MGD – Treatments When the glands that contribute to tear production fail to secrete the required quantity of tears or tears that have good quality, you will experience dry eye symptoms. Dry eye causes unending irritation of the eyes, especially on waking up after a night’s sleep. It causes grittiness, burning, itching, foreign body lodged in the eye, and other similar discomforts. If left untreated, dry eye can lead to damage of the cornea and, at worst, loss of vision.
Dry eye is very closely associated with meibomian gland dysfunction (MGD).. MGD accounts for up to a quarter of dry eye patients. The ailment is characterised by lack of lipid secretions to the tear film, making tears unstable and susceptible to quick evaporation. The origins of MGD are varied. It is most often experienced as constant tenderness in the eyelid, as a result of inflammations and/or plugs of hardened or too thick secretions (also called meibum) clogging up the openings of the glands.
The condition is greatly relieved by the use of a simple heat compress. Many studies have proven that heat compresses help increase the thickness of the lipid layer in tear film by at least 1.8 times as early as 5 minutes after starting treatment. Regular treatment can make the augmentation of the lipid layer more enduring.
A simple heat compress can be fashioned from a clean washcloth, heated in the microwave (for about half a minute) or immersed in hot tap water heated to about 45oC. You may also use a cotton stocking filled with dry ice and heated in a microwave to a comfortable temperature. Before applying the warm compress to the eyelid, it is important to test the heat to exclude the possibility of damage to the lid and eye. The heat compress is usually held in place for 3 to 10 minutes.
Whilst washcloths are commonly used, they may not retain the heat for as long as you may want. People in the know have found rice baggies more convenient. A rice baggy consists simply of some dry uncooked rice put in a cotton sachet big enough to completely cover the eyelid. Raise the temperature of the bag by heating in a microwave until a suitable level is reached. You can try out different amounts of rice and heating times until you get it right. Place the heated rice bag over the closed eyelid for up to 20 minutes. Rice baggies are able to save heat much longer than washcloths and transmit the warmth more evenly because of their weight.
Another alternative is a potato also heated in a microwave but the weight (and therefore the heat) distribution is not as even as rice baggies. A freshly boiled egg draped in washcloth may also be used. Boiled eggs provide heat for a long time but, again, uniform conveyance of warmth is not possible because of the shape.
Technology has helped create products such as infrared devices and intense light pulse instruments intended to provide the benefits of the heat compress.
The hardened meibum softens as it absorbs heat from the warm compress, becoming that less cumbersome to express by finger pressure. To maximise the benefits of heat compress for MGD, eye lid massage should quickly be performed after the heat compress to restore flow of the oily secretions so they can carry out their function in the tear film’s lipid layer. Eyelid massage after heat compress also helps restore the functions of meibomian glands once the obstructions have been unclogged.
