Meibomian Glands 101 | Eye Doctor Explains

[@wildspirit922]

Dr D you are an excellent teacher. 🙂 Thank you. Sharing your videos in my dry eye Facebook groups!

[@senseofwonder4734]

I absolutely LOVE your channel! I've learned so much, I wish i lived I your area and could be a patient. Since that isn't possible I am so very thankful for your information. Pray your channel continues to grow and you get more and more subscribers!

[@EyeSchoolwithDrD]

Thank you so much! I’m so glad I can help in some way! ❤️

[@senseofwonder4734]

@@EyeSchoolwithDrD I shared a screenshot of your channel on the dry eye support group page I'm in on Facebook. I hope that brings more awareness of your channel!

[@EyeSchoolwithDrD]

@@senseofwonder4734 oh thank you!!! That’s so kind!

[@A2Z1Two3]

Not only is doctor D very knowledgable , but she is , as the sayings go :- ‘Easy on the eye’ , and. :- ‘A sight for sore eyes’ . I feel better already, and all I have done it watch .

[@pattyschrider1681]

Dr. D, what is your opinion of Meibomian gland probing? I respect you and your opinion!!

[@cats-dogs-animals]

Hi Dr. D, thanks for the informative video. I have 2 questions: you mentioned in picture B that the glands were gone. Why are they gone? how does that happen? Can the disfunctional glands from picture C be back to normal?

[@louise2560]

Hello do block meibomian glands cause burning at the rims of the eyelids, how long does it take for the glands to get better? I'm doing all the right treatment I'd really appreciate a reply and thankyou for making this channel! 💗

[@attresyochim374]

Thank you for so much valuable information. You are smart, lovely and funny. 👍

[@guyplay]

Love your videos! Thanks for all the great info. I have MGD.

[@melissajosiah]

Great video! I'm a CPO and do dry eye treatments with the Miboflow. This was very informative and I will have a better way at describing the oil. You said baby oil and I say Crisco, lol.

[@meaningfultrickery]

Hi Dr. D! recently found your channel bc ive been experiencing dry eyes.....i was getting paranoid thinking it might be the tretinoin gel that I started using last winter that was damaging my MGs.....but also i recently started a very screen-intensive job, which is around the time my dry eyes got worse so who knows!! I've tried flipping my lids to get a look at my glands and they seem okay, just a bit squiggly, but I cant really tell how far they go without imaging tech i think....Anyways I wanted to ask, is it okay to do Meibomian gland massages/expression as a preventative act? Also, around when do patients who experience retinol-related MGD usually notice? (Months into treatment? Years later? or is it a case by case thing?) Thanks for all your great videos!!

[@YinYanUzumaki]

Did you find any answer to your question through somebody?

[@sharon8121]

My upper and lower glands are swollen and ooze. I have been diagnosed with blepheritis and dry eye. This is 2 years now. Its hindered my life! I been on anti biotic and prednisone. I also used tea tree wipes and eye wetting drops. Tried switching to glasses I don't know what to do!

[@61gamers70]

Hi dr. Is corneal nerve play role in the function of meibomian gland?

[@lauriebarkley9756]

Wonderful question, please respond thank you great job in educating us

[@ahmaddler1702]

Dr I lost the innervation to my left gland in an accident, now the gland is not functioning and i experience some degree of dryness, I use eye drops to keep it moist but i was wondering if punctal plug or punctal cauterization would be useful in my case

[@kathylam5512]

Thanks for this video, Dr D! So, once the meibomian glands are no longer working, what can be done?

[@EyeSchoolwithDrD]

If they are in distress they can be rejuvenated with ipl and heat/expression. I have seen function come back pretty nicely. However if they are gone, there’s no getting them back!

[@EyeSchoolwithDrD]

Preserve the ones you do have! And then focus on the things you can control - minimizing blepharitis, getting a handle on ocular surface inflammation, diet, all the step 1 and 2 DEWS recommendations!

