Meibography Can Ensure Better Diagnosis for Meibomian Gland Dysfunction

Dry eye is a common ocular condition that can occur for a variety of reasons. A leading cause of dry eye, however, is Meibomian Gland Dysfunction (MGD); it affects the essential oil layer of the eye’s tear film, causing tears to evaporate too quickly.

In fact, more than 85% of patients who visit their eye doctor due to dry eye symptoms are diagnosed with Meibomian Gland Dysfunction. MGD is a chronic condition that, when left untreated, can worsen overtime.

For optimal treatment, you first need to be properly diagnosed. Meibography is a non-invasive screening tool that accurately diagnoses MGD and enables your eye doctor to provide effective treatment to relieve dry eye symptoms.

What Is Meibomian Gland Dysfunction (MGD)?

Meibomian glands are located in both your upper and lower eyelids, where they produce complex oily fluid that stabilizes the tear film and slows the evaporation of your tears. This allows the tears to keep your cornea well lubricated for comfortable and clear vision.

When the meibomian glands are either blocked or don’t function optimally, the lipid (fatty) layer of your tear film isn’t rich enough to keep your eyes moist. This causes a rapid evaporation of tears and results in friction between the cornea and eyelids.

Diagnosing Meibomian Gland Dysfunction

If your eyes feel itchy and scratchy, you may have dry eye disease. Visit Livingston EyeCare Associates, who will perform a thorough clinical exam using a meibography device that utilizes high-definition imaging technology. This allows your eye doctor to view the health of your meibomian glands with optimum accuracy. The screening process is quick, efficient, non-invasive and absolutely painless.

How Does Meibography Work?

A meibography visualizes the morphology of the meibomian glands through a series of high-definition digital images. The images allow the eye doctor to observe the architecture of the glands by revealing the gland size, structure, and any structural abnormalities.

Diagnosing MGD with certainty and clarity allows the eye doctor to prescribe the most appropriate treatment to alleviate your painful symptoms.

Can Meibomian Gland Dysfunction Be Treated?

Yes. After diagnosis, your eye doctor will choose from a variety of treatments available.

The earlier MGD is detected, the better. If not treated early on, it can cause corneal damage and even vision loss. If you feel eye irritation and suspect you have MGD, contact Livingston EyeCare Associates today to schedule your appointment.

Livingston EyeCare Associates serves patients from Livingston County, Ann Arbor, Detroit Metropolitan Area, and Lansing, throughout Michigan.

What Is Lagophthalmos?

Lagophthalmos refers to the incomplete closure of the eyelids and can produce symptoms similar to dry eye syndrome, such as dry, itchy, watery eyes. In extreme cases, it can cause corneal ulcers.

There are several types of lagophthalmos, ranging from mild to severe. Common symptoms include:

• Increased tearing
• Dryness
• Irritation
• The sensation that something is stuck in the eye
• Blurred vision
• Eye pain, especially in the morning

A visit with our optometrists can determine if lagophthalmos is causing or contributing to your dry eye symptoms.

Types of Lagophthalmos

Blink Lagophthalmos

When the eyelids don’t fully close during a blink, this is called “blink lagophthalmos.” Blinking keeps the eyes lubricated by spreading the tear film evenly along the eyes’ surface. An incomplete blink can lead to dry spots on the eye and other uncomfortable dry eye symptoms. Colliding eyelashes or tasks that require a high level of focus (such as working on a computer) can contribute to blink lagophthalmos.

Nocturnal Lagophthalmos

Nocturnal lagophthalmos occurs during sleep, so people with this condition may be unaware they have it. One common cause of this type of lagophthalmos is a decrease in fatty tissue behind the eyeball. Less cushioning causes the eye to sink further into the socket, making it more difficult for the lids to completely close. The fatty tissue can deteriorate for several reasons, including the presence of an autoimmune disease.

Paralytic Lagophthalmos

Paralytic lagophthalmos results from a paralyzed cranial nerve, thus preventing the eyelids from complete closure. Paralysis of the seventh cranial nerve can be caused by Bell’s palsy, tumors, or trauma.

Iatrogenic lagophthalmos

This is when the eyes can’t fully close due to medical treatment. Medical procedures that can cause lagophthalmos include Botox injections and sutures near the eye.

How Your Eye Doctor Can Help

There are several ways to treat lagophthalmos, and sometimes surgery may be necessary. It’s best to first visit our optometrists to pinpoint the cause of your symptoms and try the least invasive and safest treatments before resorting to surgery. If left untreated, lagophthalmos can result in corneal damage.

If you’re experiencing dry eye symptoms of any kind, an eye exam at Livingston EyeCare Associates can help determine the underlying condition so that a tailor-made treatment plan can provide long-lasting relief. Dry eye relief extends far beyond the options available at your local drugstore. The friendly staff at Livingston EyeCare Associates make it their mission to provide the highest quality care for their patients. Get the relief you seek — book your appointment today.

