so one of the major causes of dry eye syndrome and dry eye symptoms it has to do with the thickening
and blockage of oil glands within the eyelids which we call meibomian gland dysfunction or
mgd for short this is where the normally smooth and liquid oils within the meibomian glands
stop producing properly and instead form a waxy
harder substance which can go rancid leading to inflammation of the eyelid
and increased tear film evaporation and this has been found to affect over 80 percent of everybody
with dry eye syndrome which is exactly why meibomian gland dysfunction treatment is such
a major focus for so many dry eye specialists but what are the most current and effective treatments
for mgd whether you are looking for advanced treatments through your eye care provider or
looking for at home therapies that's what we're covering today so let's take a look
this video is brought to you by the makers of tier restore the dry eye warm compress uniquely
designed to permit the use of your eyesight throughout the eyelid treatment which makes it
easy for me to complete my morning warm compress routine while staying productive thank you to
tear restore for helping us keep making dry eye education possible hello and welcome this is dr
allen here from the dr eye health show helping you learn all about the eyes vision and finding the
best vision products if you are new here to the channel and you suffer from dry eyes then consider
hitting the subscribe button down below so that you don't miss any of our future content on dry
eye syndrome also this video is part of a full dry eye series where we go over different types
of dry eye syndrome so you can figure out what you have as well as the different treatment options
available whether it be something done at home or if it's through your eye care provider if you want
to check out videos in that full series i'll put that link in the description below so you can find
it easily now it comes to treatment for meibomian gland dysfunction the first one that i like to
discuss is that of doing eyelid warm compresses now on this channel we've talked about eyelid
warm compresses many times before but i think it deserves mentioning again because so many of our
patients as an eye doctor a lot of people will tell them to do this and then they just fail to
really do it or incorporate it into their normal daily routine unfortunately with meibomian gland
dysfunction this is typically a chronic condition and is something that you need to keep doing and
managing over time but the whole point of doing an eyelid worm compress is to supply heat to the
meibomian glands any solidified now waxy oils can then be melted down into a liquid and then
that liquid can hopefully be expressed from these oil glands and then your eyelid is able to reduce
the inflammatory load because it doesn't have that rancid oil still stuck in the glands and that will
hopefully allow your body to make new oils so that your tears don't evaporate as quickly it also acts
as a protective function because if the oils have remained wax in those glands for too long
the gland can eventually atrophy and die off and unfortunately if that happens there really isn't
any way that we know at the time in this video to get them to grow back now there are many different
types of worm compresses on the market that you can choose from there are ones that you activate
through a sodium acetate chemical reaction such as the tier restore there's ones that you put in the
microwave and there's ones that you plug in into a computer or into through a usb into a wall socket
and then electronically heat up the oil glands with whichever method that you choose or that your
doctor recommends the important thing is that you do them on a regular basis at least once or twice
a day for at least 10 to 20 minutes at a time clinical studies and from clinical experience
that is the appropriate amount to be using to get a clinical benefit where we start to see improved
function of the oil glands after completing warm compresses many eye doctors will recommend doing
some form of eyelid massage when i was just in school maybe five six years ago then at that
time my professors would just recommend doing a little gentle digital massage with your finger
the downside of doing that is if you push too hard you could be putting unnecessary pressure on the
globe of the eye and that could increase risk for things like glaucoma if you're someone who's at
risk for it that is why now there's a lot of new devices that are coming out including one that
i featured previously on this channel called the new lids device which creates kind of a mechanical
activating motion that agitates the oil glands and allows them to encourage that oil gland those oils
to open up and release there's also other devices and warm compresses coming out that use vibration
to try and achieve the same effect now if you're somebody with a more severe form of meibomian
gland dysfunction the oil glands can become capped off in the form of eyelid scaling this
is where the eyelids themselves start to have the appearance of chapped lips in the winter
where there's dead epithelial skin cells that are not covering the oil glands and prevent the
glands from even releasing their contents in that situation your doctor may recommend doing
an eyelid debridement with a small tool in the clinic and then they could even recommend doing
meibomian gland probing where a small almost needle-like tool is used to puncture the oil
glands to allow them to open up then your doctor may even do manual meibomian gland expression this
is using a small forceps in the clinic to pinch the individual glands to really express all of
its contents i do encourage you do not attempt to do this at home it is something that must be
done by an eye care professional now let's shift over and talk about some advanced technologies for
meibomian gland dysfunction treatment that may be available for you at your local eye care provider
or eye clinic the first one i like to talk about and probably because it's been out the longest
is that of lipiflow now lipiflow is a mechanical device that either your eye doctor or a technician
can apply to your eyelids and then what it does is apply heat to both sides of the eyelid so it's
not just like doing a warm compress where you're trying to get heat through the skin it applies
heat to both sides of the eyelid at the same time and then it has a pumping action that encourages
those glands to continually express any of those oils out of the glands and since lipiflow has been
out for quite some time there are a lot of studies that do show good clinical support for benefits
of getting the lipiflow done it even shows some clinical benefit lasting up to three years after
a single treatment however i do also want to mention that a lot of people will have severe
forms of meibomian gland dysfunction and may need multiple treatments with something like lipiflow
to have really the desired effect now very similar to the lipiflow is a device called the ilux
the ilux again applies heat to the eyelids but it does this through supplying infrared and a
lime light to this top surface of the eyelid but it makes sure that it applies heat throughout the
entire lid because it also has a sensor reading that goes underneath the eyelid so it can tell
