MGD explanation

[odydnas]

Hi Dr. Bazan,

Thank you for making yourself available on this board and for answering all our questions!

With that said, I have a kind of general question, in which the answer may involve a lot detail, which I apologize in advance for.

I was wondering, what does it really mean to have meibomian gland dysfunction? Are there different types of meibomian gland dysfunctions?

In my overly simplistic view, I can up come w/ different scenarios of mgd. Such as, your glands are somehow not producing any more oil, or the quality of the oil is bad therefore clogging accords deep in the glands and no oil or thick oil come out, or somehow you could have scarring of your glands and therefore the openings are closed up? I mean, can one have some kind of congenital defect where the number of glands or morphology of the glands are abnormal, but you don't feel irritation until your late teens and beyond?

In your view, if there are different scenarios for mgd, how would you treat each patient differently? Is it even possible for a doctor to figure out the cause of each person's mgd?

Thank you so much!!!

[Justin]

Hi Dr. Bazan,
I was wondering, what does it really mean to have meibomian gland dysfunction? Are there different types of meibomian gland dysfunctions?

Thanks for you post. I love answering posts like this. A dysfunctional MG. Think about it. To me it simply means the MG's are not performing as they should. How many types of MGD depends on who is defining it. I don't think there are formal types of MGD but it is certainly a complicated condition with many variations.

It is clear that MGD has different causes and presentations. One could classify it into different types. I can understand the reason for the dysfunction being utilized as the defining point of reference. If possible I like to break things down to facilitate a more specific understanding. Ex. MGD 2ndary to obstruction from rosacea, with scant amounts of opaque meibum.

How many types? I do not know, I am not sure if anyone has ever sat down and came up with every scenario and combination.

In your view, if there are different scenarios for mgd, how would you treat each patient differently? Is it even possible for a doctor to figure out the cause of each person's mgd?

Its a matter of combining the eye docs expertise, experience, clinical skills with the patients motivation, compliance, and understanding, in a way that is most effective. If we can find out a root cause for the disease, that is a great place to initiate the appropriate treatment.

It might not be possible to figure out the cause(s) of each person's mgd. But that is not to say we can not begin by reducing the signs and symptoms of the disease that we do see. Different scenarios may share similar treatments, but each patient is treated individually.