Our practice serves patients from Livingston County, Ann Arbor, Detroit Metropolitan Area, and Lansing, Michigan and surrounding communities.

Dry Eye After LASIK

Many individuals with refractive errors like nearsightedness choose LASIK (laser-assisted in situ keratomileusis) surgery to correct their vision due to its safety and effectiveness. But dry eyes are a remarkably common after-effect of LASIK surgery, affecting up to 95% of patients who’ve undergone this procedure. In fact, dry eye symptoms are the primary reason for patient dissatisfaction after LASIK. Although symptoms of dry eye syndrome (DES) most commonly occur in the immediate postoperative phase and are generally only temporary in nature, some individuals develop chronic and severe DES that can negatively impact their quality of life.

What Is DES?

Dry eye syndrome is a multifactorial condition that is characterized by a chronic lack of ocular lubrication, which can be caused by poor quality tears, insufficient tears, pollution, allergies, or irritants.

Some symptoms of DES include, but are not limited to:

• Redness
• A feeling of dryness or irritation
• Grittiness – the sensation that something is stuck in the eye
• Fatigued eyes
• Blurred vision
• Watery eyes
• Photophobia (light sensitivity)

To learn more about DES, visit our main Dry Eye page.

How Can LASIK Lead To Dry Eye?

During the LASIK procedure, some of the cornea’s nerves are cut, leading to reduced corneal sensitivity. The eye may respond to the decreased sensitivity by not sensing the need for lubrication, thereby producing fewer tears. This reduction in tear production is usually the culprit in post-LASIK DES.

LASIK surgeons are now aware that healthy tears promote healing following surgery. For this reason they perform certain screening tests prior to the procedure to ensure that DES will not significantly interfere with the outcome of LASIK.

What Are Risk Factors For Post-LASIK Dry Eye?

The following conditions increase a person’s risk of developing DES after undergoing LASIK surgery:

• Having a high degree of myopia

• Being above the age of 50
• Being a female, especially post-menopausal
• Having an autoimmune disease, such as Sjorgen’s syndrome
• Living in a dry climate

How We Can Help Manage Your Symptoms

If you’ve undergone LASIK or are considering it for the future, know that we are here to help treat your DES symptoms, should any arise? At Livingston EyeCare Associates, we provide dry eye relief to many patients who’ve had refractive surgeries and have helped make the healing process more comfortable. You don’t have to live with the discomfort of dry eye syndrome — speak with our optometrists about finding long-lasting relief.

Our practice serves patients from Livingston County, Ann Arbor, Detroit Metropolitan Area, and Lansing, Michigan and surrounding communities.

Resources

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235707/
• https://www.allaboutvision.com/conditions/dryeye-syndrome.htm
• https://www.allaboutvision.com/visionsurgery/lasik-dry-eyes.htm

Ocular Rosacea and Dry Eye

Rosacea is a chronic skin condition that affects the face, and of them, more than 50% will experience eye-related symptoms. While there is a lot of research out there on ocular rosacea, a cure remains elusive. Fortunately, your eye doctor can help you manage your symptoms through medication and offer guidance on how to best manage this condition.

What is Ocular Rosacea?

Ocular rosacea is a common inflammatory eye condition that causes redness, itching, and burning sensations around the eyes in many people who have rosacea. The primary parts of the eyes that are affected are the eyelids, conjunctiva, and occasionally the cornea.

What Are the Symptoms of Ocular Rosacea?

Signs and symptoms of ocular rosacea are similar to dry eye. Those with the condition may experience:

• Burning, red, itchy, or watery eyes
• Grittiness or the feeling of having a foreign body in one or both eyes
• Red, swollen eyelids
• Blurred vision
• Sensitivity to light (photophobia)
• Recurrent eye or eyelid infections, such as blepharitis, pink eye (conjunctivitis), chalazia or styes
• Dilated small blood vessels on the sclera (the white part of the eye)

What Causes Ocular Rosacea?

The exact cause of ocular rosacea is unknown, but researchers have found that 85% of people with the condition have blocked oil glands around the edges of their eyelids. When these glands are blocked they cause dryness and the area around them can get irritated and swollen. This can lead to crust in your eyelashes and itching and redness in your eyes.

Other potential triggers:

• Bacterial involvement
• Blocked glands in the eyelids
• Environmental factors
• Eyelash mites
• Heredity

There are also a number of things that can aggravate ocular rosacea, including alcohol consumption, hot baths and saunas, hot or spicy foods and beverages, strenuous exercise, stress, sunlight, wind, and extreme temperatures.

Is There Treatment For Ocular Rosacea?

Ocular rosacea can usually be controlled with home eye care and medication, but these don’t actually cure the condition.

