Meibomian gland dysfunction

Clinical stages of Meibomian gland dysfunction MGD with therapeutic options

✅ Meibomian gland dysfunction Stage 1 criteria and management 

✍️ no symptoms

✍️ Minimally altered secretions

✍️ no ocular surface staining

✍️ Inform patient about MGD

✍️ management
• Alter diet
• reduce environmental stress
• Consider lid hygiene
• warm compresses and expressions

✅ Meibomian gland dysfunction Stage 2 criteria and management 

✍️ Minimal to mild symptoms of discomfort, itching, and photophobia

✍️ Minimal to mild altered secretions

✍️ none or limited ocular surface staining and TFBUT( tear film break up time ) <10s

✍️ management
• Improve ambient humidity
• increase dietary omega-3 intake
• Lid hygiene and warm expression (minimum of 4min twice daily)
• Lubricants
• topical azithromycin
• liposomal spray
• Consider tetracycline derivatives

✅ Meibomian gland dysfunction Stage 3 criteria and management 

✍️ Moderate symptoms with defnite limitation of activity

✍️ Moderately altered secretions

✍️ increased lid margin vascularity

✍️ telangiectasia

✍️ orifice plugging

✍️ Mild to moderate conjunctival and peripheral corneal staining

✍️ TFBUT around 5s

✍️ management as stage 2 Plus

• oral tetracycline derivatives
• Lubricant ointment
• Consider anti-inflammatory therapy for dry eye

✅ Meibomian gland dysfunction Stage 4 criteria and management 

✍️ Marked symptoms with definite limitation of activity

✍️ Severely altered secretions with MG dropout

✍️ displacement Central corneal staining

✍️ conjunctival inflammation and hyperaemia

✍️ TFBUT < 5s

✍️ management the same As stage 3 treatment Plus
• anti-inflammatory therapy for dry eye

✅ Meibomian gland dysfunction MGD Plus-disease 

✍️ Exacerbated inflammatory ocular disease surface disease

✍️ Mucosal keratinization

✍️ Phlyctenular keratitis

✍️ trichiasis

✍️ MG cysts or chalazion

✍️ Anterior blepharitis

✍️ management by all previously mentioned options with

• Pulsed steroid therapy
• therapeutic CL/scleral CL
• Epilation
• cryotherapy
• Intralesional steroid or excision
• topical antibiotic or antibiotic-steroid combination
• tea tree oil scrubs

Meibomian gland dysfunction powerpoint presentation :

MGD…Unplugged

1. MGD… Unplugged!New Developments, Treatment Considerations, Case Reviews Aaron Wolf, O.D.
2. Sources• The International Workshop on Meibomian Gland Dysfunction – Investigative Ophthalmology & Visual Science, March 2011 – >50 international experts, M.D.’s, O.D.’s, Ph.D’s; >2 year period• The Tear Film and Ocular Surface Society• The Ocular Surface• Ophthalmology Management• Optometric Management• Review of Optometry• Contact Lens Spectrum• Personal observations and experiences in clinical practice

The A-Z of MGD

1. The A to Zee of MGD reflections on the 2011 Workshop A J Bron Nuffield Department of Clinical NeuroSciences ,Oxford OXFORDSHIRE LOC Oct 23rd 2012
2. Definition of MGD Meibomian gland dysfunction (MGD) is a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion. This may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular surface disease.

Meibomian gland dysfunction Videos :

Management of Meibomian gland dysfunction video

Meibomian gland dysfunction