Lid/Orbit
Meibomian Gland Dysfunction
Also known as: MGD, meibomitis, posterior blepharitis, lid margin disease, Meibomian gland obstruction, meibum deficiency, lipid layer deficiency, posterior lid margin disease
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
A chronic gland-function disorder and common evaporative dry-eye mechanism. The primary problem is obstruction of the Meibomian gland orifices with qualitative or quantitative meibum change, causing lipid-layer instability. Blepharitis, Demodex, chalazia, and ocular rosacea may coexist, but this record is centred on gland obstruction, meibum quality, and evaporative tear-film failure.
Recognition
Symptoms: what patients report
- Bilateral burning, stinging, or foreign-body sensation — often worse in the morning.
- Dryness and gritty discomfort.
- Morning blur or lid stickiness related to unstable tear film, without lash-base crusting as the dominant finding.
- Variable vision, especially on waking.
- Eyelid redness and irritation.
- Symptoms worse in cold, dry, or air-conditioned environments.
- Recurrent chalazia — chronic, recurring lipogranulomata indicate underlying MGD.
Signs: what the examination shows
- Lid margin telangiectasia (dilated blood vessels on the posterior lid margin).
- Capping or plugging of Meibomian gland orifices — white or yellow paste-like material.
- Altered meibum on expression: thickened, turbid, or toothpaste-consistency expressate (normal meibum is clear and oily).
- Anterior displacement of the mucocutaneous junction (Marx's line shift).
- Posterior lid margin irregularity.
- Reduced tear film break-up time secondary to lipid deficiency.
- Anterior lash-base collarettes may indicate concurrent Demodex/anterior blepharitis rather than isolated MGD.
What OptoGuide™ covers for meibomian gland dysfunction
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Meibomian Gland Dysfunction (MGD) — EyeWiki
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- The Masquerade Syndrome. Peng MY, Kersten RC. JAMA Ophthalmology. 2017;135(2):161-162.
- Enlarging Mass of the Eyelid. Jethwa AR, Amin K, Khariwala SS. JAMA Otolaryngology-- Head & Neck Surgery. 2014;140(7):669-70.
- Inflamed Obstructive Meibomian Gland Dysfunction Causes Ocular Surface Inflammation. Suzuki T. Investigative Ophthalmology & Visual Science. 2018;59(14):DES94-DES101.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.