What is a Meibomian Gland?
Meibomian ("my-BOH-mee-an") glands are large sebaceous oil glands that line the edge of the eyelids alongside the eyelashes. Meibomian glands produce an oil called meibum that secretes onto the surface of the eye every time we blink. This oil is important for your eye health, as it keeps your eyes lubricated and prevents your tears from evaporating too quickly. Tears are made up of meibum, water, and mucus. The meibum oil helps to prevent the water layer from drying out. There are between 20 to 30 meibomian glands in the lower eyelid and 25 to 40 meibomian glands in the upper eyelid.
What is Meibomian Gland Dysfunction?
Meibomian gland dysfunction (MGD) is a common eye condition, yet some people may not realize they have it. MGD is the result of a blockage of the meibomian glands, causing them to be unable to secrete oil into the tears. MGD is associated with dry eye syndrome because the oil blockage causes tears to dry up too quickly.
MGD is actually a type of blepharitis, which is a term used to describe an inflammatory and sometimes infectious condition in the eyelids. Anterior blepharitis impacts the front part of the eyelid and lashes that can cause the eyelids to become red and inflamed. Anterior blepharitis can also cause crusty eyelashes and is often caused by staphylococcus bacteria. Posterior blepharitis, on the other hand, is what’s referred to as MGD.
Changes to the meibomian glands or the amount or quality of the meibum oil can lead to MGD. Most commonly, a combination of factors contribute to MGD. Obstructive MGD occurs when the gland openings become clogged, causing less oil to reach the surface of the eye.
The number of meibomian glands that a person has decreases as we age. Ethnicity also plays a role; for example, Asian people are three times more likely to get MGD than people of European decent. In addition to your age and ethnicity, people who wear contact lenses are also more likely to get MGD.
There are a number of common medical conditions linked to MGD including:
- High cholesterol and triglycerides
- Inflamed or damaged eyelids or cornea
- Allergic conjunctivitis and other eye diseases
- Bacterial infection
- Autoimmune diseases including rosacea, lupus, rheumatoid arthritis, and Sjögren's syndrome
Some medications can interfere with oil production, including:
- Estrogen replacement therapy
- Retinoids, from acne medication to anti-aging creams
- Drugs that reduce androgens
As MGD progresses, you will likely notice more and more symptoms begin to arise. These may include burning, itching, irritation, and dryness in and around the eye. MGD can feel like you have a small particle, like dust or sand, in your eye. You may also notice your eyelids become inflamed, irritated, and therefore red in color. Some people also experience moments of blurred vision, which may come and go.
Symptoms may worsen if you spend a lot of time on the computer, or if the air in your house or place of work is dry from air conditioning or heating. Many people who experience MGD complain about their symptoms when stepping out of a hot shower. They say that after a shower, their eyes become very red and painful. This is due to the humidity in the bathroom, which causes the tear film to quickly become unstable. This can result in a drying out of the eye, specifically the cornea.
How Long Does Meibomian Gland Dysfunction Last?
If left untreated, MGD can become more severe and alter the quality of your life. The cornea can become desiccated and dry, potentially leading to the development of scar tissue. Chronic MGD can cause the meibomian glands to atrophy, which can make it difficult to have them function normally again. MGD can turn into ocular rosacea as well, which requires more aggressive medical treatment.
Can Meibomian Glands Regenerate?
Once glands have atrophied, we don’t usually think of them as having the ability to regenerate (unfortunately). However, there has been some recent promising research into this topic. A study in the British Journal of Ophthalmology has found that probing meibomian glands in patients who have MGD could lead to the growth and regeneration of meibomian gland tissue.
In addition to this, a small ongoing study has also shown that LipiFlow, used over time, may help to regenerate the meibomian glands. This recent retrospective, observational study has revealed that 70% of those patients treated with LipiFlow showed a reversal in their meibomian gland atrophy vs. those patients who had not undergone LipiFlow. In these patients where improvement was noted, small positive changes were seen in the glands. Researchers also found long term improvements in tear break up time, tear osmolarity, and corneal staining. Click here to read more about how LipiFlow may be able to regenerate your glands.
Can Meibomian Gland Dysfunction Be Cured?
Thankfully, MGD can be treated, although there is no cure. All treatment really requires is the release of the blockage of the glands. This can be done at home or, in more severe cases, by an optometrist or ophthalmologist, who will perform a treatment to extract the blockages.
During manual expressions, doctors will use tiny paddles to compress the eyelid to squeeze out the contents of the clogged meibomian glands. In most cases, this procedure is painless, however if the eyelid is quite inflamed, it can be anaesthetised.
Some patients will only need one treatment, while others may benefit from multiple sessions. In addition to this, there are now more effective machines, such as LipiFlow, that work incredibly well for many people.
