Your eyes need lubrication and moisture to function properly. Small glands in the eyelids known as meibomian glands secrete oil that covers and protects the surface of your eye. If these glands malfunction they may become inflamed or produce an excessive amount of oil. This condition is known as meibomianitis, or posterior blepharitis.
What causes meibomianitis?
Meibomianitis occurs when the meibomian glands in the eyelids don’t work properly. Excess oil released from these glands will accumulate on the eyelids. As the oil accumulates, bacteria that are normally present in the eyes and skin begin to multiply.
Any condition that increases the oil produced by these glands will cause this disorder. Examples include:
- hormonal changes associated with adolescence
- skin conditions, such as rosacea or acne
- eyelash mites or lice
- medications that increase bacteria on the eyelids, including isotretinoin for acne
- some contact lens solutions
- eye makeup
In some cases, there’s no identifiable cause for meibomian gland malfunction, but it’s not contagious. This condition is more common in adults than children.
What are the symptoms of meibomianitis?
The symptoms of meibomianitis can be very uncomfortable and may include:
- watery eyes
- redness and swelling of the eyelids
- gritty, burning sensation in the eyes
- itchy eyelids
- skin flaking around the eye
- crusted eyelashes after sleeping
- sensitivity to light
- frequent sties, which occur when an inflamed oil gland along the edge of your eyelids causes a bump
- excessive blinking
- blurred vision
- eyelashes that grow abnormally, or misdirected eyelashes
- loss of eyelashes
- dry eyes
Some people with this condition may experience only mild symptoms, while others will experience symptoms that cause considerable irritation and discomfort. If you have any of these symptoms, you should make an appointment to see your doctor.
How is meibomianitis diagnosed?
If you have symptoms of meibomianitis, your doctor will examine your eyes. This exam will focus on your eyelids and the front surface of your eyeball. Using bright light and magnification, your doctor will be able to view your eyelids to see if you have blocked meibomian glands.
Your doctor may also use a swab to collect a sample of the crust or oil from your eyes. Your doctor will send this sample to a lab to be tested for bacteria.
How is meibomianitis treated?
If you receive a meibomianitis diagnosis, there are several treatments your doctor may recommend. To reduce symptoms of meibomianitis, you may need to clean your eyelids regularly with a warm washcloth. In some cases, this treatment may be the only method for controlling symptoms.
Depending on the cause of your meibomianitis, your doctor may prescribe antibiotics or steroids to treat your condition. Antibiotics may be in the form of eye drops or creams applied directly to your eyelids, or they may be in pill form. Steroids may help reduce inflammation.
Your doctor might recommend artificial tears if you experience dry eyes as a result of the condition.
If you wear contact lenses, you may need to stop using them during treatment. If you wear eye makeup, your doctor may recommend that you stop using it during and following treatment.
If you have an underlying cause, such as acne or rosacea, your doctor may prescribe medications to treat these disorders.
Your doctor might also perform a meibomian gland expression procedure. It will clear the oil and crust from your meibomian glands. Your doctor will massage the eyelids to unblock them.
How can I prevent meibomianitis?
In some instances, you won’t be able to prevent meibomianitis. However, proper eye hygiene will help stop bacteria growth. You should also seek treatment for skin conditions, such as acne or rosacea, which can lead to the disorder. Certain foods, including chocolate, may make your symptoms worse. If you've had meibomianitis in the past, you might want to avoid these foods to help prevent it from happening again.
What is the long-term outlook?
It’s important to remember that you won’t lose vision as a result of the condition. Unfortunately, the symptoms of meibomianitis can be uncomfortable and require you to seek treatment.
While meibomianitis is curable, people who develop this condition often get it again even after successful treatment. Treatment can be difficult because results aren’t usually immediate. Treatment, however, is effective and will reduce your symptoms.