Meibomian Gland Dysfunction | Common Cause of Dry Eye

Meibomian gland dysfunction, also known as MGD, is one of the most common causes of dry eye.  Dry eye afflicts hundreds of millions of people worldwide.

The video below demonstrates a clear case of dry caused by meibomian gland dysfunction.  There is also some secondary inflammation of the lids, called blepharatiis, which is often found together with MGD.

Symptoms of Dry Eye

Dry is caused either by decreased tear production, or, as in this case increased tear evaporation due to insufficient meibom (see below).

Symptoms of dry eye can include:

  • Tearing
  • Light sensitivity
  • Gritty sensation
  • Blurry vision
  • Intolerance to contact lenses
  • Exacerbation of allergies

Normal Tear Film

The normal tear film is composed of 3 layers:

  1. Oily top layer (also called meibom)
  2. Tears/aqueous (water) layer
  3. Mucin (allow tears to spread evenly)

The most superficial layer is an oily layer which prevents rapid evaporation of the tears.  The oil is produced by the meibomian glands and is called meibom.  The are dozens of glands along the edges of each lid.

Meibomian Gland Dysfunction

In a normal situation, oil from the meibomian gland is expressed from the glands onto the tear film.  The oil floats on the tears and protects against evaporation.

If there is insufficient “meibom,” the tears evaporate faster and produce dry eye.

In MGD, blockage of the meibomian glands prevents the oils from being secreted, or, as in this case, the oily meibom is abnormally thick and not be secreted.


Normal meibom is liquid oil.  The secretions in this patient are as thick as toothpaste.  This is a great demonstration of a patient who has dry eye due to the inability of the glands to secrete the meibom (oil) because it is simply too thick.

Heat and manual expression, as in this case, may be helpful in allowing the meibom to be secreted normally.  There are other treatments available.

If you suffer from dry eye or have questions about meibomian gland dysfunction, please give us a call.

We look forward to seeing you. If you would like to make an appointment or if you have questions, please call us.

Gregory Scimeca, M.D.
Ophthalmologist and Medical Director

Burlington County Eye Physicians
Eye Professionals, LLC (Millville, NJ)
Eye Physicians and Surgeons of Bucks County (Langhorne, PA)