[@gooner1248]

@@EyeSchoolwithDrD how do you het s handle on ocular surface inflammation if I may ask?

[@EyeSchoolwithDrD]

@@gooner1248 ipl is know to decrease IL-17 and IL-6 on the ocular surface, both of which are inflammatory mediators. So we know for sure that IPL helps. Also, use of topical drops like restasis, Cequa, xiidra and topical steroids will decrease inflammation. In office zest treatment also helps with lid inflammation and thereby surface inflammation. It often takes a few things in combination to effect change.

[@gooner1248]

Thank you for your answer! Do you also by any chance have tips for persistant blepharitis? I’m using warm compresses already and clean my eyelids with hypochlorous acid twice dailey and used antibiotics but the lower lid inflammation doesn’t seem to decrease and I still have lashes falling out. Thanks in advance🙏🏻

[@KyleGutschow]

Dr. D, appreciate the video. Is it important to image both the upper and lower lids? Or does damage typically occur to the lower lids first, so if no damage is found to the lower lids, there is no need to image the upper?

[@EyeSchoolwithDrD]

More damage definitely occurs on the lowers but I have made it my practice to image both and there have been cases in my clinic where the uppers look worse than the lowers. Especially with accutane or retinol usage. Rosacea and general aging changes in the glands tend to happen in lowers first in my experience. Good question!

[@biancacapazario9247]

@@EyeSchoolwithDrD Hi Dr, with your Accutane patients do you see a lot of hopeful results in treatment? If I can see maibomian glad orifices on my top lid does that mean my glands haven't atrophied and there's hope for me?

[@6ixof135]

This video is so informative! Thanks for making it! Would you consider making a video specifically on MGD and retinoids/retinol? It seems like the skincare world is encouraging more and more people to use retinoids/retinol long term, starting in the teenage years and only stopping for pregnancy/breastfeeding. Some content on the potential risks to the eyes from long-term retinoid use and how to reduce these risks would be a valuable perspective. Apologies in advance if you already did this and I missed it 🙂👓

[@EyeSchoolwithDrD]

Yes!! I've done a couple! They should be in my dry eye playlist!

[@PhoeNEx10]

Hi Dr D! Thnk you for all your videos, they're amazing and really helpful. I was wondering what was your opinion on eye massagers like the Renpho eye massager? Can they help blepharities? Also, how does a person with ocular rosacea and blepharities navigates between supposedly applying heat to help the meibomian glands but doesn't heat makes blepharities worse?

[@EyeSchoolwithDrD]

I don’t know about the massager you mentioned but I will look into it! Yes In terms of doing microblepharoexfoliation or heat + expression there is the concern that we are increasing inflammation. I take each case individually and try to get feedback from each specific patient on how their eyes feel after hot compresses and also just look at whether or not overall we’re achieving improvement in signs and symptoms. But I think for any of these at-home treatments the magic lies in finding the ones that work best for you in the right combination and frequency and in some cases less or no warm compresses are a better choice. I hope that helps!

[@cstnfacu]

Hi, what's your opinion of ilux? And what's the difference with IPL ? Keep up the good work, greetings from Argentina, South America.

[@EyeSchoolwithDrD]

I've had the pleasure of doing a demo with ilux. it's a nice device, but it is thermal heat + expression. The closest comparison devices are Tearcare and lipiflow. IPL is totally different...it is not thermal and doesn't require expression after (docs are split on whether or not to express. I do not routinely express after IPL) I feel that both types of treatment are necessary and I've been able to successfully reduce both signs and symptoms significantly by combining the two treatments.

[@summersadie3687]

I suffered from chronic iritis for around 15 years. The condition was marked by continual flare-ups that never subsided. Eventually, the iritis flare-ups stopped and have not returned over the past decade. My ophthalmologist said the condition eventually "burned itself out" and was unlikely to return. Would the constant inflammation I endured have anything to do with my current dry eye? I would also love for you to make a video on "uveitis" that covers its causes, symptoms, treatments etc. A woman I know actually went blind because of misdiagnosis of her iritis.

