2016年1月13日

Can Meibomian Gland Dysfunction be cured?

Meibomian gland dysfunction is a frequent cause of dry eye symptoms. It is also called MGD, meibomitis, and posterior blepharitis. The disorder is a complex condition, but it generally includes inflammation in the meibomian glands of the eyelid, which extrude the lipids (meibome) that make up the outer layer of the tear film. The inflammation may be due to an obstruction on the gland outlet at the eyelid margin.
The clog, in turn, may be due to an eyelid swelling from allergies or anterior blepharitis (in the front of the eyelid). The dysfunction may also arise from hormonal secretions, or dietary customs that affect the viscosity of the fatty substances. Sometimes, the substance may seem deeply creamy and viscous, or even toothpaste-like; at other times, a dense fatty plug may congeal at the entrance, sealing it. Another form of the dysfunction may consist of copious extrusions of lipids causing irritation to the eyes, although no obstruction of the glands happens.
The bottom line is that because of the disorder, the lipid extrusions of the gland become low in quality. There may be too much or too little; the oil may be too thick or too light. The final result is that the tear film loses stability and dries out at faster rates from the eye surface.
Symptoms and Associated Conditions
MGD manifestations ordinarily are similar to those linked with dry eye in general: burning sensation in the eye, sandiness, foreign object sensation, a mild fear of light because of high sensitivity, and crusting along the lid margins. The lid margins appear engorged and reddened and the inner rim of the eyelid may be scalloped as a consequence of scarring.
Meibomitis often occurs in association with insufficiency of aqueous tears. If this be the case, chances are you will experience very severe dry eye sensations. Approximately 60 per cent of Sjögren's syndrome patients (who suffer aqueous tear inadequacy) have been reported to also have MGD. Other skin disorders like rosacea and seborrhoea - which frequently inflict blepharitis - are also linked with meibomitis. These intertwined disorders should also be addressed during the treatment of meibomian gland dysfunction.
The possibility of developing MGD is noted to increase as you age. It may be that the meibomian glands gradually wear down in their functioning, or that age-associated alterations in the eyelids may result in irregular blink mechanisms. What has been observed is that normal eyelids in elderly patients dansko clogs outlet develop many of the alterations in structure and form reported in MGD.
meibomitis is also a consequence of long-term contact lens use. Contact lenses raise the tear evaporation rate. Rapid evaporation can lead to contact lens intolerance and further deteriorate the condition in people whose tear films are already compromised to begin with. Similarly, meibomitis is also generally reported in people with giant papillary conjunctivitis (GPC) and chalazion (plural, chalazia; a lump that remains after a sty on the eyelid heals).
Treatment
MGD, being a rather complicated disease, has many possible causes. In any person, the disorder may start from one or more of these causes. Your physician will have to keep these in mind as the therapy proceeds.
The first order of business in treatment is to manage inflammation on the eye surface, in order to dampen the damage from bacterial activity on the eyelid rim, normalise lipid function, and relieve the corollary dry eye symptoms.
Topical steroids may be used to control inflammation, although this is not immediately resorted to because of the high risk of side effects. But newer formulations, such as loteprednol, do not carry such risk and are moderately effective at dissipating inflammation. Specially compounded topical cyclosporine, such as cyclosporine emulsion in a castor oil base, has also been used successfully to minimise eye surface inflammation.
Essential fatty acids, particularly omega-3 fatty acids, have been cited in many anecdotal observations with the potency to abate dry eye symptoms, probably because of their proven anti-inflammatory properties. Their anti-inflammatory action has also been found to improve meibomian gland disease.
Lid scrubs can be effective. Scrubbing the eyelid margin helps remove bacteria and their toxins, as well as clears meibomian gland ducts. Overzealous cleansing can induce irritation, however, and should be avoided. Punctal plugs, artificial tears (without preservatives), and tear stimulants also provide relief. dansko clogs outlet: http://www.gogodansko.com

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