Blepharitis / Meibomian Gland Dysfunction (MGD)/ Ocular Surface Disease (OSD) /Dysfunctional Tear Syndrome (DTS) Dry Eye Syndrome

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DTS occurs when the tear glands do not produce enough tears, or when your tear film evaporates, causing your eyes to feel itchy, scratchy, and irritated. DES affects a significant percentage of the population, especially those older than 40 years of age. DTS can affect any race, and is more common in women than in men. It is more common with older age, because you produce fewer tears with age. It can also be associated with blepharitis (inflammation of the eyelid margins), arthritis, lupus and other inflammatory diseases or disorders. It is VERY common after eye surgeries and with glaucoma drops and becomes more symptomatic. MUST be treated, even if asymptomatic, before the testing for surgeries (Cataract or Laser Vision Correction) to optimize the measurements and the results.

Meibomian gland dysfunction (MGD). Your oil glands have gone on strike! The meibomian glands (MG) are located in the eyelids. Secretions from these glands comprise the lipid (oily) layer of the tear film which is so crucial in preventing rapid evaporation of the tears. Failure of these glands to produce or secrete oil – due to chronic blockage, thickening of the meibum, etc. will affect the quality and stability of the tear film, which in turn will produce classic dry eye symptoms even in people whose dry eye test results appear normal. MGD is quite common and unfortunately it often goes undiagnosed. Even when diagnosed is often not treated or is not treated effectively until it has become chronic or severe. MGD may be inflammatory (often as a result of blepharitis) or atrophic.

Treatment Steps: EVERY DAY PLEASE

STEP 1: Liquefy the oil: using Heat Therapy:

  • A combination of both heat and moisture will help melt and release the oils in the Meibomian Glands, so that the oil will coat the surface of the eye, and keep the natural fluid from evaporating. This can be done using
  • Warm compress applied to eyelids EVERY night for 5 – 10 minutes. It must remain wet & warm for the full 5 – 10 minutes. Options;
  • Lipiflow would give you an excellent head-start and you can do the maintenance more effectively.

 STEP 2: Express the oil: KEEP MG FLOWING

  • Forcefully squeeze your eyes repeatedly or Gently massage the eyelids while the compress is over the eyes. This will help squeeze the gland to secrete and express the liquefied/melted oils.
  • Lipiflow would give you an excellent head-start and you can do the maintenance more effectively. It does the step 1 & 2 very effectively.

STEP 3: Remove the bad oil: Lid Scrubs with

  • “TheraLid Eyelid Cleanser” or “Systane wipes”, AFTER the warm compress and squeezing
  • Close eyes and apply foam to lid margins (base of eyelashes) to wash away the debris that the warm compress has released. Rinse thoroughly.
  • If TheraLid or Systane wipes are not available, you can try diluted baby shampoo. Apply 2 drops of baby shampoo, to a wet washcloth. Rub until it lathers, then close eyes and apply to eyelid margins. Rinse thoroughly. Baby shampoo can leave behind a residue, so it is not our 1st choice.

 STEP 4: Omega-3 Supplements

  • will help fight inflammation in the glands, as well as help the oil in the glands flow more readily. Here are the options
  • PRN brand, What makes PRN different from regular over-the-counter Omega-3s?Highly purified and concentrated. Natural triglyceride form for maximum absorption. No fishy after taste. Low cost per therapeutic dose. Go to or call 888-776-9144
  • Or 2ed choice ‘Triple Strength Fish Oil’ is a product that contains ALL the daily requirements. With a triple strength Omega-3, only 2 tablets per day are required. This can be purchased at GNC, near the Cornwall Square Food Court or a Life Brand Triple Strength fish oil can be purchased at Shopper’s Drug Mart.
  • OR 3nd choice – Over-the-counter Omega-3 from Fish Oil, should meet the following Daily Requirements: EPA + DHA (added together) = 2000mg per day Confirm with your pharmacist to ensure you are taking the correct daily dosage.
  • Only if needed, Artificial Tears like “Refrash Optive Advance” or “Systane Balance” – DO NOT USE VISINE OR MURINE!!. If you do the first 4 steps well, you might find yourself not needing artificial tears as you will be producing your own, which are much better and help the survival of the very precious Meibomian glands. The glands die if the first 4 steps are not done on time and properly. PLEASE SAVE YOUR GLANDS.
  • If you use the drops frequently, like more than 4 times per day, use a Preservative-free drops, to avoid toxicity from the preservative.


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