[@EyeSchoolwithDrD]

How interesting! Yes Uveitis is a great video topic and common condition that its important not to miss! Uveitis is internal inflammation and Dry Eye is external inflammation. Autoimmune disease can be the root cause of either one of these conditions so its possible for a person to have uveitis and dry eye from the same systemic autoimmune disease. Its also possible that they are unrelated.

[@ykook7000]

Yes!! I had a severe case of iritis 25 years ago out of the blue ...in my right eye...now l've been diagnosed with MGD / blepharitis in both eyes but my right eye is worse ..l have scar tissue in there etc so the optometrist says ...lm looking to go to an opthamologist to investigate that right eye further

[@Aldarinn]

For those with blepharitis and ocular rosacea, there is no way to apply heat without raising inflammation. What's the way around this?

[@EyeSchoolwithDrD]

Either by using IPL or another light therapy like LLLT ( both considered “cold”) or I like the zocular “ZEST” treatment in-office - polysaccharide from okra and calms inflammation while cleansing lids

[@Mickado]

Hey not sure if you'll see this, but lately I've been seeing both of my natural blind spots flickering in my vision.. It happens when i wake up, and will go away after a minute. Or if i shake my head, or look far to left or right, i will see it a little. Do you or anyone know what this is? I cant find anything online about this... I also have Visual Snow, and im not sure if this is connected?

[@jettjeff686]

Docotor what u mean. Retinol can cause dry eyes ????

[@katebutt]

Omg are you serious??

[@Monicalala]

What about IPL, does that not help in MGD since a dysfunction is already present.

[@EyeSchoolwithDrD]

IPL absolutely helps in MGD as well. The mechanism isn’t well understood but what I see clinically is that the expression from the glands thins and gradually becomes more normal as you go through the 4 sessions. IPL also can kill Demodex mites which frequently contribute to MGD!

[@samodell2393]

Good Evening "Dr. D" I apologize for always commenting, But Something Came to mind that I was told one time That I never thought about it to till the other day but I thought I should Ask Dr D, and that is this. Back in 2017 I had what's called a "Dysplastic Nevus" removed of my back, It was not cancerous by any means, BUT has a potential later on becoming that. But the dermatologist told me that due to being fair Skinned, I had a risk of getting them, he also said it's possible to get them in the eyes (Although I've never had one) he said it's possible, well as with me Whenever I learn something like that I like to conduct research and In my Research studies I read one time that people like myself who have light eye colors run the high risk of getting nevusis in the eye and having eye disease, Is this true?

[@EyeSchoolwithDrD]

Yes! Actually nevi are quite common, I see them nearly every day. And this is a great video idea. In the back of the eye they must be monitored for growth over time not unlike a “freckle” anywhere else on the body. Melanomas can also occur in the eye so that’s what we’re monitoring for - Nevus vs melanoma. Thanks for your questions, please keep them coming!

[@samodell2393]

@@EyeSchoolwithDrD You're welcome, Thank you for answering the questions, Just one more though, Is there any truth to their being risk factors as well for just simply having light eye color?

[@A2Z1Two3]

I found that when I pinch my nose and push air down to my nostrils , if I push a bit harder , I get some air coming back up to my eye through ONE of my tear ducts . I suspect that this is normal, but should perhaps happen in both eyes . ( or is it abnormal ?)

[@shahrukhlko]

You are absolutely amazing...it was fun an informative. I’m an optician from India and I needed to learn about MGD, this video helped me a lot. Just subscribed to your channel. Wanna checkout all the videos now 😎

[@gabrielbarrantes6946]

What to do if all the glands are gone?? ☹️

[@EyeSchoolwithDrD]

Control inflammation, supplement with artificial tears and lubricants. Moisture chamber goggles, etc

[@denathompson104]

👌🏽💯

[@blackhawk8678]

Video is helpful. You resemble "Sarah Connor".

[@rcm666]

EYEDUCATION

[@richardburnett-_]

She didn't draw that.