Eye Lubricants

Consider ocular lubricants with lipid-containing supplements. These help to supplement abnormal lipid production, as they closely mimic the oil layer of the tear film that is secreted from the meibomian glands.

1. NovaTears (PBS) and NovaTears + Omega-3

Eyelid/Eyelash Hygiene & Warm Compress

1. Eyelid and Eyelash Cleansers
   • Helps clear away everyday debris, crusting or flaking that builds up on your eyelashes.
2. Warm Compress
   • Warm compresses can supercharge your meibomian glands, making them function better.
   • When your meibomian glands are warmed, they release lipids (fat), making your tear film stronger.

Meibomian gland dysfunction

<aside> 💡 Develop a daily eye hygiene routine and perform it once or twice a day!

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Prescription Antibiotic Treatment

Topical Antibiotics

• Topical broad spectrum antibiotic ointment for severe staphylococcal blepharitis with good gram+ coverage.
  • Dosage: Apply directly to lid margin for 7-10 days.
• Topical ocular 1% Azithromycin (AzaSite), requires compounding in Australia.
  • Dosage: 1 drop twice a day for 2 days then 1 drop once a day for 12 days.
  • Caution in patients who are already at risk for cardiovascular events.
  • Studies have shown the results of topical Azithromycin showed more superiority over those of taking oral Azithromycin.

Oral Antibiotics

• Doxycycline - Anti-inflammatory and Lipid regulating

  At high doses (100mg or 200mg twice a day), doxycycline acts as an antibiotic and anti-inflammatory.

  In lower doses, 20mg-50mg daily, doxycycline acts primarily as an anti-inflammatory for patients with rosacea or blepharitis. Anti-inflammatory properties are particularly important for healthy meibomian gland secretions.

  • Dosage: 50mg twice a day for 1-2 weeks, reduce to 25mg once daily for 1-6 months.

• Azithromycin

  • Dosage: In adults, it is often 500mg for three days, repeated in three to four months.
  • Caution in patients who are already at risk for cardiovascular events.
  • It should also be acknowledged that there is a lack of high-level evidence supporting the use of oral azithromycin in meibomian gland dysfunction yet.

Current evidence suggests that both topical and oral antibiotics appear to have substantial short-term benefits when used to manage meibomian gland dysfunction. However, diminishing positive effects with time after completed treatment were also reported and evidence for lasting improvement after completed treatment was lacking.

<aside> 💡 We also recommend to take probiotics to support gut health while taking oral antibiotics

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In-Office Procedures