Meibomian glands – to discuss or not to discuss. This is the argument that’s been dominating our office for the last three months.
My marketing team tells me it’s important to keep explanations about dry eyes simple. I, on the other hand, don’t want to shy away from technical explanations that can give our customers more insight into uncomfortable eye conditions.
Today, most research suggests that meibomian glands are at the heart of the chronic dry eye issue. In fact, optometrists and ophthalmologists agree that Meibomian Gland Dysfunction (MGD) is the leading cause of dry eyes (1). That’s why, if you have dry eyes, it’s important to understand this particular piece of anatomy.
The meibomian glands make meibum – a mixture of oils that contribute to the fatty layer of the tear film. Without meibum, our tears evaporate quickly, leaving the eye surface unprotected. And if the tears don’t lubricate the eyes correctly, dry eye symptoms – burning, tearing, redness, blurry vision – set in.
Besides keeping tears from evaporating, meibum is also important for increasing surface tension and protecting the eye from bacterial infection.
The meibomian glands are located behind the upper and lower eyelids, lined up like keys on a piano. Each meibomian gland is made up of multiple acini, with a long duct running along their length.
At the end of the gland is a muscle called Riolan’s muscle. Every time you blink, that muscle squeezes out the oily meibum (2). If the duct of a gland becomes clogged, however, meibum builds up and the gland can eventually deteriorate.
There are a number of factors at work here. Aging, for instance, is one contributor. Between the ages of 20 and 80, the delivery of meibum from the glands decreases by 50 percent (2). Hormonal changes or chronic inflammation can add to this problem. Other factors, like medication, chemicals, wearing contact lenses regularly, cold weather, and having lasik or cataract surgery can also impact our likelihood of developing dry eyes and the severity of those symptoms.
One study by Suhalim et al. also points out that there’s a sort of chicken and egg question at the heart of the meibomian glands discussion. When the surface of the eye dries out (thanks to wearing contact lenses or looking at a computer screen for many hours a day), that dryness affects the function of the meibomian glands (3). At the same time, poorly functioning or clogged meibomian glands also cause dry eyes.
Wonder why staring at a computer screen for too long might contribute to dry eye symptoms? When we stare at a computer screen, we typically blink less than the we normally do. The less we blink, the less meibum gets sent to the tear film.
As mentioned above, meibomian gland dysfunction is the most common cause of dry eyes. So if you are experiencing dry eye symptoms, it’s a good chance your glands are not working properly.
However, in some cases and particularly in early stage of MGD, the meibomian glands may be plugged up without a person experiencing significant dry eye symptoms (4). That’s why, if you are considering lasik or cataract surgery, it’s important to ask your eye surgeon to evaluate your meibomian glands prior to your operation.
You’re probably wondering why a blog dedicated to omega-3 would discuss meibomian glands.
Many dry eye treatments, like eye drops, only provide temporary dry eye relief. Getting enough omega-3, however, can help calm the inflammation fueling the Meibomian Gland Dysfunction.
Besides fighting chronic inflammation, omega-3 fatty acids can help with MGD in several ways. When you get the right lipid balance in your body, the meibomian glands are less likely to get clogged up. Omega-3 helps to improve the quality and composition of lipids in the meibum (5). In addition, omega-3, which works on the same biochemical pathways as over-the-counter pain relievers, can potentially reduce inflammation and corneal pain.
To learn more about how omega-3 works in the eye, read Using Omega-3 Supplements to Treat Dry Eye Symptoms. This particular blog also surveys some of the recent research done on fish oil supplements and dry eyes.
As you move forward with looking for dry eye solutions, remember: To experience benefits from taking an omega-3 product, it’s important to get an effective dose and a fresh oil. That true, whether you are fighting MGD, joint discomfort, or other health issues where getting enough omega-3 has been known to help.
1. Anterior Segment Section Symposium: MGD: The Science under the Glands. Academy 2014 Denver Handouts. American Academy of Optometry. 1 August, 2014.
2. Olennikov, Leanna, Cunningham, Derek and Whitley, Walter. Improve Your Understanding of Meibomian Gland Function —and Dysfunction. Review of Optometry. 15 May 2016.
3. Suhalim, Jeffrey L. et al. Effect of Desiccating Stress on Mouse Meibomian Gland Function. The Ocular Surface 12.1 (2014): 59–68. PMC. 26 June 2016.
4. Opitz DL et al. Diagnosis and Management of Meibomian Gland Dysfunction: Optometrists’ Perspective. Dove Medcical Press (2015): 59—69. 28 August, 2015.
5. Qiao, Jing, and Xiaoming Yan. Emerging Treatment Options for Meibomian Gland Dysfunction. Clinical Ophthalmology (Auckland, N.Z.) 7 (2013): 1797–1803. PMC. 9 September 2013.