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If you have been told you have Dry Eye, there is a good chance the problem starts with something more specific: Meibomian Gland Dysfunction, or MGD.MGD is one of the most common causes of Dry Eye and, importantly, it is often treatable.
Along the edges of your eyelids are rows of tiny oil-producing glands called Meibomian glands.
Every time you blink, these glands release a fine layer of oil into your tears. This oil sits on top of the watery part of the tear film and helps stop your tears evaporating too quickly.
It is a small job with a very big effect.
When these glands become blocked, inflamed or stop producing good-quality oil, the tear film becomes unstable. Tears evaporate faster and the surface of the eye begins to dry between blinks.
This can cause:
Screen use can make things worse. When we concentrate on computers, tablets and phones, we tend to blink less often — and many of those blinks are incomplete.
Blocked Meibomian glands do not necessarily stay blocked forever — but if poor gland function continues for long enough, the glands can begin to shorten and waste away.Once significant gland tissue has been lost, it may not recover. That is why we prefer to identify MGD early, while there are still healthy glands there to work with.
At Shattky Optometrists we can image the Meibomian glands themselves, assess the quality of the oils being produced and look closely at the eyelids and tear film.It gives us a much better idea of why your eyes are dry rather than simply treating the symptoms.
Warm compresses have been recommended for Dry Eye for years — and the idea is sound.
Heat can soften thickened oils inside the Meibomian glands.
The difficulty is getting enough heat to the glands, for long enough, to make a meaningful difference.
A warm flannel often cools quickly and may be useful for mild symptoms or ongoing maintenance, but established MGD frequently needs more than home heating alone.
This is where modern Dry Eye treatment has changed considerably.
There is rarely one single treatment for MGD.
The problem may involve blocked glands, thickened oil, inflammation around the eyelids, poor blinking and an unhealthy lid margin.
Our treatment is therefore tailored to what we find.
IPL — Intense Pulsed Light
IPL delivers controlled pulses of light to the skin around the eyelids.
It is particularly useful where inflammation is contributing to MGD and can help improve the environment around the Meibomian glands and encourage healthier gland function.
For many patients, IPL forms an important part of our Dry Eye treatment programme.
LipiFlow
LipiFlow is designed specifically to treat blocked Meibomian glands.
It gently heats the glands from the inside surface of the eyelids while applying controlled pulsation from the outside.
This helps soften and express thickened oils that can be difficult to clear with home treatment alone.
Heat therapy and gland expression
Controlled heating can be followed by gentle expression of the glands to help clear stagnant oils and assess how well the glands are responding.
The aim is simple: get the natural oils moving again.
For more established Dry Eye and MGD, we often recommend our 10-Week Dry Eye Programme. Rather than relying on one treatment, we use a planned combination of therapies over several visits.
Depending on what we find, this may include:
IPL, LipiFlow, controlled heat therapy, Meibomian gland expression, lid care and carefully selected lubricating drops.
We also monitor how the glands and tear film respond as treatment progresses. The goal is not simply to make the eyes feel better for a few hours. It is to improve the underlying environment of the eyelids and tear film and give the Meibomian glands the best chance of functioning properly again.
The simple things still matter.
Regular complete blinking when using screens, good lid hygiene, appropriate lubricating drops and a properly heated eye mask can all help support gland function. Think of home treatment as maintaining the glands, while in-practice treatment is aimed at restoring function where things have become blocked or inflamed.
If your eyes regularly feel gritty, burn, water in the wind or your vision clears when you blink, there may be more going on than simply “not enough tears”.
Come in and let us take a closer look.
At Shattky Optometrists we can assess your tear film, image your Meibomian glands and determine whether MGD is contributing to your Dry Eye — then build a treatment plan around what your eyes actually need.
The earlier we identify struggling glands, the more we have to work with.
Kiwi's know that good things take time, so come to us, have the tests done without feeling that you have been "rushed thru", and you'll know what we mean when we say "we take the time!"
Book appointmentKiwi's know that good things take time, so come to us, have the tests done without feeling that you have been "rushed thru", and you'll know what we mean when we say "we take the time!"
Book appointment
