From the Guidelines
Treatment of preseptal meibomian gland dysfunction typically involves a combination of warm compresses, lid hygiene, and topical antibiotics 1. Warm compresses can be applied to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions 1. Eyelid cleansing can be accomplished by brief, gentle massage of the eyelids, and eye cleaners with hypochlorous acid at 0.01% have a strong antimicrobial effect 1.
Key Treatment Options
- Warm compresses: applied to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions 1
- Eyelid cleansing: brief, gentle massage of the eyelids, using eye cleaners with hypochlorous acid at 0.01% 1
- Topical antibiotics: such as azithromycin 1% ophthalmic solution, dosed at 1 drop twice daily for 7-10 days, or doxycycline 50-100mg orally twice daily for 7-14 days, to reduce bacterial load and inflammation 1
- Topical corticosteroids: such as loteprednol 0.5% ophthalmic suspension, dosed at 1 drop 4 times daily for 7-10 days, to control inflammation and prevent scarring 1
Additional Considerations
- In-office procedural treatments, such as vectored thermal pulsation, microblepharoexfoliation, and meibomian gland probing, may also be effective in improving meibomian gland function and reducing dry eye symptoms 1
- Topical lotilaner ophthalmic solution 0.25% has been found to be effective and safe in the treatment of Demodex blepharitis 1
From the Research
Treatment for Preseptal Meibomian Gland Dysfunction
- The treatment for preseptal meibomian gland dysfunction typically involves a combination of warm compresses, lid hygiene, and topical medications 2, 3, 4, 5.
- Topical antibiotics, such as azithromycin, have been shown to be effective in reducing the symptoms of meibomian gland dysfunction by decreasing the bacterial load and inflammation 3, 4.
- Azithromycin 1% ophthalmic solution has been proposed as a novel treatment for posterior blepharitis, with studies demonstrating significant improvements in meibomian gland plugging, meibomian gland secretions, and eyelid redness 3, 4.
- Other treatment options for meibomian gland dysfunction include nonsteroidal and steroidal anti-inflammatory agents, essential fatty acid supplementation, hormone therapy, and control of Demodex infestation 5.
- Procedures such as intraductal meibomian gland probing, electronic heating devices, intense pulsed light therapy, and intranasal neurostimulation may also be used to treat meibomian gland dysfunction 5.
Topical Treatments
- Topical treatments, including antibiotics, steroids, and lubricants, may be used to treat blepharokeratoconjunctivitis, a condition related to meibomian gland dysfunction 6.
- However, the evidence for the efficacy and safety of topical treatments for blepharokeratoconjunctivitis is limited, and further clinical trials are needed to determine the best course of treatment 6.