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Dry Eyes - Meibomian Gland Dysfunction

First of all, the most common symptoms of dry eye syndrome are:
  • Dryness
  • An itchy sensation
  • A gritty or sandy sensation
  • Sensitivity to light
  • Excessive tearing
  • Blurry vision or difficulty seeing at night
  • A stinging, burning sensation
  • Red and irritated eyes
  • Eyelashes or lids with crusts, flakes, excess oil or dandruff
If you have any of these symptoms then you are most likely suffering from dry eyes.  There are three cases of dry eyes: blepharitis, meibomian gland dysfunction and tear film problems.  Here we focus on MGD:

Meibomian Gland Dysfunction, or MGD, is characterised by blockage of the oil glands in the eyelids as well as redness of the lining of the eyelids.  Each eye has approximately 50 glands on the upper eyelids and 25 glands on the lower eyelids.  Normally, the glands produce the outer, oily, tear film layer but in cases of MGD the glands, if pressed, will produce a cloudy, granular or toothpaste-like secretion.

How To Treat Dry Eyes
  1. Start drinking plenty of water.
  2. Start taking Omega-3 supplements – Omega-3′s have proven to be beneficial for reducing inflammation and improving tear secretion.
  3. Improve your diet – even if you are taking Omega-3′s it’s a good idea to ensure that you have a good and varied diet. Make sure that you eat fat fish such as salmon. Leafy green vegetables are also good.
  4. Start exercising – Everything that improves your blood circulation will be good for you.
  5. Improve your ocular environment – avoid direct air currents (from fans and air conditioning), use humidifiers when indoors, use sunglasses when outdoors etc. If there isn’t any sun consider using clear lens glasses to shield the eyes from wind and dust.
  6. Start taking eye drops – you will probably have to use eye drops to some extent. Artificial tears and lubricants come in the form of drops, gels, ointments etc and help provide moisture and lubrication to the surface of the eye. There is no universal tear replacement that will work for everybody. Find out what type of dry eye that you have and start using the eye drops for that particular condition. Then determine, by trial and error, what exact brand of artificial tear that provides the most relief.
  7. Contact lenses – do you wear contact lenses? In my personal opinion, stop it.
  8. Avoid LASIK – a natural step for people who stop using contact lenses is to have LASIK.  A LASIK procedure is probably one of the worst things that you can have if you’ve had dry eye symptoms previously.  Even if you don’t have any issues with dry eye, LASIK will in many cases lead to you developing it.

How To Treat Meibomian Gland Dysfunction By Yourself

To treat Meibomian Gland Dysfunction successfully one needs to use multiple methods of treatment. Perhaps it is one of the conditions that requires the most diligent and consistent treatment schedules. Some of these treatments have a lot in common with traditional blepharitis treatment.
During the acute phase stronger measures may have to be taken to get the inflammation, constipation and irritation under control. Once this has been accomplished the frequency of the treatments can be reduced. In most cases of Memboitis one needs to stick to a daily schedule though.

1. Do regular warm eyelid compresses
Since one of the core problems with MGD are constipated glands on the rim of the eyelids you will needs to heat these glands so that the oil can get back to a more natural flow. You do this by applying hot eyelid compresses. This is done several times a day in the acute phase and reduced to a couple of times per day once the situation has stabilized.  Using a warm wash cloth as compress is recommended as it also provides moisture.

2. Do regular eyelid massage
After you have applied the hot compress you will need to perform an eyelid massage. This is done to express any blockage from the glands and also get them to work more naturally.

3. Do regular eyelid scrubs
It is very important that you keep a good eyelid hygiene. Eyelid scrubs are most effective if done after the hot compress and eyelid massage.  A general guideline is to use commercially prepared, or home made lid scrubs and cleansing agents two times a day, in the morning and in the evening. Apply the cleansing agent, by either massaging it with the tip of your fingers or by using a cotton swab moistened with the cleansing agent.

5. Artificial Tears
As with any case of dry eye you will most likely need to use artificial tears.

6. Vitamins & Supplements
You may require adding supplements to your treatment. A very common supplement for dry eye patients is Omega-3 fish oil or flaxseed oils.

7. Reducing Inflammation
Meibomian Gland Dysfunction is an inflammatory disease so suppressing the inflammation is something that you will want to focus on. This can be done by antibiotics but before taking medication you should try changing your diet first. There are foods that will improve the body’s natural ability to fight inflammation and there are also foods that will increase the risks of inflammation.

How To Perform An Eyelid Massage

1. Wash your hands properly so that there are no bacteria or dirt on your fingers. It is very important to keep a good hand hygiene when performing the massage.

2. Start with the upper eyelids. Close your eyes and shift your gaze downwords.

3. Start with applying a light pressure with your index finger at the rim of the eyelids, starting either from the nose area or the outer part of your eyelid.

4. You should only apply a light pressure so that you don’t hurt your eyes by mistake. Avoid getting your nails onto the eyes. In some cases it can be worth trying to use your ring finger rather than your index fingers as you most likely will feel that it’s easier to use a gentle touch that way.

5. Keep your finger for 2-10 seconds on one single spot, then move your finger to a new spot for another 2-10 seconds. Continue doing this until you’ve covered the entire upper lids on both eyes. You should really only need to switch your spot 5-7 times per lid.

6. Next, move on to the lower eyelids repeating the entire process.

When you have completed this procedure you will most likely feel that the eyes are “wet” and your vision may even become “grainy”. This is due to oil being released from the glands. If this happens, it’s really good news.  Make sure that you perform these massages regularly.

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