that it's fully heated up the lids but then the device also has a mechanical pumping action
which again helps express the oils from the eyelid now as far as the difference between lipiflow and
ilux the lip flow is something where your doctor can set it up and then they can just hit the start
button and it'll run on its own ilux is something that has to be done mechanically and manually so
your eye doctor or your doctor's assistant will have to perform that procedure on your eyelid
and as far as the ultimate clinical result between those two at least one study has shown them to be
equally equivalent at treating meibomian gland dysfunction one additional technology i want to
mention is that of tearcare some eye clinics will offer tear care as a way to add additional heat to
those eyelids within the clinic but this device does not have the mechanical pumping action so
instead your doctor may offer a meibomian gland expression done in the clinic again using some
sort of mechanical forceps now just to speak on my personal experience i've had both the lipiflow and
the ilux done i find them to be very comfortable and have good results as far as having a something
like tear care or manual expression i've never really had that done but i've done it for patients
and they seem to respond well to it as well the one other cool technology that many eye clinics
are now starting to offer is something that is technically not fda approved for the treatment
of dry eye or meibomian gland dysfunction at this current time i say that because i believe they are
applying for fda approval at this current moment and it's something that we'll talk
about in a future video hopefully when that comes out otherwise this is something called ipl intense
pulsed light this originally was developed for dermatologists to treat things like ocular
rosacea and just rosacea of the skin in general but they have since found that it has this kind
of this side effect extra benefit of reducing the inflammatory load on the eyelids and heating up
these oil glands and helping remove telangiectasia which is the growth of abnormal blood vessels
on the eyelids too now the treatment with ipl is a little bit more involved they do have to have
a handheld device put onto the lids and it requires several treatments at least usually four
treatments to have a benefit but i would not be surprised if you go to see a dry eye specialist in
your area and they discuss with you the advantages of something such as the ipl treatment but be sure
to stay tuned to the channel because hopefully we'll have some cool videos coming out soon
on the ipl so now that we've discussed some new technologies in the eye clinics that are available
for helping meibomian gland dysfunction now let's move over and talk about some of the different eye
drops medications that are available as well as oral medications or supplements that your dog eye
doctor could recommend for you now two medications that are available in the form of an eye drop for
treating meibomian gland dysfunction one of those is something called cyclosporine a that's the
generic name otherwise they're brand names such as Restasis or a new form called Cequa are available
these are eye drops used twice a day and have long since been used mainly for different forms
of dry eye disease but there are studies that do show that there is some clinical benefit for
meibomian gland dysfunction through using these eye drops some of the biggest downsides for using
a medication such as Restasis or Cequa is often time the cost the prices for these medications
can get quite costly and they often take several months to start seeing a clinical benefit however
with that being said i have many patients who are on or using these medications and they have
excellent responses so again something to talk with your iq provider about another topical eye
drop that can be used to help with meibomian gland dysfunction is that of topical Azasite now topical
Azasite is often used as an antibiotic usually prescribed for just a seven day course however
eye doctors have been shown in studies that if you're using it for a longer treatment period
they can have benefits for the meibomian glands in the eyelid however oftentimes just like topical
cyclosporine these medications can sometimes be rather expensive so it's important to again talk
with your eye care provider and work with your insurance to see what's going to be best for you
now is very similar functioning to Azasite that this medication helps
reduce inflammation in these oil glands there's also the use of taking oral doxycycline now oral
doxycycline is again an antibiotic that's often prescribed for many different forms of infection
however usually at a lower clinical dose that doesn't necessarily have the same side effects
as a full antibiotic dose of doxycycline has also been shown to change the function of these
oil glands in your skin and consequently can help improve things like rosacea as well as these oil
glands functioning of the meibomian glands but in comparison to the topical azosite, doxycycline has
been out for a long time and so usually it's much more affordable the biggest downside is that oral
doxycycline may have more side effects than using something like the topical azasite now another
possible treatment for meibomian gland dysfunction is that i'm taking supplements for omega 3s now
omega-3 fatty acids has been an interest of study in medicine in many different subjects of medicine
whether it be cardiology neurology dermatology and then of course eye care for quite some time
and in the dry eye space there is a lot of conflicting evidence now while there is some
debate of omega 3 for its benefits for dry eye and even meibomian gland dysfunction i'm mentioning it
here because i think it is something that some doctors will recommend for you but i think it's
really important that before taking any supplement whether it be something like flaxseed oil or fish
oil anything like that best talk to your eye care provider so they can go over your medications and
health history to make sure it is something best for you or if it's something that they
even recommend but either way eating a diet that has more omega-3s and less omega-6s is healthy for
the body and recommended no matter what dry eye or not so now where are you at with meibomian gland
dysfunction do you have a really severe case have you had any of these treatments mentioned such as
a lipiflow ilux maybe ipl treatments have you been taking omega 3 supplements have you been put on
medications like Restasis are you doing warm compresses every single day let us know in
the comments what you have tried what has helped for you and overall kind of where you're at with
your whole dry eye experience or if you need help finding a dry eye specialist in your area again
drop comments in the section below i'll include extra links in the video description to help you
find a dry eye specialist otherwise thank you so much for watching if this video helped you out
hit the like button for us share this with friends and family anyone you know that is struggling with
dry eye syndrome either way thanks so much for watching again this is Dr. Allen here from doctor
eye health keep an eye on it and we'll talk to you soon