What Is Meibomian Gland Dysfunction (MGD)?

Meibomian Gland Dysfunction (MGD) is a common but often overlooked eye condition. It can affect your vision and cause discomfort, making it difficult to function normally day to day.

In this comprehensive guide, we'll discuss the causes, symptoms, and treatment options for MGD, empowering you to take control of your eye health.

What is Meibomian Gland Dysfunction (MGD)?

Meibomian gland dysfunction (MGD) is a common eye condition that occurs when the meibomian glands in the eyelids aren’t functioning properly.

Normally, the meibomian glands produce an oily substance called meibum, which prevents tear evaporation and keeps the eyes lubricated. However, with MGD, certain abnormalities or conditions block the meibomian glands.

This can happen due to:

• Clogging. The gland openings can get plugged in, making it hard for the oil to get out.
• Oil changes. The meibum itself can get thick and clumpy instead of flowing nicely.
• Inflammation: The eyelids can get red and irritated, making the whole situation worse.

What Causes MGD?

MGD is actually one of the most common causes of dry eye. Although anyone can get MGD, there are certain things that can increase your risk of getting it, including:

• Age
• Autoimmune diseases like rosacea or Sjogren’s syndrome
• Medical conditions like hypertension or Stevens-Johnson syndrome
• Spending too much time staring at screens
• Not removing eye makeup before bed
• Bacterial infections

MGD is more common among Asian people. Certain medications can also interfere with oil production, namely retinoids, birth control pills, and estrogen replacement therapy.

What are the Symptoms of MGD?

Most of the time, MGD is asymptomatic, meaning it causes no symptoms. However, when symptoms do appear, they typically include:

• Burning and itchy eyes
• Dry eyes
• Irritation
• Inflamed eyelids
• Red eyes
• Uneven and rough inner eyelids
• Blurry vision when blinking
• Light sensitivity
• Crusty eye discharge

How is MGD Diagnosed?

Although MGD may not show symptoms sometimes, there are ways to diagnose the condition. An eye exam can be performed to examine the eyelids closely and check the meibomian gland openings. 

During the exam, they may apply light pressure to your eyelids with their hands or a meibomian gland evaluator (MBE). Applying pressure releases oil from the meibomian glands, which helps your doctor determine if you have MGD.

In some cases, they may conduct a tear breakup time test (TBUT) to assess the stability of the tear film. This involves using a small amount of dye on the tear film. Lastly, dynamic meibomian imaging (DMI) can be used to see if you have sufficient meibomian glands.

Why Should You Get Treatment for MGD?

Although MGD might seem like a harmless annoyance, it can damage your eyes if left untreated. This is because the lack of oil reaching the eye can affect your eye’s tear film. 

A poor tear film makes tears evaporate quickly, resulting in various eye conditions, such as dry eye syndrome, blepharitis, and allergic conjunctivitis. People with MGD also have a much higher risk of getting an infection after laser refractive surgery.

Additionally, MGD can make wearing contact lenses uncomfortable. Because of the lack of oil, contact lenses may feel scratchier when blinking. Many people with MGD end up quitting contact lenses altogether because of the discomfort.

Treatment Options for MGD

MGD can be treated through various methods. For example, artificial tears can help relieve dry eye symptoms. To control infections and reduce inflammation, doctors may prescribe the following:

• Topical or oral antibiotics
• Steroid eye drops
• Other anti-inflammatory drugs

For more severe cases, an immunosuppressant eye drop, like cyclosporine, may be prescribed.

MGD can also be treated in-office with procedures like:

• LipiFlow. Uses heat and gentle pressure to unclog the meibomian glands.
• TearCare. Heating patches are applied to the external eyelids to melt waxy build-up.
• iLUX. A handheld device that warms the inner and outer eyelid surfaces.
• Intense Pulsed Light (IPL). Uses specific wavelengths of light to reduce inflammation and bacterial overgrowth.
• BlephEx. A device that exfoliates the eyelid margins to eliminate debris and open the glands.
• Gland probing. A method of clearing internally blocked meibomian glands involves inserting a fine wire called a probe to unblock it.

At-Home Remedies for Managing MGD

Aside from in-office treatments and medications, there are also ways to manage or treat MGD at home. Here are some of our tips that can help manage your symptoms:

• Apply a warm compress or heat pack on the eyelids for 5 minutes, twice daily, to loosen the oil in your glands.
• Massage your eyelids after applying a warm compress.
• Clean your eyelids with mild soap or specialized eyelid scrubs that can remove oil, bacteria, and debris from the glands.
• Take omega-3 fatty acid supplements to improve oil production in the meibomian glands. 
• Make lifestyle changes to manage underlying conditions and prevent or manage MGD.

By understanding MGD and exploring the various treatment options, you can take proactive steps to protect your eye health. We always recommend having a simple conversation with your eye doctor as the first step towards clearer, healthier eyes.