Overcoming MGD: How I Restored My Eye Health (English version)

· What is Meibomian Gland Dysfunction? (MGD)
· What are the differences between MGD and "ordinary dry eyes" in terms of symptoms
· How did I discover this might be MGD
· How did my doctor diagnose my MGD?
· What are some possible causes of MGD aside from poor eye health habits.?
· What did I do to improve my MGD besides the prescribed medication?
∘ Maintaining a healthy MG is essential, and three things are crucial.
∘ 1. An electronic Self-Heating Mask that can reach and maintain at least 45°C
∘ 2. Disposable self-heating Eye Mask
∘ 3. Artificial eye drops that are lipid-based
· Do I need to throw away my old lubricating eye drops?
· Long-Term Habit-Changing Solutions for Managing Meibomian Gland Dysfunction (MGD)

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 have provided relief.

While the symptoms aren't always unbearable, my blurry vision worsens, making me feel frustrated, having been born with posterior capsule cataracts and having a history of conjunctivitisConjunctivitiscern that this situation might have deteriorated after using steroid-containing eye drops.

I've visited three eye clinics where each doctor indicated 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've 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 can't produce enough quality tear film oil or your meibomian glands are obstructed. Using artificial tears that do not contain oil WILL 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. At the same time, MGD usually gives you a noticeable, itchy, and dry feeling right after you wake up in the morning.

Another main difference is people who suffer from MGD might have sticky eye crust that sometimes hurts when you try to wipe them off.

Since these symptoms are very similar to ConjunctivitisConjunctivitistors will make wrong diagnoses, prescribing artificial tears or steroid eye drops, which is not 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 feel uncertain and worry that my concerns might be unfounded. I need 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 doctors first put numb eye drops and lightly press your lower eyelid using Q-tips. She took a picture, and it looks like this (just an illustration)

credit: The Root Cause to your Dry Eye and how to Treat It (eclipseeyecare.com)

The doctor said my Meibomian Gland was blocked, but there were plenty of tears produced. At this point, there's no sign of shrinking. However, eye drops are not enough, so she prescribes oral medication.

My medication includes

1. oral doxycycline four times per day in the beginning. (Note that you cannot take isotretinoin when taking doxycycline.)
2. sulfamethoxazole (eye drops), four times per day
3. Tetracycline (eye ointment) before sleeping

As my symptoms improve, the medication is 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 tons of possible non-habitual causing MGD, including medications, age, environmental factors and autoimmune diseases such as Sicca syndrome.

All there are reasonable. However, the low dosage of isotretinoin, even retinol applied on the skin, will affect Meibomian Gland surprised me. Therefore, I stop taking isotretinoin not only for restoring my Meibomian Gland but also for taking doxycycline.

What did I do to improve my MGD besides the prescribed medication?

Maintaining a healthy MG 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 Gland is 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 can't 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 doesn't have to be expensive as long as it generates sufficient heat. I've purchased these on Shopee, and they work pretty well. At 0.093 USD per day, they offer 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.

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's recommended that you apply them before your eyes get blurry or dry.

Not only are you supplementing the tears with artificial tears so then you can have better vision but you’re coating the surface of the eye and trying to prevent those patches those dry eye patches from showing up you’re trying to prevent keratitis or inflammation of the cornea and so by using artificial tears.

I bought Systance Complete online. This is the only lipid-based I can get in my country. However, you can easily get Systance Complete on Amazon. Next time I'm going to try Refresh Mega 3 on Amazon if there’s 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 don't need to throw away all the eye drops.

Long-Term Habit-Changing Solutions for Managing Meibomian Gland Dysfunction (MGD)

1. Find Offline Hobbies that help you stay away from the screen during the weekend.
2. Blink More Often
3. Use Lipid-base eye drops and a heat mask immediately when you feel dryness