Meibomian Gland Dysfunction

With modern technology, your eye care professional can now see and evaluate the condition of your meibomian glands using meibography. The morphology of the glands is visible with this type of examination as much on the lower and upper eyelids.

meibographie

Morphology of meibomian glands through meibography

The meibography is the only method used to clearly visualize in what state are the meibomian glands. With these images, the health professional can assess the degree of severity of meibomian gland dysfunction. The images allow to clearly visualize the ducts as well as the acinis of the glands.

Meibography is used to assess chronic blepharitis and DGM through objective analysis of the meibomian glands. In addition, it is possible to link the state of the glands with the osmolarity of the tear film when evaporative ocular dryness is evident.

Meibomian glands secretions

The dysfunction of the meibomian glands often amounts to an abnormal and / or reduced secretion of the lipid which enters into the composition of the tear film. Ironically, less lipid is produced by these glands and the more they tend to atrophy. The lipid produced by the meibomian glands is essential for a healthy tear film with normal tear break up time. This is called a stable lacrimal film. If the chemical composition of the lipid changes or if it is in too small quantity, the lacrimal film becomes unstable and the tear film break up time is proportionally decreased.

For better diagnosis of meibomian gland dysfunction

Meibography is an additional tool within the medical profession in the fight against dry eye. There are several instruments manufactured by several different companies to photograph these glands and more and more optometrists and ophthalmologists have one in their practices.

meibomian gland dysfunction

Meibomian gland dysfunction severity state classification with meibography

As you can see from the image above, the condition of the meibomian glands is generally classified as 4 level. The ideal level being level 0 since this means that all meibomius glands function normally. On the other hand, level 4 is the worst level you do not want to reach. The more advanced you are, the more your evaporative eye dryness will be uncomfortable or suffering. For this reason, no matter what condition your glands are in now, it is never too late to start doing what it takes to slow down and maybe even stop the degeneration of the glands. Left untreated, meibomian gland dysfunction can become very annoying and seriously impacting your quality of life.

Some tricks to maintain the good functioning of the meibomius glands:

  • Do blinking exercises to stimulate the glands

    • Press your fingertips on the corners of each of your eyes and blink. If you feel anything, it is that you use the defense muscles that lie along your face. The muscles that allow the blinking of the eyes are located above your eyelids.
    • Read the blinking sequence. It is very important to take a break so that there is complete contact between the upper and lower eyelids (people who suffer from dry eyes often blink only partially of the eyes). If you perform the sequence correctly, you should not feel any movement under your fingers.
    • The frequency of blinking depends largely on the tasks to be performed. For example, if you spend considerable time working on the computer, you probably blink less often. You still have to think about doing your blinking exercises! Other activities that will reduce the frequency of blinking include driving, reading, watching television, sitting at an office, or other tasks requiring a degree of visual concentration.
    • Finally, if you have difficulty consciously incorporating your blinking exercises into your schedule (ie five times per hour), it may be useful to think of activities that are part of your daily routine , Such as answering the phone, sending emails, taking a sip of water, dressing and preparing yourself, etc. If you make an effort to think of completely blinking and squeezing a little whenever you do any of these tasks, this will help you to blink the eyes a habit.
      • BLINKING SEQUENCE TO BE FOLLOWED
      • BLINK – PAUSE – PAUSE – OPEN
      • RELAX
      • CLOSE – PAUSE – PAUSE – SQUEEZE – OPEN
      • RELAX
    • When you work on the computer, your eye blink rate per minute drops drastically unconsciously. To compensate for this phenomenon, a free little software is available to remind you regularly of the importance of doing blinking exercises while you are in front of the screen. To download it, visit http://www.eyeleo.com/
  • Massage of eyelids and meibomian glands

    • As we have already said, the malfunctioning of the meibomian glands often leads to evaporative ocular dryness. When suffering from this type of dry eyes, doctors often advise to apply warm compresses on the eyes in order to decongest the meibomian glands. Following the application of these hot compresses, an eyelid massage is often recommended in order to bring out the lipid which has been liquefied by the heat of the compress. But how to do eyelid massage? First of all, know that too much is like not enough … The eyelid massage should not last more than a few seconds and the pressure should be firm but delicate enough not to hurt you. Do not forget that after eyelid massage, it is strongly recommended to clean the eyelids with a specially designed product. In the past, I was already suggested the baby shampoo diluted in hot water. Personally, I have never liked this option and I prefer solutions such as Ocusoft or LidHygenix that I find much less irritating.
    • If you have chronic blepharitis and / or meibomian gland dysfunction that causes you dry eye symptoms, you should ensure that you have excellent eyelid hygiene. The edge of the eyelids may show a slight swelling, redness and crusts. Eyelid hygiene is very important. Apply hot compresses to the closed eyelids for about 10 minutes. The application of heat serves to fluidize the abnormally solid oily secretions contained in the glands. Imagine the butter you put in the refrigerator, it becomes solid. Once put on the pan, it becomes more fluid. It is the same with the meibomian secretions. Once more fluid, they can be better secreted by the meibomian glands. These oily secretions are intended to stabilize the tear film and delay the evaporation of the thin layer of tear film on the surface of your eye.
  • Meibomian gland dysfunction and relation with styes and chalazions

