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Meibomian gland dysfunction (MGD) is a common eye condition that occurs when the Meibomian glands in the eyelids do not function properly. These glands produce an oily substance called meibum, which helps to lubricate the eyes and prevent tears from evaporating too quickly. When the glands become blocked or do not produce enough meibum, it can lead to symptoms such as dryness, redness, itching, and blurry vision.
It used to be that imaging of these Meibomian glands would reveal short, missing, or clogged glands for many patients in their 70s and 80s. More recently, we are seeing this more and more frequently in patients in their 20s and 30s. But how is this possible when younger people have more robust, resilient anatomy? From my experience, the disparity stems from big differences in lifestyle—namely, hours spent staring at device screens.
The earlier onset of Meibomian gland dysfunction (MGD) has been a major topic of discussion among dry eye specialists, particularly the last 5 years. In a recent study, 42% of kids aged 4 to 17 years showed some evidence of Meibomian gland atrophy. We do not have direct evidence that screen time is the culprit, but because many children spend long hours using screens, blinking less frequently and completely, we think screen time may contribute to the problem. Ten years later, that teenager is coming in with the complaints, presentations, and challenges of dry eyes. Many of them have already spent a decade in contact lenses, and now they cannot wear them anymore. Others have had refractive surgery, which disrupts the corneal nerves. Many of them want to know if something can be done about their eyelid redness and tired appearance.
Unfortunately, we can’t cure dry eyes, but we do have good therapies that can help to keep these Meibomian glands healthy and keep our eyes comfortable. If we work hard in the first year, we can make a huge impact on how our eyes look and feel, as well as keep the ability to wear contact lenses and enjoy our favorite activities.
Because young patients will rely on their Meibomian glands for perhaps another 70 years, we need to treat aggressively and do all we can to preserve the anatomy and restore function.
We have in-office therapies such as the TempSure radiofrequency treatment which heats the blocked up oil glands to allows the oil to flow more freely. It also stimulates collagen production to help with gland function and health.
At-home care such as omega -3 supplements, immunomodulator drops, hot compresses, lid hygiene, and good artificial tears are supportive treatments, but patients can do less treatment at home when they have effective in-office treatment. By matching the right treatments to the right patients, we can avoid gland loss and achieve a more stable tear film that functions properly.
Gupta, P. K., Stevens, M. N., Kashyap, N., & Priestley, Y. (2018). Prevalence of Meibomian gland atrophy in a pediatric population. Cornea, 37(4