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    Understanding the link between MGD and OSD

    Atlanta—Meibomian gland dysfunction (MGD) may be misdiagnosed. While MGD is one of the most common chronic ocular conditions, diagnosing MGD isn’t as simple as it seems.

    ODs must improve on identifying the differences between dry eye and MGD to effectively treat each disease, says Optometry Times Editorial Advisory Board member Ben Gaddie, OD, FAAO, at SECO 2017.

    “There are quite a few people who think that all dry eye is MGD,” says Dr. Gaddie. “That’s too simplistic.”

    While inflammation and MGD are separate, they are conditions that often appear together in symptomatic dry eyes.

    “They’re actually congruent diseases—they co-exist,” says Dr. Gaddie.

    Previously from Greg Hill: Stem cells offering faint cure possibility for glaucoma

    MGD components contribute to symptoms

    Many patients presenting with dry eye symptoms suffer from a lack of meibomian gland expression. Dr. Gaddie believes that MGD has two primary components:

    • Inflammatory

    • Evaporative

    He says the mucin layer of the eye is a key evaporative component of MGD and dry eye symptoms.

    “If you don’t have a pristine mucin layer, you could have evaporation,” says Dr. Gaddie. This evaporative balance is a critical part of tear film quality and eye health overall.

    In Dr. Gaddie’s opinion, both of these factors must be addressed during dry eye therapies.

    He says that many ODs attempt to manage symptoms by using drugs like Restasis (cyclosporine, Allergan) or managing MGD on its own—but neither strategies alone are enough.

    Related: How to know when it’s not dry eye

    “If you do only one of the two, you’re going to halfway treat this disease,” says Dr. Gaddie.

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