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Top 3 Causes of Meibomian Gland Dysfunction

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Posted in Dry Eye, Dry Eye Diagnosis, Hormones, Omega-3

Dry eye disease affects nearly 25% of Canadians each year and there is an increasing prevalence due to higher screen times. Irritated eyes and red eyes are common symptoms. 

Did you know that dry eye is an umbrella term and there are actually many different types of dry eyes? The first type is called evaporative dry eye and it is commonly caused by meibomian gland dysfunction (MGD). It is the result of oil depletion in your tears. The second type is called aqueous-deficient dry eye and that is associated with the lack of water in your tears. Lastly, the third type is a combination of a lack of tears and oil, which is called mixed dry eye. 

In this blog, we will discuss the various causes of MGD. Keep in mind that this list is non-exhaustive, but we will hone in on the top 3 common causes of MGD. 

Aging 

As we age, there are many changes that happen to our body. The production of the natural pigment in our hair slows down causing gray hairs. Our skin’s collagen also starts to break down and wrinkles appear. Our meibomian glands are no different and they aren’t immune to the inevitable causes of aging. 

As studied in human and mouse models, the aging meibomian gland exhibits signs of decreased oil production, altered oil composition and atrophy. Additionally, there were also signs of declining cell renewal and gland size shrinkage which contributes to poor oil secretion. 

Dietary Intake 

The food that we consume fuels our body, but it can also affect us negatively if the food is inflammatory inducing. In North America, most individuals are eating lots of fatty foods and not enough fruits and vegetables. As a result, there is an increased amount of omega-6 fatty acids in Western diet compared to omega-3 fatty acids. Why is this a problem and how does it relate to dry eyes?

Well, omega-3 fatty acids decrease the production of inflammatory mediators which is one of the root causes of dry eyes. The best way to consume omega-3 fatty acids in your diet is to consume cold watery fatty fish such as salmon, mackerel, anchovies and herring (remember the acronym, S.M.A.S.H). You can still eat foods with omega-6, but ensure to obtain it from healthy sources such as olive oil and avocados. 

Systemic and Topical Medication

Every medication has side effects, but some cause dryness more than others.  Retinoids are shown to decrease the cells that create the healthy oils in our tear film. One acne medication called Accutane is associated with severe atrophy of the meibomian glands. Eye creams that contain retinoids should be avoided or minimally used to prevent MGD. Our previous blog discusses several systemic medications that can contribute to dry eye symptoms. 

In addition to systemic medications, there are prescription eye medications that can also cause MGD. Glaucoma medications have been associated with changes in meibomian gland morphology, decreased cell density and size. Some glaucoma drops have preservatives that can also irritate the surface of the eye, however, there are preservative-free options available. Make sure to ask your doctor for that option if you are suffering from glaucoma and dry eyes. 

Do You Want to Reduce Your Dry Eyes? Find a Dry Eye Doctor to Help!

If you are suffering from MGD and want to reduce your dry eye symptoms, speak to an expert in the dry eye field. There are many procedure based treatments and at home therapies that will be recommended by your eye doctor. Head over to our doctor locator to find a clinic near you and get the help you deserve!

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