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Meibomian gland dysfunction and dry eyes

28 March 2023

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

World Glaucoma week

13 March 2023

Glaucoma Awareness Week is a yearly event tat is happening from March 12th to 18th this year to raise awareness about glaucoma and encourage people to get regular eye exams. 

Glaucoma is a leading cause of blindness worldwide, but early detection and treatment can help prevent vision loss. By raising awareness about glaucoma and encouraging people to get regular eye exams, we can help reduce the impact of this disease on individuals and society as a whole.

 So what exactly is glaucoma you ask? Glaucoma is an eye disease that can damage the optic nerve and cause vision loss or blindness if left untreated. The optic nerve is responsible for carrying visual information from the eye to the brain, and damage to this nerve can result in irreversible vision loss.

The most common type of glaucoma is called primary open-angle glaucoma, which occurs when the fluid inside the eye (aqueous humor) doesn't drain properly, causing a gradual increase in pressure within the eye. This pressure can damage the optic nerve over time and lead to vision loss.

Other types of glaucoma include angle-closure glaucoma, which occurs when the iris is too close to the drainage angle in the eye, and normal-tension glaucoma, which occurs when the optic nerve is damaged even though the pressure inside the eye is normal.

Glaucoma usually has no symptoms until it has progressed significantly, which is why regular eye exams are important for early detection and treatment. Treatment may include medications, laser therapy, or surgery to lower the pressure inside the eye and prevent further damage to the optic nerve.