Meibomian Gland Dysfunction and Blepharitis

 

What are Meibomian Glands?

These are oil glands within the eyelid that drain near the eyelashes. When we blink, the force of the blink causes oil to be released onto the eyelid and into the tear.  The oil secretion is an essential part of healthy tear film, ensuring our tears do not evaporate.

 

What is Meibomian Gland Dysfunction and Blepharitis?

It is one of the most common forms of eyelid margin disease. When the glands are dysfunctional, they become clogged and no longer secrete oil, or secrete unhealthy oil, which results in changes to the tear film, tearing and/or dry eyes. Symptoms include dryness, burning, itching, foreign body sensation, tearing, light sensitivity, red eyes, fluctuating blurry vision and, in severe cases, chalazions/styes.

 

Mild Blepharitis Treatment Protocol

 

  1. Hot compress – at least 5min twice a day (in the morning and in the evening)
    Used to open the glands, melt the oil secretion and loosen the solidified oil. Use a warm eye mask/heating pad or warm washcloth that has been soaked in hot/warm water.  Place warm eye mask over your closed eyelid for 5 minutes or more.  The temperature should be as hot as you can tolerate but do not burn yourself.
     

  2. Massage your eyelid – twice a day (after the application of the warm compress)
    Done to encourage drainage of oil secretion
    Using your clean finger rub your upper eyelid in the downward direction and your lower eyelid in an upward direction. Repeating this action several times.

     

  3. Lid cleaning (using baby shampoo or eyelid cleansers/wipes) – twice a day (after the application of the warm compress/massage in the morning and evening)
    Used to remove debris, bacteria, and oil on the lid margin.
    Using eyelid cleanser/wipes or baby shampoo on a cotton pad, clean the lids with your eyes closed using lateral side to side strokes.  Rinse as necessary

     

  4. Lubricating eye drops (artificial tears) – 1 drop 3 times a day or as needed
    Used to help alleviate eye discomfort, and help the tear film recover.
     

  5. Omega-3 fatty acid supplements – use according to the manufacturer’s direction
    Used to help decrease inflammation and improve tear production.

 

Moderate-Severe Blepharitis Treatment Regimen

 

  1. Follow all the above steps for Mild Blepharitis
    (Steps 1-5 above)
     

  2. Antibiotic or combined antibiotic/steroid ointment – prescription medication use as per instructions
    Antibiotic ointment used to stop the growth of bacteria, steroid to reduce inflammation.
    Use this prescription ointment after step 3 above as instructed. Gently apply the ointment to the lid margin (just above and along the eye lashes) using either your clean fingers or a cotton tip applicator. Be sure to apply this to both the upper and lower lid.

     

  3. Oral Doxycycline – prescription medication use as per instructions
    Very low dose systemic antibiotic used to reduce inflammation.
    Use this prescription for several months as instructed. Please note that doxycycline may increase your skin’s sensitivity to the sun. Also, it should not be taken within an hour of eating dairy. This medication is contraindicated in pregnancy, while breast feeding and in children.