Treatment may include applying a warm moist compress to your eyelids. Your eye doctor might recommend antibiotics, prescribe eye drops, or ointments with steroids to help with your symptoms.

In rare circumstances, left untreated, severe ocular rosacea can damage your cornea or scar your eyelid. Both can affect your vision.

To help prevent flare-ups:

• Gently wash your eyelids at least twice a day with warm water or a product your doctor recommends. This will keep your eyelids clean.
• Avoid makeup. If your eyes are inflamed, makeup can irritate them. If you do decide to wear makeup when they aren’t inflamed, choose types that are non-oily and free of fragrance.
• Avoid wearing contact lenses during flare-ups.
• Avoid things that trigger or worsen your ocular rosacea. Items that tend to dilate blood vessels in the face include alcoholic beverages and hot, spicy foods.

To learn more about ocular rosacea and dry eye, contact Livingston EyeCare Associates. We can help you prevent flare-ups and treat your ocular rosacea-induced dry eye.

Our practice serves patients from Livingston County, Ann Arbor, Detroit Metropolitan Area, and Lansing, Michigan and surrounding communities.

Electronic Devices And Dry Eye

Nowadays, screen usage has become a normal part of most people’s daily routine. Whether you use a smartphone, tablet, laptop, or other devices, the time you spend focusing on a screen can often be felt in your eyes.

Dry eye syndrome (DES) is an eye condition characterized by dry, uncomfortable, red, itchy eyes, and can be caused by several factors: poor quality tears, insufficient tears, allergies, environmental irritants, and spending excessive time staring at a screen. Left untreated, DES can cause corneal damage and scarring, and sometimes permanent vision loss.

If you think you have DES or are experiencing any of its symptoms, our Livingston EyeCare Associates optometric team can help.

How Using Electronic Devices Can Lead To Dry Eye Syndrome

Several studies have linked digital screen usage to symptoms of DES. While research is ongoing, it’s already known that the following factors all play a role.

Reduced Blink Rate

Our blink rate is reduced by 66% when staring at a digital device’s screen. This finding is significant because blinking less frequently increases the risk of developing dry eye syndrome.

Blinking is a major component in keeping the eyes feeling fresh and healthy. With every blink, the eye’s tear film is replenished and spread evenly across the eye’s surface. When that happens at a reduced rate, symptoms of DES can develop.

Even if you blink often enough, you may not be fully blinking, leaving a tiny gap between the upper and lower eyelids upon closure. This tiny gap causes a ‘dry spot’ on your cornea, which does not receive any replenished fresh tears and can compromise your eye comfort. So make sure that you fully shut your lids when you blink.

Recent studies have shown that incorporating a blinking exercise into your daily routine can reduce your DES symptoms. Consider setting up reminder that pops up on your screen every few minutes.

Reduced Tear Stability

A stable tear film keeps the eyes feeling comfortable and functioning optimally.

Mucin 5AC, a protein, is an essential component of a healthy tear film that helps the watery portion of the tears cling to the surface of the eye. A study in Japan found that employees who spent the most time in front of screens (7 or more hours per day) had the lowest amount of mucin 5AC in their tears. This led them to complained of DES symptoms, like itchiness and irritation.

The employees who endured the least amount of screen time from the group (less than 5 hours per day) had higher amounts of mucin 5AC in their tears, similar to those without DES.

Higher Rate of Meibomian Gland Dysfunction

The meibomian glands are the tiny glands that line the lid margin and secrete essential oils onto our tears. When these glands don’t function properly, an eye condition known as meibomian gland dysfunction (MGD) occurs.

MGD is an umbrella term for gland complications that can lead to an altered tear film composition, ocular and eyelid discomfort, evaporative dry eye, and ocular surface disease.

Studies have shown that people who spend 4 or more hours staring at a screen have higher incidences of MGD and DES symptoms.

So, What Can You Do To Protect Your Eyes?

Here are a few tips that may help you combat symptoms of DES when using a digital device:

• Take frequent blink breaks
• Use a cool-mist humidifier near your work station
• Avoid having a fan or air conditioner blow air directly into your face
• Stay hydrated with water, fresh fruit or vegetable juices, milk or soups
• Eat water-based dairy foods such as yogurts, smoothies, and oatmeal
• Use artificial tears or prescription eye drops if necessary

The most important thing you can do for your eyes is to visit a dry eye optometrist. At Livingston EyeCare Associates, we know how uncomfortable and even debilitating DES can be — and we’re here to help.

An eye doctor with specialized training and knowledge of DES can diagnose and treat the underlying cause of your condition and provide a range of effective, life-changing options.

To schedule your appointment and find the relief you need, call Livingston EyeCare Associates in Hamburg Township today.

Our practice serves patients from Livingston County, Ann Arbor, Detroit Metropolitan Area, and Lansing, Michigan and surrounding communities.

References

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371992/