How to look for Meibomian Gland Dysfunction
Normal meibum is thin with clear liquid which is expressed very easily. With various stages of MGD, the meibum becomes thicker, (see photo above) and the expressed liquid becomes thicker, granular and some time in clumps and the liquid become opague. The expressing meibum can be very difficult.
Often MGD is accompanied by lots of inflammation - on the eye lid, in the eye. In most cases, MGD is accompanied also by tear volume in-sufficiencies (Lacrimal Gland). Thus setting up a situation where dry eyes cause inflammation and the inflammation causes the tear secretion glands to shut down.
Certain drugs can cause MGD, especially drugs to dry up acne - such as Accutane, antihistamines used in allergy treatments.
Treatment of Meibomian Gland Dysfunction
Typical treatments for MGD includes:
1. Wet hot compresses - twice a day, each time 10 minutes to unclog the meibomian glands
2. Eye lids cleaning daily to minimize eye infections
3. Oral Antibiotcis - Doxycycline or Azithromycin daily
4. Steroid eye drops - such as Lotamax or PredForte to calm down inflammation during a flare. Steroid eye drops are limited to one month since long term use may result in kidney and liver damages.
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photo curtesy of Gary N. Foulks MD, FACS.