MGD affects the oil-producing meibomian glands in the back of the eyelids.  MGD may contribute to dry eye.  The meibomian glands secrete lipids that combine with and coat the tear film.  This essential component of the tear film prevents tears from evaporating to keep eyes moist and comfortable.

Symptoms

Fluctuating vision, burning and stinging.

Signs

Red, thickened eyelid margins with prominent blood vessels or capped oil glands at the eyelid margins, frothy tear film, capped glands.

Treatment

1.   Warm compresses and lid massage

2.   Scrub eyelid margins twice a day with mild shampoo (e.g. Johnson’s baby shampoo) on a cotton-tipped applicator or a wash cloth, or use a foaming lid scrub (e.g. Steri-Lid) to mechanically remove crusts

3.   If associated with dry eyes, use artificial tears 4-6 times per day

4.   Topical eye drops, antibiotic-steroid combinations help with decreasing the number of pathogenic organisms and decreasing inflammation

5.   Unresponsive meibomitis can be treated with tetracycline 250mg by mouth 1-2 times per day, or doxycycline 100mg by mouth once a day for one to two weeks, then taper slowly to one-fourth full dose for 6 months

a.   Tetracycline and doxycycline should not be used in pregnant women, nursing mothers, or children under 8 years old.  Erythromycin 200mg by mouth two times per day can be used instead