What is MGD (Meibomian Gland Dysfunction) and What Are MGD Treatments?
By Eye Doctors Jenna and Travis Zigler
What is MGD (Meibomian Gland Dysfunction)?
The meibomian glands in your upper and lower eyelids help to produce tears, and this is where MGD begins. This disease is a progressive, obstructive disease that advances from the production of normal, healthy oils of the tear film into thicker secretions that cause stagnation and blurry vision. If left untreated, the glands can become completely obstructed and eventually atrophy.
Symptoms of MGD include blurred vision, red eyes and eyelids, dry, scratchy eyes, and overall irritation. Unfortunately, this disease currently has no cure, but there are ways to effectively treat it and reverse some of the issues.
What are MGD Treatments?
Step 1: Use a Warm Compress Mask
A warm compress eye mask is step number one because those with meibomian gland dysfunction have hardened, impacted oils within their glands. This is a problem because those hardened oils have a hard time expressing onto the eyes. Without the proper healthy oils, you end up with a disruption in your tear film which can lead to discomfort, redness, watery eyes, and overall dry eye.
A warm compress mask is easy to use. You simply place the entire mask into the microwave, heat it on high for 20 seconds, and then test the temperature of the mask on the inside of your wrist. As long as it's not too hot, you can lie back and place the mask over your closed eyelids for 15-20 minutes. Making this a part of your daily eyelid hygiene regimen is a wonderful way to ensure that you're keeping those oils flowing.
Step 2: Gently Express the Meibomian Glands
After heating the oil within your eyelids, you still may have to help those oils out onto the eyes. New procedures such as Lipiflow and MiBo Thermoflo can simultaneously heat and express the glands, and they are quite effective! However, these treatments can be pricey to have done regularly. Expression of the glands can also be manually done by your eye doctor, but sometimes it's a good idea to do this at home as well. You can use either your finger or a cotton swab, and it's easy to do.
Using a wet cotton swab on the outside of your eyelid, roll the swab from the upper eyelid crease down to the eyelashes and repeat this across the entire upper eyelid. Then, do the same on the bottom eyelid, rolling up toward the eyelashes. This process helps to break up the impacted oil and release it from the glands onto your eyes. Take care not to push too hard, but you do want to use enough pressure to be effective.
Step 3: Use a Hypochlorous Acid Cleanser
Hypochlorous acid (HOCl) has become a very popular product for eyelid cleansing in recent years. This natural substance is produced by neutrophils in the body in response to bacterial invaders and inflammation. It works to fight off microorganisms on the skin and mucous membranes, ensuring that the affected area is clean. It is well known that clean eyelids can help alleviate the signs and symptoms of blepharitis, dry eyes, and meibomian gland dysfunction.
After using a warm compress and gently expressing the glands, you'll want to use a HOCl cleaner to rid the eyelids and eyelashes of any debris left there. Simply spray the solution onto your closed eyelids. Rubbing the solution in and then letting it dry is enough, although some people prefer to spray onto a cotton ball or round before application. Either is fine and very effective at keeping the skin clean! A hypochlorous acid cleanser should be used twice per day for maintenance of clean eyelids.
Step 4: Increase Intake of Omega-3 Fatty Acids
Omega-3 fatty acids are so important for those with MGD. Because the meibomian gland oils of those with MGD are of poor quality, it is imperative to ensure you're ingesting a good ratio of Omega-3 to Omega-6 either through food or supplementation. A healthy Omega-6 to Omega-3 ratio is 4:1 but, sadly, our Western diet almost guarantees that yours may be closer to 20:1. To make sure your ratio is healthy, eliminate all processed and fried foods and sugars and replace them with healthy omegas like wild caught salmon, mackerel, walnuts, chia seeds, flaxseed, and avocados.
For those who wish to supplement, the Heyedrate Omega-3 for Eye Health contains high quality, triglyceride-based omegas, as well as a few other important vitamins and can help balance out your ratio. The recommended dosage is three softgels per day, which can be taken all at once or separately.
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