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Meibomian Glands

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DP Eyecare Column: Meibomian Glands?

Q: I have used artificial tears for years to keep my eyes comfortable, but I read something about treatment to help your eyes make their own natural tears again. Does this really work?

A: Yes! In fact, some studies indicate that habitual use of “artificial tears” may actually worsen your underlying dry eye disease over time. It is not surprising that our natural tears are the very best kind. You may want to understand that your tears have three layers: a mucin layer against your eye surface, a watery layer, then a lipid layer on the outside.

This outermost layer of lipids or oils is critical to prevent evaporation. Especially these days, as we all spend hours every day staring at digital screens. And I do mean “staring”, in that normally we blink our eyes about every 5 seconds but when using a screen, that blink rate slows to about every 20 seconds! This is also why we are seeing so many younger patients now with dry eye symptoms when this used to be mostly an “ over 50 ” type of complaint.

There are a few lipid-type dry eye drops available, but most are not. And still, the type our own eyes produce is the healthiest. Along the edge of our eyelids….right inside our eyelashes….are tiny lipid-producing oil glands called “ Meibomian glands”. We generally have about 40 per eyelid, and normally the mere muscle contraction of a blink should squeeze out a tiny bit of the precious lipid oil. Really a marvelous engineering design! Unfortunately, for many people low-grade inflammation causes our Meibomian glands to produce a secretion that is too thick ( think toothpaste ) and the blink cannot squeeze out the secretion. The result? Our tear film is deficient in lipids, and so evaporation is much too quick. Dry areas form on our eye surface that makes our vision less sharp, and sometimes the next blink actually hurts a little ( rubbing over those dry spots ) and triggers excessive “reflex tears”. This is why it sounds so odd to say that watering can be a symptom of dry eyes!

Finally the good news: We now can safely heat those clogged oil glands in the office to melt the waxy secretions and express the bad stuff out. This leaves your Meibomian glands open and ready to resume normal lipid secretion. Eyelid heat treatments are not permanent, but most patients seem to maintain good comfort and vision for about half a year. So, like you should have your teeth cleaned every 6 months, likewise your eyelid oil glands need care twice a year also. Patients are generally very excited about how good their eyes feel again, and having a more crisp vision for our digital world is a real benefit!

Call Morgantown Eye Associates on 304-381-5353 to schedule an eye exam with our Morgantown optometrist.

Alternatively book an appointment online here CLICK FOR AN APPOINTMENT


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How To Prevent “Mask Fog” on Your Glasses

How Pregnancy Affects Vision

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