Meibomian glands are small, sebaceous glands located in the upper and lower eyelids. They secrete an oily substance called meibum which prevents tear evaporation and forms an important part of the tear film covering the eye. Meibomian gland dysfunction (MGD) refers to a condition characterized by changes in the quality and/or quantity of meibum secretions caused due to changes in the meibomian glands themselves.

Causes of MGD

Some of the main causes of MGD in Americans include aging, excessive digital device usage, nutritional deficiencies and certain medical conditions. As we age, the meibomian glands tend to atrophy which reduces their ability to secrete appropriate amounts of meibum. Excessive screen time spent on computers, smartphones and tablets leads to decreased blink rate which causes inadequate lubrication of the eyes over long periods. Nutritional deficiencies of omega-3 fatty acids, vitamins A and D which are essential for meibomian gland health can also contribute to MGD. Certain medical conditions like rosacea, dry eye syndrome, thyroid disorders and connective tissue disorders are known risk factors.

Symptoms of MGD

The most common symptoms of U.S. Meibomian Gland Dysfunction include dry eyes, irritation, redness, foreign body sensation, sandy or gritty feeling in the eyes, sensitivity to light and blurred vision. These symptoms can range from mild to severe depending on the underlying cause and severity of the disease process. The symptoms are usually worse in the mornings just after waking up and towards the evenings due to increased time spent with digital displays during the day. Significant inflammation and infection of the meibomian glands can also cause swelling and tenderness of the eyelids.

Diagnosis and Treatment

Diagnosis of MGD involves a detailed case history, assessment of symptoms, lid examination and diagnostic tests like meibum expression and evaluation. Doctors evaluate the quality and quantity of expressed meibum secretions for signs of blockage or changes. Advanced testing with Imaging and molecular evaluation may also be done in certain cases. Treatment focuses on clearing blockages and normalizing secretions from the meibomian glands. Warm compresses, lid hygiene techniques, over-the-counter lubricating eye drops, oral omega-3 supplements, antibiotics and localized steroid treatments may be prescribed depending on the case. Severe cases sometimes require in-office procedures like intense pulsed light therapy, lipiflow thermal pulsation or expression. Topical cyclosporine eye drops are also used in some resistant MGD patients. Lifestyle modifications to reduce screen time and follow a healthy diet are also emphasized. Prompt treatment enhances outcomes and helps better control symptoms.

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