How to Unclog Meibomian Glands | How to Express Meibomian Glands at Home
Treatment of meibomian gland dysfunction will vary based on the severity of the blockages. When MGD is severe, it’s best for meibomian gland expression to be performed by a doctor, optometrist or ophthalmologist. For milder cases, there are a couple things you can do at home to help unclog the meibomian glands. For some people, one type of treatment will be enough, but for others, a complete regimen is needed to alleviate their symptoms. Here is a list of things you can do to unclog your meibomian glands at home:
Most doctors recommend applying a warm compress to the eyes every day, followed by a lid hygiene routine. Although you can use a washcloth and hot water, that’s super tedious. We recommend purchasing the Heyedrate Warm Compress Eye Mask and heating it in the microwave for 20 seconds. Place it over the eyes and keep the compress on the eyes for 10-15 minutes. Adjust the heat as necessary to suit your comfort levels, however keep in mind that the heat is what is causing the blockages to dissolve. You can also gently massage the mask into your eyes to stimulate the glands during compression, just make sure to do this gently. We recommend using a warm compress after removing makeup but before your eyelid hygiene (more on this below).
Lid hygiene is the number one most important step in treating MGD! Here are some of the main steps:
If you wear makeup, it’s important to make sure you clean the products off your eyes every night before bed because it can contribute to the clogging of the meibomian glands. To make sure your skin is clean, use the Heyedrate Eye Makeup Remover. Not only will this oil remove your makeup, but it is specially formulated for dry, itchy, and inflamed eyes. Made with tea tree oil, this makeup remover will moisturize your skin while it kills microorganisms, neutralizes inflammation, and prevents the reproduction of eyelash mites. To use, apply 2-5 drops to a cotton round and gently cleanse the eyelid area, motioning back and forth to remove any eye makeup.
After removing your makeup, it’s time to cleanse your face. Use the Heyedrate Tea Tree Soap, which will support skin blemishes, soothe irritated eyes, and calm itchy, inflamed skin conditions. The tea tree oil will remove contaminants and leave your skin feeling refreshed. To use, wet your face and hands with warm water. Lather the soap in your hands, and massage the lather onto your skin and closed eyelids in a gentle circular motion. Rinse off the soap and pat your face dry with a soft towel. Repeat every morning and evening.
Using a lid and lash cleanser can make all the difference if you have MGD. After you’ve used your warm compress, this eyelid cleanser should be used for both gland expression and hygiene. To use it, spray a Q-tip with the Heyedrate Lid & Lash Cleanser until damp. Looking in the mirror with one eye closed, roll the damp Q-tip on your eyelid in a downward motion, starting in the inner corner of the eye and making your way to the outer corner. Repeat this on the bottom lid by keeping your eye closed and rolling up toward the lash line.
Once you’ve done both the top and bottom lids, use your damp Q-tip (spray more Heyedrate Cleanser if it’s no longer damp) and run it across the lid margin or waterline of the upper and lower lashes. The last step is to close your eyes and spray your eyelids with the Heyedrate Lid & Lash Cleanser and let it dry. Repeat once or twice per day!
Omega-3 fatty acids have been shown to normalize the meibomian glands by improving the gland oil consistency and quality. Other nutrient supplements that may help with MGD are flaxseed oil and fish oil. Try the Heyedrate Omega 3 for Eye Health, which works from the inside of your eyes to the outside to address the underlying cause of irritation. With powerful anti-inflammatory properties, this supplement with moisturize your eyes and provide comfort and relief.
Tips on Meibomian Gland Expression:
- Do this once a day. It is not necessary to do it more than that.
- There are a couple of different options on what to use:
Using a Q-tip
- Use Heyedrate Lid & Lash Cleanser by Eye Love and spray on the Q-tip so you know that it's damp.
- Look in the mirror.
- Start on one corner of your eye and roll down and across your entire eyelid.
- Use a little pressure, but don't put too much.
- Then, on the bottom lid, keep your eye closed and roll up.
- The bottom lid's a bit tougher, so if you want you can just press right below that lower lash line all the way across.
- Once you've done that, make sure your Q-tip is damp with Heyedrate Lid & Lash Cleanser and run it across the lid margin to get all of the oil out.
Using your finger
- You're going to do essentially the same thing...
- Start on one corner and roll down all across your eyelid.
- You can also just press the eyelid with your fingertip.
- Then, using the Heyedrate Lid & Lash Cleanser, spray your eyelids with it and let dry.
That's it! You don't have to wash off the cleanser, either, as it's safe to let dry on your eyelids. Your eyes will feel better after a couple of weeks of following this protocol. You just really have to be consistent with it. Do this once a day. And let us know in the comments below if you have any questions or if you have any comments.
Do you have a routine for treating your MGD? Let us know what it looks like in the comments below!