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Meibomitis

Meibomian Gland Dysfunction (MGD)

The Meibomian glands are specialised oil-producing glands located within the eyelids. They secrete lipids that form the outer oily layer of the tear film, which slows evaporation and keeps the eyes comfortable.

Meibomitis (MGD) occurs when these glands become inflamed or blocked. When this happens, the quantity and quality of oil decrease, leading to rapid tear evaporation and ocular surface irritation.

Signs and Symptoms

Symptom Pattern

Typical Symptom Pattern

Symptoms are often worse on waking, improve as the day progresses, and may worsen again in the evening as dryness increases. This happens because tear production slows during sleep while inflamed lids remain in contact with the eye.

General Symptoms

Common Indicators

  • - Red, thickened, or swollen eyelid margins.
  • - Burning, stinging, or gritty "foreign body" sensation.
  • - Watery eyes (a paradoxical response to dryness).
  • - Blurred or fluctuating vision.

Causes and Risk Factors

When glands are inflamed, oil becomes thick and stagnant, encouraging bacterial growth. Contributing factors include:

Risks
  • - Skin Conditions: Rosacea, acne, or dandruff.
  • - Hygiene: Poor eyelid cleaning or makeup habits.
  • - Environment: Allergies and eyelash mites (Demodex).
  • - Systemic: Hormonal changes or a compromised immune system.

Note: Medical treatments, including antibiotics or steroids, should only be prescribed by your eye care practitioner.

Core Treatment Strategies

While MGD is a chronic condition, symptoms can be effectively managed with a consistent daily routine:

  • - Warm Compresses: Apply for 10 minutes daily (ideally in the morning) to liquefy thickened oils.
  • - Eyelid Massage: Gently massage the lids after heating to help express oil from the glands.
  • - Lid Hygiene: Use a specialised cleanser to clean the lash base and eyelid margins.
  • - Artificial Tears: Use preservative-free drops to relieve surface dryness and irritation.

Medical Options: In severe cases, your practitioner may recommend Omega-3 supplements, oral doxycycline to improve oil quality, or short-term topical steroids.

Long-Term Outlook

MGD is present in up to 60% of dry eye patients. If left untreated, chronic inflammation can lead to permanent gland loss and persistent discomfort. However, with consistent hygiene and professional guidance, most patients experience significant improvement in comfort and vision.

Clinical References

1. EyeWorld. Meibomian Gland Dysfunction. Available at: https://www.eyeworld.org
2. Optometric Management. Gilbard, J.P. (2002). Meibomianitis. Available at: https://www.optometricmanagement.com
3. Review of Ophthalmology. Meibomitis and Dry Eye Treatment.
4. Glazier, A. Meibomitis and Dry Eye. Available at: https://www.reviewofcontactlenses.com