Meibomian Gland Dysfunction (MGD) is one of the leading causes of dry eye disease, significantly impacting eye comfort and vision. When MGD progresses to moderate levels, managing symptoms becomes crucial to prevent further complications and improve your quality of life. In this blog, we’ll cover understanding moderate dry eye: causes, symptoms, and effective treatments, including the benefits of warm compresses, advanced lid hygiene options like the ZEST treatment, and lifestyle adjustments.
What is Meibomian Gland Dysfunction?
The meibomian glands are tiny oil-producing glands located along the edges of your eyelids. They secrete the oils that form the outer layer of your tear film, which prevents tears from evaporating too quickly. In MGD, these glands become blocked or dysfunctional, reducing the quality or quantity of oil released. This disruption leads to tear film instability and dry eye symptoms.
Types of Dry Eye: Aqueous-Deficient vs. Evaporative
Dry eye disease is categorized into two main types: aqueous-deficient dry eye and evaporative dry eye. Approximately 86% of dry eye cases are evaporative and related to MGD, while the remaining 14% are aqueous-deficient or mixed. Understanding the difference between aqueous-deficient and evaporative dry eye is crucial for choosing the right treatment.
Dry Eye Statistics and Prevalence
Evaporative Dry Eye: Approximately 86% of all dry eye cases are evaporative, primarily due to Meibomian Gland Dysfunction (MGD).
Aqueous-Deficient and Mixed Dry Eye: The remaining 14% includes cases of aqueous-deficient dry eye and mixed dry eye, where both evaporative and aqueous-deficient components are present. Mixed dry eye becomes more prevalent in moderate to severe cases.
1. Aqueous-Deficient Dry Eye
What It Is: This occurs when the lacrimal glands don’t produce enough of the watery (aqueous) component of the tears. As a result, the eyes lack adequate hydration.
Common Causes: Conditions like Sjögren’s syndrome, lacrimal gland dysfunction, and certain autoimmune diseases. The Schirmer’s test is often used to diagnose this type by measuring tear production.
Symptoms: Persistent dryness, grittiness, and more extensive corneal staining are common indicators.
2. Evaporative Dry Eye
What It Is: This is more common and occurs when the oily (lipid) layer of the tear film is insufficient, causing tears to evaporate too quickly. It is often linked to Meibomian Gland Dysfunction (MGD).
Common Causes: MGD, blepharitis, prolonged screen use (reduced blinking), and environmental factors. A short Tear Break-Up Time (TBUT) and signs of meibomian gland blockage are key indicators.
Symptoms: Burning, stinging, and discomfort that worsens in dry or windy environments or during prolonged screen time.
How MGD Contributes to Moderate Dry Eye
When meibomian gland dysfunction worsens, it leads to moderate evaporative dry eye. The reduced oil secretion allows tears to evaporate too quickly, resulting in chronic dryness, inflammation, and discomfort. The symptoms can be more persistent and harder to manage compared to mild dry eye.
Symptoms of Moderate MGD and Dry Eye
If you’re dealing with moderate MGD and dry eye, you may experience:
Burning or Stinging Sensation: A persistent feeling of burning or stinging in your eyes.
Grittiness or Foreign Body Sensation: The sensation of having sand or grit in your eyes.
Blurred Vision: Vision may become intermittently blurred, especially when reading or using screens.
Light Sensitivity: Increased sensitivity to bright lights.
Eyelid Inflammation or Redness: The edges of your eyelids may appear inflamed or red.
Increased Eye Fatigue: Tired eyes, especially after extended use, like working on a computer.
Common Causes of Meibomian Gland Blockages
Several factors can lead to blockages in the meibomian glands, disrupting oil flow and worsening dry eye symptoms. Common culprits include:
Aging: The meibomian glands naturally deteriorate with age, reducing their ability to secrete oil.
Hormonal Changes: Hormonal fluctuations, particularly in postmenopausal women, can impact oil production.
Blepharitis: Inflammation of the eyelid margins can lead to crusting and block the glands.
Poor Eyelid Hygiene: Accumulated debris, bacteria, or makeup can clog the gland openings.
Prolonged Screen Time: Reduced blinking during screen use can cause oil stagnation and blockages.
Contact Lens Use: Wearing contact lenses for extended periods can alter the oil composition and affect gland function.
Environmental Conditions: Dry climates, exposure to wind, or air-conditioned environments can exacerbate gland dysfunction.
