A sensation of dry and irritated eyes in the mornings does not necessarily mean that one has dry eyes from lack of tear production. Many times, it suggests that there may be a problem with the meibomian glands along the eyelid margins.
The meibomian glands secrete oils which help to keep the tear film stable on the surface of the eye. In meibomian gland dysfunction (MGD), the secretion of the meibomian glands are thickened and inflamed. The secretions seep onto the eye surface when you sleep, causing redness, irritation and discharge. After waking, the blinking of the eyelids slowly washes the secretions away, and the eyes begin to feel better. This condition is also known as meibomitis or posterior blepharitis.
Because the secretions do not work properly, tears are more prone to evaporation. In the San Francisco Bay Area, MGD is commonly seen because of prolonged staring with the use of computers and mobile devices. Taking breaks from staring may improve symptoms, but does not improve the underlying MGD pathology.
Traditional treatments include warm compresses to soften the clogged meibomian secretions and lid massages to encourage the outflow of these secretions. Prescription medications to treat MGD include oral doxycycline and Azasite eye drops. There is even a procedure called meibomian probing that can physically open up the pores for improved flow.
At the San Jose Eye Institute, we have been very successful with using the latest generation of oral omega-3 fish oil. The anti-inflammatory properties of the omega-3 in the fish improve the quality of the meibomian secretions, treating MGD at its root cause. Because there are variations in absorption and individual needs, we will sometimes test omega-3 blood levels to titrate dosing in order to achieve the most optimal results.
If you have dry eye symptoms, we can see if MGD is a contributing factor and help plan the best course of action.