secretion stops. If at all, the oil makes it out of the glands, it is granular, unhealthy and causes irritation in the eyes.
Other significant causes that can lead to the meibomian gland dysfunction include:
The aging process:
Just like the dry-eye syndrome, the meibomian gland dysfunction occurs due to the aging process. Adults above the age of 40 are more likely to suffer from meibomian gland dysfunction. Children and people below this age are comparatively at a lower risk.
Wearing eye makeup:
Using heavy eye makeup like eyeliner can be one of those reasons why ladies can develop this type of gland dysfunction. The makeup clogs the openings of the glands and hence the glands then fail to produce enough oil (meibum) to retain the water component of the tears. Ladies who wear heavy eye makeup or do not remove it properly before sleeping are more prone to developing such type of abnormality in the eyelid glands.
Deficiency of sex hormones:
There are many strong evidences which prove that any sort of changes in the level of sex hormones in a person’s body can disrupt the homeostasis of our lacrimal system and cause dry eye symptoms. The main sex hormone that governs the functioning of the meibomian gland is-Androgen. Increased level of Androgen increases the amount of oil secreted by these glands whereas it’s deficiency results in less secretion of oil and hence causes gland dysfunction.
The use of contact lenses:
Although it has not been proven completely and a number of specialists are unsure about this, yet some experts say that the continuous usage of contact lenses by a person can also increase the risk of the meibomian gland dysfunction. They add that discontinuing the use of contact lenses cannot eliminate the damage that has already been done.
High cholesterol level:
People with a cholesterol level higher than normal tend to have this kind of gland dysfunction. The meibum containing higher concentrations of cholesterol is viscous at physiological temperatures. The secreted oil fails to come out of the tiny openings of the glands because of the high viscosity and hence clogs the opening of the glands.
Any sort of infection in the body might also lead to malfunctioning of some glands (meibomian in this case). The infections caused by bacteria and viruses spread through various means such as:
- Coughing and sneezing
- Physical contact with infected creatures.
- Touching infected and contaminated surfaces.
Symptoms Of Meibomian Gland Dysfunction
The major symptoms of the meibomian gland dysfunction includes:
The eyes and the eyelids start getting dry, due to the lack of secretion of oil from the meibomian glands. The water component of the tears starts evaporating and hence the eyes start to show the same symptoms as shown in the case of dry eye syndrome.
Due to the blockage of the openings of the meibomian glands, the eyelids become sore and swollen. These swollen eyelids cause pain and irritation which becomes unbearable at times.
Redness in the eyes:
Due to the unusual blockage in one of the glands inside the eye, the eyes tend to become red. The redness causes pain and sometimes itching as well.
Due to the redness and swelling in the eyes, the eyes become watery and hence a water film forms on the surface of the eyeball. This makes the vision of the person slightly blurry.
Treatment Of Meibomian Gland Dysfunction
Meibomian gland dysfunction in adults cannot be treated completely. Their symptoms can be made bearable upto a certain extent but cannot be made to fall down to zero.
Some of the treatment methods that can be used for treating meibomian gland dysfunction are as follows:
- The old and traditional methods recommended for the treatment of Meibomian Gland dysfunction include applying warm compress to the eyelids followed by a gentle massage.
Steps to apply the warm compress:
- Take a soft cloth and fold it into half.
- Dip it into a tub containing hot, boiling water.
- Squeeze out the water well and put the cloth on the eyelids.
- Gently press the cloth onto the eyelids to make the warmth reach to the inside.
- After the temperature of the water begins to fall, stop the warm compress process and massage the eyelids with soft hands.
Applying such type of heat treatment to the eyelids helps in liquefaction of the meibum and prevents tear evaporation. The heat reaches the glands and melts the thickened oil that has been clogging the opening of the glands.
Although this method provides means of relief to the clogged openings, it isn’t sufficient to adequately treat the dysfunction and restore the normal functioning of the glands.
Meibomian gland probing:
In this method, the patient is first given local anaesthesia or mild sedation. The doctor then uses the end of a hand-held, sterile, stainless steel wire to probe and dilate the openings of the meibomian glands from both the ends.
This method of treatment has proven to be quite effective as it restores the healthy meibomian gland secretions providing immediate relief from lid tenderness with very minimum postoperative down time. But is somewhat uncomfortable for both the doctor and the patient.
This is a new technique for treating the meibomian gland dysfunction. The LipiFlow thermal pulsation system is an in-office medical device that applies sufficient heat to the eyelids in order to melt waxy deposits in the meibomian glands. At the same time, it applies pulsed pressure to the eyelids to open and thoroughly express the contents of the glands.
The process takes around 12-13 minutes to complete. The system is designed in such a way that the heat which is being applied to the eyelids, does not get transferred to the eyeball. If the heat escapes to the eyeball, it can cause damage to the delicate, internal parts of the eye such as retina and cornea.
This is relatively a new in-office treatment for the meibomian gland dysfunction. The iLUX MGD Treatment System uses a portable, hand-held LED-based heat source to warm the inner and outer surface of the eyelids to melt waxy secretions trapped inside the meibomian glands. Once sufficient heat has been applied to melt the secretions, the optician will apply compression to the lids to express the clogged meibomian glands.
In most of the cases, the process takes 8 minutes or less to complete. Studies show that this method of treatment can show significant improvements in the symptoms of meibomian gland dysfunction.
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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