What is the best treatment option for Meibomian gland dysfunction?

Question

I have tried Lipiflow, that provided some relief for a very short while, and I have tried IPL, one treatment and had a bad reaction to it. I suffered migraine for 2 weeks and hence didn't have any repeat treatment of that. I get dry eyes, sticky eyelids and fatigued eyes all the time. I get burning sensation of eyelids most of the times. I was wondering what is the best treatment option available today for MGD. Please please help!!

Ahad Mahootchi, MD · Answer

There can be two issues with Meibomian Gland Dysfunction. One is the production of thick or abnormal and inflammatory meibomian gland oil. The second problem is when that abnormally thick oil blocks the ducts.
Combination Antibiotic/Steroid eye drops usually give quick relief but aren't good long term solutions because of side effects like glaucoma. TobraDex is wonderful for quick short term relief.
Low dose oral daily doxycycline works great to stop production of inflammatory oil. It doesn't really work as an antibiotic at low dose. It changes the melting point of the oil, is antiinflammatory, and blocks lid damaging enzymes made by the overgrowth of normal lid bacteria. Another wonderful solution is oral once weekly Azithromycin (250mg). It works great for most cases.
Lipoflow seems to unclog the blocked glands but doesn't stop the production of bad oils. Mibo is another less expensive alternative. A well done hot compress to the lid is very difficult to actually perform effectively. Again, all the options in this paragraph don't address the underlying "bad" oil production so these must be repeated quite frequently. When mixed with some of the above options, these options may be things done only once or twice a year.
IPL seems to work by doing working on both problems but it sounds like you had a very rare and possibly technique related issue.
Finally a diet rich in omega 3 oil and some plant based oils can provide some baseline level of relieve.

Melissa Toyos, MD · Answer

Easy. IPL for dry eye with expression following. The expression gets rid of the clogged meibomian glands and clears them out. The infrared component of the IPL melts that abnormal secretions to make them more easily expressed. The IPL is anti-inflammatory, kills Demodex and closes the abnormal blood vessels on your lid margin that perpetuate the cycle of inflammation.

What is the best treatment option for Meibomian gland dysfunction?

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What is the best treatment option for Meibomian gland dysfunction?

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