Ophthalmology • Optometry • Opticianry
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Meibomitis Management

Meibomitis is a dysfunction of the meibomian glands. Usually there are about 25 glands lining the upper lid and about 20 glands on the bottom lid. They are halfway between the lashes and the eyeball. These glands secrete oil into the eye to keep it lubricated. Normally when I press on the lid margin, a thin oil should come out (it looks like salad oil). Your glands are clogged so that when I press on them, the secretions look more like toothpaste. Because of this, the eyes don't get well lubricated and your tears evaporate. This leaves the eyes dry, red, and sometimes itchy. You may also wake up with some "junk" in the corners in the mornings.

The treatment is easy. You need to get some hot water on them. The best way is to soak a washcloth in hot water. You can do this in the shower or when you wash your face. Hold the washcloth on the lids for at least 1-2 minutes. The longer you can do this, the better. If you can hold it for 5-10 minutes, that is great. Some people like to get a wet washcloth and put it in the microwave. (Be sure not to burn yourself). Then they hold it on the lids while they watch TV. No matter how you get the hot compresses on, the steam from the washcloth will start to open the glands. Yet remember that this is only the first part. The second part is actually pressing or massaging the eyelids as to push out the clogged secretions into the tear film. This means pressing up on the lower lid and down on the upper lid. You are milking the glands towards the eyes. You can use your finger, the washcloth, or a Q-tip to do this. Do not push right against the cornea or it will hurt. Look up when you press against the lower lid and press the lid against the white of the eye. Look down when you press on the upper lid and again, press against the white of the eye. You won't be able to look in the mirror while you are doing this - so you will have to get a feel for it.

Once you have completed this, put one to two drops of artificial tears in each eye. This is important because you will have a lot of "junk" floating around in the tear film and the artificial tears act like windshield wiper fluid. Use the artificial tears at least 2-3 other times during the day to help wash away debris.

Think of this like brushing your teeth. It is something that you will need to continue. Do it once or twice per day while you are symptomatic. Usually after 2-3 weeks this can be reduced to every other day. If you are doing well with that, then you can back down to twice per week. Yet I wouldn't go below that or it will just come right back. Luckily, the whole process does not take very long.

If you have been instructed to use Erythromycin or Bacitracin ointment at bedtime, do this right before you go to bed. Put a thin layer on your finger or a Q-tip and rub it on the eyelashes- top and bottom. Try to get it at the base of the lashes where the lash meets the skin. It is ok if the ointment gets in the eye as it is for the eye. Yet it may blur your vision if it gets in the eyes-so do it before you turn off the lights. It may be hard to read or watch TV afterwards. In the morning you can wash it off.becomes much more difficult and costly. Vitrectomy surgery is required to remove the blood, apply laser, release scar tissue and reattach the retina if necessary.