meibomian gland dysfunction

Meibomian gland dysfunction (MGD), is a chronic dysfunction of the meibomian glands. This means that the oily secretion that stabilises the tear film and protects it from evaporation is produced incorrectly in the eyelid margin glands. On the one hand, the composition can be altered, on the other hand, the glands can produce too much or too little sebum, which leads to blockages of the sebaceous glands. If the secretion is too viscous, it accumulates in the gland ducts.

The consequences of MGD: The aqueous layer of the tear fluid is not sufficiently coated with the lipid layer. The tear film can break down more quickly and leave the eye surface unprotected, which can cause burning, itching and redness. Meibomian gland dysfunction is often accompanied by eyelid margin inflammation (blepharitis) and is one of the most common causes of dry eyes.

Meibomian gland dysfunction usually leads to chronic eye conditions such as dry eyes or chronic blepharitis. Typical symptoms include:

• dry eyes
• red eyes and eyelids
• itchy eyes and eyelids
• burning eyes and eyelids
• swollen eyelids
• sticky discharge and encrustations on the eyelashes
• eyelids stuck together in the morning
• tired eyes
• watery eyes
• foreign body sensation
• impaired vision
• increased sensitivity to light

If the sebum residues are not removed regularly, germs can accumulate at the eyelid margins, which can repeatedly trigger inflammations. If a single sebaceous gland becomes blocked, a chalazion may form. A bacterial infection of a sebaceous gland can also cause a painful stye (hordeolum). The permanent state of irritation considerably impairs the well-being of those affected.

Meibomian gland dysfunction is treated by careful and regular eyelid margin hygiene:

• Heat treatment: Exposure to constant heat for several minutes stimulates the glandular function and softens the secretion accumulated in the gland ducts. Warm compresses are suitable for this, but self-heating eye masks are even more effective, as they keep the temperature constant at around 45 degrees.
• Cleaning the eyelid margins: Immediately after the heat treatment, massage the eyelid margin to remove the liquid secretion from the meibomian glands. Then remove the residue with a damp cotton pad or a lid hygiene wipe. For hygiene reasons, use a fresh wipe or cotton pad for each eye.
• Eyelid care: After cleaning, apply a nourishing eye spray to soothe eyelid irritation and leave eyes feeling comfortable for the day.

To relieve the acute discomfort of eyelid margin inflammation, anti-inflammatory eye drops and eye ointments can help. In addition, moisturising or wetting eye drops should be used several times a day to treat eye discomfort. An eye ointment can also protect the eyes during the night if the symptoms are severe, and can prevent the scratchy feeling in the morning after waking up.

Meibomian gland dysfunction is considered a chronic eye disease and has no cure. However, it can be alleviated by consistent eyelid margin hygiene. People who suffer from the dysfunction should take care to clean and look after the eyelid margins twice a day and include eyelid margin hygiene in their daily routine. This can not only reduce redness, swelling and sticky discharge of the eyelids; those affected can even live largely symptom-free.

However, negligence in eye care can quickly cause symptoms to return. It is therefore all the more important that you are disciplined in carrying out eyelid margin care.