What Are Meibomian Glands? Video 2 in Dr. Zigler’s Dry Eye Educational Series presented by Eye Love


Hello everyone, and welcome back. I am Dr.Travis Zigler. Today we’re going over Meibomian glands,
what they are, and why they are such a big role in dry eye. Dry eyes almost always have an underlying
problem that simple artificial tears will not cure. Finding an underlying cause is very helpful
in figuring out the correct treatment for dry eye. For the majority of our patients, the underlying
cause is Meibomian Gland Dysfunction or MGD. Before we go into what Meibomian Gland Dysfunction
is, let’s go over what the Meibomian Glands are. There are approximately 31 meibomian glands
in the upper eyelid and about 26 in the lower eyelid. The glands in the upper eyelid are longer
and produce more oil, or meibum. Each gland contains little pockets that act
like an oil factory, producing this oil. These pockets produce the oil and push it
out onto the duct to exit the eyelid. A muscle inside your eyelid assists in milking
the glands during a blink and pushes the oil to the opening and out onto your eye. Upon exiting the duct and being pushed onto
your eye, the oil then forms the outer layer of your tears called the lipid layer. Let’s take a closer look at the tears. The oily outer layer, produced by these meibomian
glands, serves to prevent evaporation of the saltwater middle layer of the tears. The inner layer against the eyeball is made
of mucus secreted from cells on the front surface of the eye and is important in helping
the saltwater layer spread evenly across the surface of the eye. So in review: The oily outer layer is produced
by Meibomian glands in the eyelids. It lubricates and prevents the evaporation
of the middle saltwater layer. The middle saltwater layer nourishes and protects
the covering (cornea) of the eye. The inner mucous layer keeps all the tears
attached to the eye. Meibomian Gland Dysfunction by definition
is a chronic abnormality of the meibomian glands, commonly characterized by terminal
duct obstruction, and qualitative changes in glandular secretion resulting in alterations
of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular
surface disease. That is quite a mouthful! Take a deep breath, and let’s break that
down. Meibomian Gland Dysfunction is chronic. This means its long-term. We do not have a cure for this condition,
we can just treat it. Symptom relief will happen when treatment
is actively occurring, but symptoms will return if treatment is stopped. MGD means that the exit from the oil factory
is blocked. Treatment for this is simply unblocking the
exit. When that exit is blocked, you’re also more
prone to styes, or little bumps on the eyelids. The reason is because the oil factory keeps
on producing oil but has nowhere to go. Also, qualitative and quantitative changes
in glandular secretion are issues we run into. The oil that is being produced is not top
quality oil. Treatment is focused on increasing the quality
of the oil. I encourage you to go back through this lesson
a few times, and let us know if you have questions!

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