Meibomian Gland Dysfunction

Meibomian gland dysfunction (MGD) is a chronic condition that affects millions of people worldwide. 

Also referred to as posterior blepharitis, it is one of the most common disorders encountered in ophthalmic practice. 

Maintaining proper eyelid hygiene is essential for managing MGD, which can manifest as two types of blepharitis: 

Anterior, affecting the eyelid margin where eyelashes attach, and Posterior, affecting the inner eyelid margin and resulting from clogged meibomian gland ducts. 

Techniques such as MGD manual expression can help alleviate symptoms.

Skin Disorders: Conditions such as acne rosacea and seborrheic dermatitis are highly associated with problems in eyelid hygiene, impacting overall eye health.  

Gland Blockages: Thickened or hardened oils can lead to Meibomian Gland Dysfunction (MGD), physically blocking gland openings, trapping secretions, and encouraging bacterial overgrowth.  

Hormonal Changes: Fluctuations during adolescence, menopause, or use of oral medications can modify the quantity and quality of eyelid oils, exacerbating issues related to MGD.  

Environmental Factors: Prolonged screen time or wearing contact lenses reduces blink rates, resulting in incomplete gland expression and pooling of oils, further contributing to Meibomian Gland Dysfunction.  

Ageing: As we age, natural changes in the body can cause glands to atrophy or malfunction, making eyelid hygiene even more essential to maintain eye health.

Warm Compresses: Apply a warm, moist washcloth or a dedicated, microwaveable eye mask over closed eyes for 5 to 10 minutes. This helps soften the hardened oils that can block the glands, particularly in cases of Meibomian Gland Dysfunction (MGD).  

Eyelid Massage: Immediately after the compress, gently massage the eyelids to promote better eyelid hygiene. Use your finger to roll gently downwards on the upper eyelid and upwards on the lower eyelid, focusing on the edges near the lashes, which is essential for effective MGD manual expression.  

Lid Scrubbing: Clean the lid margins to remove loosened oils and debris. Use a cotton swab dipped in a highly diluted solution of baby shampoo or a specialized over-the-counter lid wipe to maintain optimal eyelid hygiene.

Pre-heating: The lids and lashes will be cleaned with medical eyelid wipes to promote eyelid hygiene. 

The clinician will then warm the eyelids using a heated eye mask for 15 minutes. Proxymetacaine drops will be administered to temporarily numb the eyes' surface. 

Expression: A specialized tool is then used in the MGD Manual Expression process to press along the upper and lower eyelid margins, safely squeezing out the waxy secretion from the glands, which can be a contributing factor in Meibomian Gland Dysfunction. 

Afterwards, you may be given eye drops or ointment to take home with you, and you will be instructed on how to take it.

You may return to your usual activities straight away after the procedure. 

Typically, you can resume using makeup the day after; it's recommended to use clean and new makeup if possible to maintain proper eyelid hygiene. 

Follow-up appointments are usually arranged for 4 to 6 months to assess the effectiveness of the procedure and discuss eyelid hygiene management, particularly in relation to Meibomian Gland Dysfunction and MGD Manual Expression.