Meibomian Gland Dysfunction: Causes, Symptoms, Diagnosis, and Treatment

By | 13/11/2018
meibomian gland dysfunction icd 10

MGD: It’s a term that refers to a highly common ocular disease that can result in dry eye syndrome if not quickly treated.

The Meibomian glands, also known as tarsal glands, are a type of exocrine glands that keep the ocular surface clean and well-lubricated.

Both upper and lower eyelashes have two types of secretory glands, one of them is the glands of Zeis, and the other is the Moll’s glands.

Both of these glands’ secretions lubricate the eye and help to form the outer lipid component of the preocular tear film that covers the cornea.

In this particular arrangement, the role of the Meibomian glands, located between the lashes and the bulbar conjunctiva, is to exude a fat and oil mixture onto the ocular surface.

The lipids secreted by these glands also help to form the surface lipid layer of the tear film, which prevents excessive evaporation of tear fluid.

MGD is a condition that consists of a blockage or an abnormality that prevents the Meibomian glands from secreting the amount of oil needed for the tear film.

That results in the quick evaporation of the tears, which leads to dry eye syndrome, a severe lacking of sufficient lubrication and moisture on the surface of the eye.

Causes

A relevant factor in the development of this condition is the age of the patient. As people grow old, the amount of functioning meibomian glands goes down gradually.

Patients over 40 years old are prone to displaying at least one sign of MGD.

Some medical experts consider constantly wearing contact glasses as another risk factor that could contribute to the premature appearance of this ocular condition.

In other cases, the ethnic background may play a significant role as Asian people are about three times more likely to develop MGD.

Wearing too much make-up such as eyeliner can clog the openings of the Meibomian glands and increase the risk of developing this disease.

In this particular instance, women who don’t thoroughly clean their eyelids and remove all traces of eye makeup before sleep have a higher risk of suffering from this condition.

Other potential causes associated with medical issues may include the ones listed here below:

  • High cholesterol and triglycerides
  • Other ocular diseases such as Allergic Conjunctivitis
  • Damage to the eyelid or cornea due to inflammation or trauma
  • Bacterial Infection
  • Autoimmune conditions such as Rosacea and Sjögren’s syndrome

There are other causes usually linked to the use of medication that may cause issues with the oil production of these glands.

Such cases may involve estrogen replacement therapy, the use of drugs to reduce androgen, or something as simple as taking acne medication and using anti-aging creams.

Symptoms

In the early stages of MGD, the patient may not display any noticeable sign of having this condition.

But as the disease progresses the patients have less oil or poor-quality oil, their eyes may burn, itch, or get irritated.

Due to the fact, the eyes get dry as the condition worsens, people may feel like they have sand or dust in their eyes.

The eyelids may get inflamed, irritated, and could even appear to be reddened. Their inner rind will look uneven or rough in some cases.

Some patients can experience moments of blurred vision that could get worse as MGD progresses.

Diagnosis

There isn’t a single test that can completely confirm the presence of MGD.

Usually, medical experts have to perform a physical examination looking closer at the patient’s eyelids to inspect the gland openings. Doctors may press on the eyelids to squeeze oil out.

Eyecare providers can also use the Schirmer’s test, which consists of placing filter paper inside the lower eyelids of the eyes to determine how quickly the eyes produce secretions.

Medical experts will likely use several different tests, and the combination of the results will help them to diagnose a case of MGD.

Treatment

The viable means to correct the MGD or prevent it from getting worse will depend on the severity of the condition.

Some medical experts recommend the use of medications such as lubricants, antibiotics, cyclosporine, or steroids.

Several of these medicines come in the form of eye drops, creams, or pills.

In other cases, doctors may need to use medical devices to open the blocked glands with heat or pulsed lights, which could alleviate the symptoms.

The means and the recommended therapy to deal with MGD may vary from case to case.