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Meibomian gland dysfunction (MGD) is the most common cause of dry eye syndrome. Upwards of 75% of dry eye patients have MGD, which causes dry eye due to increased evaporation of the tears or decreased tear production. MGD is also known as meibomitis or meibomianitis (inflammation of the meibomian glands).

Symptoms of MGD are exactly the same as dry eye symptoms, including crustiness, redness, blurry vision, itching and tearing.

The meibomian glands are located in your eyelids. There are 30 to 40 glands in your upper lids and slightly fewer in your lower lids. The glands secrete an oily substance through openings located on the edge of your eyelids adjacent to your eyelashes.

The oil is called meibom and is an oily mixture that forms the top layer of the tear film. The oil, also called “lipid,” prevents the watery tears from rapid evaporation.

There are 3 layers to a normal tear film:

  1. Oily or lipid layer (superficial top layer of tears)
  2. Aqueous (the actual fluid of tears)
  3. Mucin (allows tears to spread evenly across the eye)

What is Meibomian Gland Dysfunction?

MGD occurs when the glands are unable to normally secrete their oils into the tear mixture. Blockage of the glands prevents the oils from being secreted. Meibomian gland dysfunction can also occur when the oily meibom becomes too thick and cannot be expressed normally. Insufficient meibom or poor quality meibom can also result in rapid tear evaporation.

How we Diagnose Meibomian Gland Dysfunction

A complete medical history and evaluation of your symptoms will help us make the diagnosis of meibomian gland dysfunction. During your examination, we will look for characteristic changes in your eyelids typical of MGD. Manually expressing the oils of the glands will also provide helpful clues, especially if the meibom is too thick and difficult to express.

Diagnosis and treatment of dry eye syndrome due to MGD is important:

  • Before cataract surgery to allow accurate measurements for IOL calculations
  • For contact lens patients where MGD can develop
  • For patients with recurrent styes, rosacea and blepharitis