Meibomitis or Meibomianitis is an inflammatory condition of the Meibomian glands which is often seen in patients with acne or rosacea. Along the margin of the lids there are a series of small sebaceous glands called the meibomian glands. The meibomian glands create and distribute an oily substance called lipids. Whenever the eye blinks the produced oil coat the tear layer protecting it from evaporation. When a patient is affected by a inflammation the produced oil is less in quantity and worse in quality as a result quicker tear evaporation. In addition, these oils become stagnant and bacteria, usually staph bacteria, colonize inside the meibomian glands. Moreover, these bacteria produce toxins that cause the lids to become red and inflamed. The symptoms are different for each patient but most of the times are similar to common blepharitis.
As we described above, meibomitis occurs due to the fact meibomian glands do not work properly resulting the common bacteria already existed on eye to over-multiply. The most common causes are the following :
- Hormonal changes associated with adolescence
- Skin conditions, such as rosacea , acne or scalp dandruff
- Eyelash mites or lice
- Medications that increase bacteria on the eyelids, including isotretinoin for acne
- Some contact lens solutions
- Eye make-up
- Poor eye hygiene
- Poor nutrition
- Compromised immunity
Symptoms may vary but the most common are the following :
- Red eye
- Red eyelid margins
- Watery eye
- Dry eye
- Burning eye
- Blurry vision
- Foreign Body Sensation
- Light sensitivity ( especially in the morning hours )
The treatment is similar to common blepharitis treatments. This list below shows the most successful treatments of Meibomianitis.
- Warm compresses in the morning ( Apply clean hot towels on your eyelids helping oil in the glands to flow more easily )
- Lid hygiene ( a lot of cleaning solutions exist for the eyelid margins and eyelashes )
- Lid Massage ( massage on your eyelids will help oil to flow more easily )
- Eye drops for eye lubrication ( help with eye discomfort )
- Oral Antibiotics ( The purpose of the antibiotics is to not to kill the bacteria but to increase the quality of the oil. Antibiotic Treatment might last several months)
- Omega 3,6 & 9 diet ( Recent research proved that omega 3 acids diet or supplements help meibomian oil to restore its quality and stabilize inflammation. )
- Topical Steroids ( used in severe cases to reduce the inflammation and protect the eye from damage )
- Vitamin C and A
- N-acetyl cysteine
You should never ignore symptoms of posterior blepharitis. In some cases, it can cause complications such as:
- Styes (This is a painful infected swelling most prominent on the outside of the eyelid. It is due to an infection of the root of an eyelash)
- Dry eyes Syndrome
- Conjunctivitis (infection of the covering over the white part of the eye)
- Thickening, scarring, or notching of the eyelids
- Loss of eyelashes
- Ulceration of the cornea (the clear part of the front of the eye)
- Scarring and blood vessel growth in the cornea
- MGD (Meibomian glands are blocked by inspissated secretions)
Blepharitis generally is classified in two basic forms : posterior blepharitis and anterior blepharitis. Anterior blepharitis affects the outside of the eyelid where the eyelashes attach. Posterior blepharitis develops when oil glands in the inner eyelid allow bacteria to grow. A patient may be affected by both types on the same time. Many times ophthalmologists refer to Anterior blepharitis simply as Blepharitis and posterior blepharitis simply as Meibomitis or Meibomianitis.
What is the difference between MGD and Meibomitis ?
Many times Meibomitis or Meibomianitis is confused with the term “meibomian gland dysfunction” or MGD. In the 1980s, blepharitis, meibomitis, meibomian gland disease, and meibomian keratoconjunctivitis, among others term, has been used to describe the same condition. However, meibomitis ( or meibomianitis), are more specific to a subset of disorders which is caused due to inflammation. On the other hand, MGD is not necessary related to inflammation. In bibliography meibomitis is a synonym of posterior blephartitis.
Who can be affected by meibomianitis ?
Meibomianitis affects patients of all ages. It is not contagious and generally does not result in permanent eye damage. It is frequently occurs in people who have oily skin, dandruff, or dry eyes.
Is it possible Meibomitis and Dry Eye Syndrome to coexist?
Patients with dry eye suffer from decreased tear production or less quality tear which evaporates more quickly.The related symptoms get worse as the day goes on.On the other hand , people who are suffering from posterior blepharitis fill more dryness in the morning hours. These two eye disorders can coexist. A chronic meibomitis can lead to Meibomian gland dysfunction (MGD) . The inflammation’s products might block the meibomian glands resulting decreased tear production and eye dryness.
Are there any food that patients should avoid ?
Patients should focus on a diet that is designed to lower inflammation. Processed foods, such as high-fat meats; dairy products; foods that contain sugar; and fast foods must be avoided. Moreover, meat that contains nitrites and saturated fats should be limited or select lower-fat versions.