In 2011, the Tear Film & Ocular Surface Society published a defining study indicating that Meibomian Gland Dysfunction (MGD) is a major cause of dry eye disease. The study, which involved more than 50 global experts over the course of two years, explored the structure and function of the meibomian glands in our eyelids and discovered that decreased function, due to an excessive amount of Staphylococcal bacteria, has been highly underestimated as one of the primary causes of dry eye disease.
As an optometrist specializing in the treatment of dry eye disease, I come across MGD in patients every day. After my early success treating the eye lids in dry eye disease, which was supported the MGD study, there has been a significant shift in the way I treat my dry eye/MGD patients. Here’s a look at my experience with MGD and dry eye disease.
Most patients today have learned to accept their “dry eyes” as normal. On average, they try at least three different tear supplements before giving up with little relief. Even though we have an eye drop called Restasis that stimulates tearing, it doesn’t treat the main underlying cause of the problem, and that is MGD.
I literally started pushing on patient eyelids about 5 years ago and found a tremendous number of patients with either a frothy tear film or completely plugged meibomian gland openings. This leads to a marked decrease in the lipid (oily) layer of the tear film, leading to increased tear evaporation and overall dryness.
“I believe that MGD is one of the most over-looked conditions diagnosed today”. I have also seen first-hand, how 90% of my patients with “dry eyes” benefit from a simple treatment regimen of heat, massage and an antibiotic. I will still use Restasis in conjunction with these lid treatments on patients with systemic illnesses such as rheumatoid arthritis and diabetes, which are known to cause decreased tear production. Glaucoma patients are also great candidates for treatment since they are more likely to experience dry eye due to their topical glaucoma medications.
My stated mission is to help educate both my patients and my peers as to the success I have had treating dry eye disease by better managing eyelid health and hygiene through simple tests and techniques. Unfortunately there is no cost-effective magic bullet, but with a simple-to-follow protocol and time, you will be on your way to healthy, happy eyes and eyelids!
About the Author
Jeffrey Rautio, OD is the founder of the Dry Eye Institute of Michigan and an optometrist practicing at Dr. Jeffrey Rautio- CVC in Ann Arbor, Michigan. A graduate of the Michigan College of Optometry, Dr. Rautio specializes in the diagnosis and treatment of dry eye. Dr. Rautio is a member of the American Optometric Association and the Michigan Optometric Association. Learn more about Dr. Rautio and his practice here.