How Meibomian Gland Dysfunction is Treated

In meibomian gland dysfunction, there either isn't enough oil produced by the tiny meibomian glands located on the edges of the eyelid or it isn't of good enough quality. The result is dry eyes and inflamed eyelids. This can also produce blurry vision that comes and goes.

Treatments may initially involve common home remedies, including warm compresses and massage. Prescription drops may be needed by some. In other cases, in-office procedures to help treat your meibomian glands may be recommended.

Every case is unique and may require the use of one or more treatments. Here are some of the options to keep in mind as you navigate treatment for meibomian gland dysfunction.

Home Remedies and Lifestyle

Since meibomian gland dysfunction can cause the buildup of oil, bacteria, and dead skin, part of the treatment approach is in clearing this debris away so oil can flow from the glands to the eye. This may involve a regimen performed twice a day when symptoms are active or just once for prevention. It can include:

• Applying warm compresses: Run a washcloth under warm water, wring it out, and then apply it to your lids for at least four minutes at a time. The idea is to soften any area debris and heat the meibomian gland oil to allow it to flow more freely.
• Massaging the area: While using the warm compresses, you may also be asked to gently massage the area just above the lashes. While looking up, try rolling your finger upward on the lower lid and do the same thing in the opposite direction while looking down.
• Use of lid scrubs: Gently use a washcloth, cotton ball, Q-tip cotton swab, or even your fingers to scrub along the lash line with diluted baby shampoo or a cleanser for sensitive skin once a day. This can help remove any debris in the area.

Over-the-Counter Therapies

Another possibility is trying an over-the-counter (OTC) approach. The meibomian glands normally produce oil (lipids) that is used in the tear film that keeps the surface of the eye moist and healthy. Without enough oil, the eyelids can become inflamed and you can experience dry eye symptoms.

You may try soothing your eyes with lipid-containing emulsion drops from your drugstore. These drops have oil (lipids) suspended in water and are considered an optional treatment for meibomian gland dysfunction. These drops may be beneficial to the quality and stability of the tear film, potentially relieving dry eye symptoms.

Also, the use of omega-3 essential fatty acid oral supplements may work to reduce inflammation in meibomian gland dysfunction and improve the quality of the oil the glands produce. Omega-3 fatty acids are found in fish oil and flaxseed.

Prescriptions

Your practitioner may also prescribe drops for meibomian gland dysfunction if your symptoms call for them. Some prescriptions you may be given include the following:

• Steroid drops: These help to tamp down inflammation of the eyelid and increase the flow of oil to the eyes. They may be prescribed together with drops to reduce dryness.
• Restasis eye drops: These drops increase tear production.
• Oral Vibramycin (doxycycline): This is a longtime treatment for meibomian gland dysfunction.
• AzaSite (topical ophthalmic azithromycin): This is a broad-spectrum antibiotic that kills bacteria. What role bacteria have in meibomian gland dysfunction is unclear, but this antibiotic seems to help clear them.

Surgeries and Specialist-Driven Procedures

There are also a variety of approaches to physically alleviate symptoms of meibomian gland dysfunction. Some approaches that your practitioner may recommend for you include:

• Intraductal probing of the meibomian gland: With this approach, performed under topical anesthesia at the slit lamp (a microscope with a bright light), the meibomian gland is mechanically opened with a 2 millimeter probe. The idea is to remove any abnormal meibomian gland secretions. Patients can expect to have relief for at least one month.
• Debridement of your lids: Using a handheld device, your eye practitioner may unclog your meibomian glands by cleaning away debris from the eyelid margins.
• BlephEx: In this approach, which is performed in a doctor's office, your eye care professional exfoliates the margins of the eyelids using a handheld device. The aim is to open the meibomian glands by reducing bacterial debris and decreasing inflammation.
• LipiFlow: Your practitioner uses this device to deliver both heat and gentle-pressure lid massage to improve oil quality and open the meibomian glands. The warming portion of the device resembles a large lens that covers even the whites of the eyes. Also, an eyecup with an inflatable air bladder massages both the upper and lower lids in a 12-minute treatment.
• iLux: With this handheld heating device, your practitioner can warm the inner and outer portions of your lids. The idea is to improve oil flow by melting any waxy secretions with the device.
• TearCare: This handheld device heats both the inner and outer lid surfaces. Your practitioner uses it to melt meibomian gland secretions. This improves oil flow by alleviating waxy secretion buildup, which is melted away.
• Blephasteam: This device consists of eyelid-warming goggles that resemble swim goggles. Its electronic controls maintain a constant temperature during the procedure, which may unblock the meibomian glands.
• Intense pulsed light therapy: This device produces specific light wavelengths that are absorbed by pigments in the small blood vessels. The device is passed over the eyelid margin under the eye, with shields to protect the eye itself. It aims to reduce the bacterial load and eyelid inflammation in meibomian gland disease.

Complementary and Alternative Medicine

In addition to traditional Western approaches, alternative strategies have been reported to help alleviate symptoms for some patients with meibomian gland dysfunction. These include acupuncture, in which extremely thin needles are placed in specific places, and moxibustion, which involves burning herbs.

Summary

Treatment for meibomian gland dysfunction ranges from home remedies and self-care to OTC drops and supplements, prescription medications, and procedures your eye-care professional can perform.

A Word From Verywell

Meibomian gland dysfunction leads to discomfort and blurry vision, which can reduce your quality of life and make tasks requiring sharp vision difficult. With many different options for treating the condition, you can work with your eye care professional to find the right ones for you. If one approach is not successful, you can switch to another to get your meibomian gland dysfunction effectively under control.