Teary eyes and puffy eyelids?

Waking up in the morning with eyelids that feel as though they’re stuck together? Are they sore and swollen? 1, 2, 3   Are your eyes red and watery, with a gritty feeling? You may even find that your vision is blurry, and that you struggle with your contact lenses if you wear them? 1, 2, 3, 4

 

You may have a condition called meibomian gland dysfunction (MGD) 1, 2, 3, 4

Meibomian glands release a clear oil (called meibum) onto your tears through a row of small openings along the edge of your eyelids. This oil coats the surface of our eyes and keeps the water component of our tears from evaporating (drying out). Together, the water and the oil layer make up the tear film. 1, 2, 4 

If the meibomian glands are not working properly, your eyes may feel dry and uncomfortable. 4

Meibomian gland dysfunction (MGD) is a condition where the glands are not secreting enough oil or when the oil they secrete is of poor quality. When the glands become blocked, the oily part of the tears cannot be released. This causes the watery tears to try out more quickly which results in the eye becoming dry and can make it feel sore. The oil that does make it out of the glands can be granular (crusty) or otherwise abnormal, and can also cause irritation. 1, 3

MGD is a common condition and can affect anyone. 3  However, it is more likely to happen after the age of 50, if you have diabetes or oily skin conditions and it is also more common in women. 3

The following changes in your meibomiam glands can cause MGD: 4
  • The skin lining the small openings may thicken due to aging, medication use, contact lens wear, hormones, or certain types of skin conditions.

  • The glands may not produce enough meibum (due to ageing or medications).

  • The glands may produce too much meibum (due to certain types of skin conditions).

  • The presence of bacteria can change the quality of the meibum. 

 

If left untreated, MGD can cause or worsen dry eye symptoms and eyelid inflammation. 1, 3

The oil glands become blocked with thickened secretions. Chronically clogged glands eventually become unable to secrete oil which results in permanent changes in the tear film and dry eyes. 1, 3

 

Tips to treating MGD: 4, 5
  • Avoid dusty and windy environments as they can worsen your discomfort.

  • Take omega– 3 fatty acids to decrease inflammation and help with dry eyes.

  • Apply warm compresses in the morning and before bed, to melt and release the meibum. 

  • Use an eyelid cleanser in the morning and before bed, to clear away bacteria on your eyelids.

  • Use artificial tears to keep your eyes moistened and lubricated. 

Ask your eye care practitioner for advice and more information
 
References:
  1. American Association for Pediatric Ophthalmology and Strabismus. Meibomian Gland Dysfunction and Treatment. Available from: https://aapos.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=47156971-67ae-c303-eda8-d99762392d33&forceDialog=0 [Last accessed October 2021]
  2. Abelson MB, Oberoi S. Treating Dysfunctional Meibomian Glands. Review of Ophthalmology. 16 August 2006. Available from: https://www.reviewofophthalmology.com/article/treating-dysfunctional-meibomian-glands [Last accessed October 2021]

  3. Association of Optometrists. Meibomian gland dysfunction. Available from: https://www.aop.org.uk/advice-and-support/for-patients/eye-conditions/meibomian-gland-dysfunction [Last accessed October 2021]

  4. Centre for Contact Lens Research School of Optometry & Vision Science. Meibomian Glands. 17 February 2015. Available from: https://contactlensupdate.com/2015/02/17/patient-handout-meibomian-gland-dysfunction/ [Last accessed October 2021]

  5. Roach L. Rethinking Meibomian Gland Dysfunction: How to Spot It, Stage It and Treat It. Ophthalmic Pearls. American Academy of Ophthalmology. EyeNet Magazine July/August 2011. Available from: https://www.aao.org/eyenet/article/rethinking-meibomian-gland-dysfunction-how-to-spot?julyaugust-2011 [Last accessed October 2021]

 

OPTIVE® Lubricant Eye Drops and OPTIVE® Unit Dose Lubricant Eye Drops – Class B. Contains carboxymethylcellulose sodium 5 mg/ml and glycerine 9 mg/ml. For full prescribing information refer to the Instructions for use. For adverse events, report to MEAPV@abbvie.com. AbbVie (Pty) Ltd, Reg. 2012/068113/07. Address: Building 7, Waterfall Corporate Campus, 74 Waterfall Drive, Midrand, 1685, South Africa. Tel: 011 031 1600. Date of Publication of this material: May 2025. Promo. No. ZA-OPT-250020