MGD (Dry Eye) Treatment Guide - How to Treat Meibomian Gland Dysfunction

Meibomian glands are large oil-producing glands present in the eyelids. Healthy glands are necessary to maintain stable, adequate ocular surface lubrication. In meibomian gland dysfunction (MGD), these glands become clogged or inflamed leading to a reduction in the amount of oil (meibum) in the tear film. The meibum component of tears is crucial in protecting and stabilizing the tears on the surface of your eye. MGD is a chronic condition with no cure, but there are many at-home measures which can be taken in order to reduce symptoms and stay comfortable. 

What can I do at home to treat MGD?

1. Warm compresses: Applying heat over closed eyes in the form of a soft eye mask or eyelid compress directly targets the meibomian glands. This will soften any hardened meibum and make it easier for it to flow out of the glands and help the glands open up (3). After your compress, a gentle massage on your eyelids can also help to facilitate this same process. Ask your optometrist for more specific instructions on how often and for how long to do warm compresses. The Blinkjoy rechargeable heat mask provides controlled heat and adjustable eyepieces creating the perfect environment to not only treat MGD, but also to soothe away tension and stress for a relaxing nighttime routine.
   
   

2. Maintenance of eyelid hygiene: Keeping the eyelid area clean and free of debris and bacteria helps to prevent the meibomian glands from becoming clogged or blocked (3). There are many available products and methods for lid hygiene. A gentle eyelid cleanser like Blinkjoy's lid & lash cleanser or medical grade eyelid wipes work well.  
   
   

3. Diet/supplements: Many studies have shown a significant improvement in meibomian gland function as well as consistency of meibum with moderate intake of omega-3. Good sources of omega-3 in your diet are fatty fish and flaxseed, but diet-only intake may not be sufficient for treatment of MGD. For omega-3 supplementation, a specific form of omega-3 is recommended: this is called re-esterified triglyceride form so make sure that this is what you are getting when purchasing any supplements for proper absorption and maximum possible therapeutic effect. The improvement in gland function is generally seen after a few months of consistent intake (1).
   
   

4. Water intake: Currently, there are conflicting studies on water intake. High water intake was not associated with decreased risk or clinical signs of dry eye disease, however, it was associated with decreased symptoms of dry eyes (2), so making sure you stay hydrated is still important.
   
   

5. Humidifiers: Adding hydration to your surroundings as well as avoiding hot, dry environments can be an important lifestyle modification for dry eye disease in general (3).
   
   

6. Screen use: Limiting screen time as you are able and taking frequent breaks from digital devices can help reduce symptoms of MGD (4). It is recommended to “look 20 feet away for 20 seconds every 20 minutes” or, the 20-20-20 rule, to reduce dryness while using devices.
   
   

7. Artificial Tears: Most mild to moderate dry eye will respond to artificial tear therapy (5). Ask your optometrist about what type of drops to use and how often in order to get the most benefit.
   
   

8. See your optometrist regularly: The best recommendation for management of MGD will come from regular monitoring by your eye care professional, especially as your condition changes over time. Depending on each case, at-home management simply may not be enough for certain patients - very severe or advanced MGD may require more intensive professional treatments like in-office IPL or iLux, or even medications. It is important to make sure you see your optometrist if your symptoms are not improving with your current management. 

Conclusion

There are lots of strategies available to help manage MGD. Some take a little more time than others for their effect to “kick in.” If this list of home-based treatment options is not helping to reduce your symptoms, it is likely best to consult with your eye doctor. 

References:

1. Al-Namaeh, Mashael. "A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction." Therapeutic advances in ophthalmology 12 (2020): 2515841420952188. https://journals.sagepub.com/doi/full/10.1177/2515841420952188 

2. Chiang, Jeremy Chung Bo, and James S. Wolffsohn. "Perspectives of dry eye patients in the United Kingdom on risk factors and desired treatment outcomes." Contact Lens and Anterior Eye (2024): 102340. https://www.sciencedirect.com/science/article/pii/S1367048424002339

3. Narang, Purvasha, et al. "Evaporative dry eye disease due to meibomian gland dysfunction: Preferred practice pattern guidelines for diagnosis and treatment." Indian Journal of Ophthalmology 71.4 (2023): 1348-1356.  https://journals.lww.com/ijo/fulltext/2023/04000/Evaporative_dry_eye_disease_due_to_meibomian_gland.38.aspx

4. Al-Mohtaseb, Zaina, et al. "The relationship between dry eye disease and digital screen use." Clinical Ophthalmology(2021): 3811-3820. https://www.tandfonline.com/doi/full/10.2147/OPTH.S321591#abstract 

5. Semp, David A., et al. "Artificial tears: a systematic review." Clinical Optometry (2023): 9-27. https://www.tandfonline.com/doi/full/10.2147/OPTH.S35833

Contributors:

Sarah Farrag, OD

Dr. Sarah Farrag is originally from Halifax, Nova Scotia, and is happy to be practicing optometry in her hometown. She graduated with honors from the University of Waterloo Doctor of Optometry program in June 2015. In addition to routine optometric care, Dr. Farrag also facilitates an advanced dry eye clinic offering specialty consultation and treatment for severe chronic dry eye.