    Inside our eyelids are the meibomius glands responsible for producing the essential oil for a healthy tear film. When one of these glands becomes blocked, it can become infected and swollen which may favor the appearance of a stye or a chalazion.

    Chalazion

    When the secretions produced by a meibomian gland accumulate inside the duct without being able to be evacuated, a blockage of meibomian gland may occur. This is called chalazion. This part of the eyelid will swell and may even become painful. If untreated, the secretions thus trapped in the gland can harden and form a mass in the eyelid. Surgery is then necessary to remove it.

    Eyelid Styes

    The stye may appear as much on the upper eyelid as on the lower eyelid, but it is more common to see it in the upper eyelid. It is a bacterial infection when there are too many staphylococcus on the eyelid. The stye resembles a small nodule.

    Eyelid Disorders

    Eyelid disorders such as chalazion and stye may resemble each other and have common symptoms. If you experience discomfort, bump, swelling, redness or tingling on your eyelids, it would be wise to consult your eye doctor.

    Styes Treatment

    Styes are usually treated by the application of hot compresses several times a day. Often, this is enough to get a complete cure in about 7 to 10 days. However, if the situation does not improve or if the stye reappears, it would be important to consult your optometrist or ophthalmologist. He may prescribe an antibiotic for you.

    Chalazion Treatment

    Unlike styes, chalazions are not an infection. There is therefore no bacterial infestation. It is rather an accumulation of meibomian secretions that block the evacuation canal of the gland. The use of warm compresses for several days can help soften these secretions and thus promote its evacuation. If this does not work after a few days, consult your optometrist or an ophthalmologist who will probably have to remove it surgically.

    Use of hot compresses for the treatment of styes and chalazions

    In our opinion, the use of hot water compresses over the sink is simply not effective enough. The compress cools very quickly and the temperature is not constant. At the Dry Eye Store you will find excellent hot compresses specially designed for this type of use. They are easy to use and the compress remains warm long enough to have a therapeutic effect. It is the same type of compress as those used for meibomian gland dysfunction.

  • BlephEx is a new treatment for Blepharitis.

  • It is a in-office treatment made by your doctor. The doctor thoroughly and precisely eliminates the scurf and bacterial debris, the main causes of inflammatory lid disease.

    What are the common symptoms of blepharitis ?

    Reduce Blepharitis symptoms with BlephEx

    Performed properly, BlephEx will reduce chronic symptoms of blepharitis. Treatment can be repeated at regular intervals depending on the severity of the disease.

    Inflammatory etiology of blepharitis

    By eliminating the inflammatory etiology of blepharitis, the overall health of the eyelid is improved. Patients can then begin to produce more of their own tears and finally enjoy a life free from the chronic and irritating symptoms associated with blepharitis and its subsequent dry eye disease.

    In office doctor procedure for blepharitis

    The results from the BlephEx procedure can be achieved in just a few minutes at the end of a regular exam. The treatment is well tolerated. Most patients only experience a tickling sensation of the lids and lashes. Patients report an almost immediate relief from their symptoms. They notice a improvement of the chronic irritation and eye rubbing that they have endured and lived with for many years.

    BlephEx removes excess bacteria, biofilm and bacterial toxins. The main causes of inflammatory dry eye and lid disease.

    So if you have dry eyes, blepharitis or any of the symptoms mentionned above, it would be a good idea to check with your doctor if you can get BlephEx treatment.

    How Blephex Works ?

    BlephEx is a painless in-office procedure performed by your eyecare professional or trained technician. A revolutionary new patented BlephEx handpiece is used to very precisely and carefully, spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids.

    The patented micro-sponge is disposable and for optimal cleaning and exfoliating, a fresh clean one is used for each individual eyelid. The eyes are rinsed well afterwards.

    The procedure lasts about 6 -8 minutes and is well tolerated. Most patients simply report a tickling sensation. A numbing drop is usually placed in each eye prior to treatment for increased comfort.

    After the procedure, the patient is instructed on how to maintain their clean eyelids with regular nightly lid hygiene. Since home treatments are only semi-effective, the procedure is typically repeated at 4-6 month intervals.

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