Meibomian Gland Dysfunction (MGD) & Blepharitis
Meibomian glands are oil glands which run along your top and bottom eyelids to secrete oil into your tear film. We need oil in our tear film to make it stable, prevent evaporation, protect against bacteria and environmental factors, prevent overflow of tears, create a smooth refractive surface and much more.
When these glands are not functioning as they should, either not producing enough oil or producing poor quality oil, there is a break down of the tear film which can then cause dry, gritty, irritated eyes and blurred vision. If left untreated these glands become clogged up and cause inflammation or infection of the eyelids, increased discomfort and sensitivity, red and crusty eyelid margins and eventually loss of glands.
Meibomian gland dysfunction is not unusual, in fact it is the cause of 86% of chronic eye discomfort with a known cause2. The good news is there are simple and effective treatments to relieve discomfort and improve the quality of your tear film and consequently your vision.
Blepharitis is an inflammation and infection of the eyelid margin/eyelashes caused by various bacteria which often goes hand-in-hand with Meibomian Gland Dysfunction. It causes irritated, red, scratchy eyes with crusty eyelashes and thickening of the eyelids. It may come and go, improving for a period of time and then relapsing. If left untreated it can be associated with chronic dryness and discomfort, lumps within the eyelid, and loss of eyelashes.
For both Meibomian Gland Dysfunction and Blepharitis there are some home-based treatment methods that can help to relieve symptoms in mild cases; warm compresses, eyelid scrubs, dietary intake of omega 3 (fish and flaxseed oil), and Optimel honey eyedrops.
However, in some cases this is not enough to control the ocular discomfort particularly during times of exacerbation. In these cases, in-office treatments are also required such as BlephaSteam and IPL.
Blephasteam is a 2-step therapy involving heat and expression. A pair of heat/moisture goggles are worn for 10 minutes to create optimal conditions to soften the oil within the meibomian glands and allow easy expression. This enables your optometrist to clear a blocked pathway and improve your natural secretion. From the image on the right depicting expression as seen through the optometrist’s microscope it is easy to see the beneficial effects of Blephasteam.
Intense Pulsed Light (IPL)
IPL treatment is used concurrently with lid hygiene and has many benefits for both ocular health and the surrounding skin and blood vessels. It involves brief pulses of light at particular wavelengths which are varied depending on your skin type, medical history and the required treatment so as to preferentially target the desired location.
Abnormal blood vessels, particularly in rosacea patients, are a major source of inflammatory factors. IPL destroys these vessels while also promoting the release of anti-inflammatory agents. Furthermore, it reduces bacterial load by targeting demodex mites present on the eyelids and surrounding skin. The light pulses also create heat within the glands to soften the oil and allow effective expression as with the Blephasteam.
The short duration of each pulse and the pattern of pulse delivery prevents damage to surrounding tissue and creates a very safe yet effective treatment. IPL is delivered from ear to ear under the eyes to target the effected glands and usually takes approximately 4 sessions to achieve symptomatic improvement.
1. www.allaboutvision.com 2. Lumenis 3. blephasteam.co.nz/ 4. www.premiumvisionsc.com