Overcoming MGD: How I Restored My Eye Health (English version)
Three months ago, I began experiencing severe dry eye symptoms accompanied by blurred vision and increased halos. Despite trying several types of artificial tears, none provided relief.
While the symptoms were not always unbearable, my blurry vision worsened, making me feel frustrated. I was born with posterior capsule cataracts and have a history of conjunctivitis, so I was concerned that the situation might have deteriorated after using steroid-containing eye drops.
I visited three eye clinics where each doctor indicated there were no issues. I even invested in an advanced eye exam, which yielded the expected results. However, after reading an article about oil-deficient dry eyes, I started considering whether it would be beneficial to consult a specialized hospital for further evaluation.
What is Meibomian Gland Dysfunction? (MGD)
Meibomian Gland Dysfunction (MGD) is a common eye condition affecting the eyelids' meibomian glands. These glands produce an oily substance called meibum, a crucial tear film component that keeps your eyes moist and prevents the watery layer from evaporating too quickly.
Simply put, MGD happens when your meibomian glands cannot produce enough quality tear film oil, or when your meibomian glands are obstructed. Using artificial tears that do not contain oil may not help improve MGD.
What are the differences between MGD and ordinary dry eyes in terms of symptoms?
The differences can be hard to perceive and very subtle.
However, one key point is that ordinary dry eyes usually deteriorate in the late afternoon, while MGD often gives you a noticeable itchy and dry feeling right after you wake up in the morning.
Another main difference is that people who suffer from MGD might have sticky eye crust that sometimes hurts when they try to wipe it off.
Since these symptoms are very similar to conjunctivitis, doctors may make incorrect diagnoses, prescribing artificial tears or steroid eye drops, which may not be helpful. At least three doctors did not give me the proper prescriptions in Taiwan, where the medical system is recognized as top-notch worldwide.
How did I discover this might be MGD?
Numerous medical sources have reported that more than 80% of dry eye cases in Taiwan are attributed to meibomian gland dysfunction (MGD), which is primarily due to a lack of oil rather than a lack of tears.
Despite consulting several doctors, I still felt uncertain and worried that my concerns might be unfounded. I knew I needed to limit my phone usage after work. After researching extensively online, including watching a YouTuber, I finally decided to visit Dr. Tsai at Far Eastern Hospital.
How did my doctor diagnose my MGD?
The doctor first applied numbing eye drops and lightly pressed my lower eyelid using Q-tips. She took a picture, and it looked like this illustration:
The doctor said my meibomian glands were blocked, but I was producing plenty of tears. At this point, there was no sign of gland shrinkage. However, eye drops alone were not enough, so she prescribed oral medication.
My medication included:
- Oral doxycycline four times per day in the beginning. Note that you cannot take isotretinoin when taking doxycycline.
- Sulfamethoxazole eye drops, four times per day.
- Tetracycline eye ointment before sleeping.
As my symptoms improved, the medication was gradually reduced under the evaluation of the doctor.
What are some possible causes of MGD aside from poor eye health habits?
In addition to poor eye health habits, there are many possible non-habitual causes of MGD, including medications, age, environmental factors, and autoimmune diseases such as Sicca syndrome.
All of these are reasonable. However, what surprised me was that even a low dosage of isotretinoin, or even retinol applied on the skin, may affect the meibomian glands. Therefore, I stopped taking isotretinoin, not only for restoring my meibomian glands but also because I was taking doxycycline.
What did I do to improve my MGD besides the prescribed medication?
Maintaining healthy meibomian glands is essential, and three things are crucial.
1. An electronic self-heating mask that can reach and maintain at least 45°C
In the video, the doctor recommends that the heating mask reach at least 45°C to ensure the meibomian glands are warmed to 41°C, which helps soften the obstructed oil.
A microwave heating mask is not recommended based on my experience because the temperature often cannot last for over 10 minutes.
2. Disposable self-heating eye mask
Before sleeping, I use a disposable self-heating eye mask, as the electronic ones are often too bulky and nearly impossible to wear to bed. It does not have to be expensive as long as it generates sufficient heat. I purchased some on Shopee, and they worked pretty well. At 0.093 USD per day, they offered significant relief by the next morning.
However, I found that these masks will likely oxidize and lose their heating capability after a few months, so do not stockpile them.
3. Artificial eye drops that are lipid-based
In this video, the doctors mentioned that even though lipid-based eye drops are not the real solution, it is recommended that you apply them before your eyes get blurry or dry.
Not only are you supplementing the tears with artificial tears so you can have better vision, but you are also coating the surface of the eye and trying to prevent dry eye patches from showing up. You are trying to prevent keratitis or inflammation of the cornea by using artificial tears.
I bought Systane Complete online. This is the only lipid-based eye drop I can get in my country. However, you can easily get Systane Complete on Amazon. Next time, I am going to try Refresh Mega 3 on Amazon if there is a discount.
Do I need to throw away my old lubricating eye drops?
The most common non-lipid-based lubricating eye drops are still very helpful in relieving dryness caused by air conditioners in the office. I think using preservative-free eye drops that contain hyaluronic acid is fair enough; you do not need to throw away all your eye drops.
Long-term habit-changing solutions for managing Meibomian Gland Dysfunction (MGD)
- Find offline hobbies that help you stay away from screens during the weekend.
- Blink more often.
- Use lipid-based eye drops and a heat mask immediately when you feel dryness.
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