Chronic Allergies: Allergies and associated rubbing of the eyes can lead to inflammation that blocks the glands.
Cosmetic Use: Eyeliner applied to the waterline or mascara buildup can obstruct the glands over time.
Effective Remedies for MGD and Moderate Dry Eye
Managing moderate MGD and dry eye involves a combination of self-care practices and advanced treatments. Here are the most effective options:
1. Warm Compresses: A Key Component in MGD Treatment
Using a warm compress is one of the simplest yet most effective ways to manage MGD. The heat helps to liquefy the thickened oils in the meibomian glands, making it easier for the oils to flow and coat the surface of your eye.
How They Help: Warm compresses are particularly beneficial whether or not you have blepharitis. They not only improve oil flow from the glands but also help reduce eyelid inflammation.
Best Practice: Use a heated eye mask for 10-15 minutes daily. Make sure to follow up with a gentle eyelid massage to express the oils from the glands.
Pro Tip: Always use a quality heated eye mask rather than a DIY solution like a warm washcloth, which loses heat quickly and doesn’t maintain the ideal temperature.
2. ZEST Treatment: Deep-Cleaning for Your Eyelids
The Zocular Eyelid System Treatment (ZEST) is an advanced in-home treatment that provides a deep, thorough cleaning of the eyelid margins. It uses natural ingredients like okra extract to remove biofilm, bacteria, and debris that can block the meibomian glands and worsen symptoms.
When to Consider ZEST: ZEST is ideal for those with chronic dry eye, mild to moderate MGD, or individuals who haven’t seen significant improvement from at-home treatments like warm compresses and lid hygiene alone. It’s also highly beneficial for people with blepharitis or persistent lid inflammation.
How It Works: ZEST is a one-time, in-home treatment that gently exfoliates and cleanses the eyelid margins, helping to restore normal gland function and provide long-lasting relief.
Research Insight: A study published on PMC found that using lid scrubbing with natural extracts, including okra extract, improved tear film stability, reduced corneal damage, and alleviated ocular symptoms. This makes ZEST a promising alternative for managing mild to moderate dry eye and MGD effectively.
3. Lubricating Eye Drops: Essential for Symptom Relief
Using the right eye drops can provide immediate relief from dryness and irritation while supporting the tear film.
For Evaporative Dry Eye (MGD-Related):
Product Recommendation: I-DROP® MGD – Contains 0.20% viscoadaptive hyaluronan and bioprotectants that stabilize the lipid layer, reduce tear evaporation, and offer prolonged comfort.
How It Helps: These drops supplement the lipid layer of the tear film, reducing evaporation and providing longer-lasting relief.
For Aqueous-Deficient Dry Eye:
Product Recommendation: Thealoz Duo® – Combines trehalose and sodium hyaluronate to deeply hydrate and protect the corneal surface from dryness and oxidative stress.
How It Helps: Provides lasting hydration and restores the health of the corneal surface.
Tip: Use preservative-free formulations to avoid irritation, especially if you’re using drops frequently.
4. Lifestyle Adjustments and Supplements
Omega-3 Supplements: Taking a high-quality, re-esterified Omega-3 supplement with a 3:1 ratio of EPA to DHA can reduce inflammation and improve the quality of oil produced by the meibomian glands. Aim for at least 2000 mg of combined EPA and DHA daily.
Stay Hydrated: Drink plenty of water throughout the day to support tear production.
Use a Humidifier: Increase humidity in your home or office to reduce tear evaporation.
Practice Conscious Blinking: Make an effort to blink more frequently, especially during prolonged screen use, to spread tears evenly across your eye surface.
Conclusion
Understanding moderate dry eye: causes, symptoms, and effective treatments is crucial for managing symptoms and improving eye health. Whether you need hydration-focused solutions for aqueous deficiency or lipid-based therapies for evaporative dry eye, having the right routine can greatly improve your comfort. If you’re ready to take control of your dry eye symptoms or need guidance on the best treatments, consider booking a consultation.
Whether you need hydration-focused solutions for aqueous deficiency or lipid-based therapies for evaporative dry eye, having the right routine can greatly improve your eye health. Incorporating Omega-3 supplements and making lifestyle adjustments can also provide comprehensive relief.
If you’re ready to take control of your dry eye symptoms or need guidance on which treatments are best for you, consider booking a consultation.
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Disclaimer
This blog is for educational purposes only and does not replace professional medical advice. Always consult your optometrist or an eye care professional for a comprehensive evaluation and personalized treatment plan.