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How to treat meibomitis?

Q: I am suffering from maebomitis since (I feel) around 10 years.I have already consulted around 8 to 10 eye specialists in these years but not of any real good help to me. I always have a burning sensation in my eyes. I also have drowsiness thruout the day. The dostor i am visiting now has suggested me wipe eyes with lukewarm water for 5 to 10 mins in the mornings & nights.Tears plus a lubricant & ciplox an ointment to apply to the eyes after the washing of my eyes at night times. but till now I havent found any better.The only advantage of the washing of my eyes will be I will be off to sleep very quickly. Can you suggest if you have any therapy or medication.

A:Meibomian gland dysfunction (meibomitis) is a very common cause of eye irritation and redness. Meibomian glands are present embedded within the upper and lower eyelids, and they produce a oily secretion which forms an important part of tears. If the character of this oily layer is abnormal, tears will not be stable and the eye will dry out faster causing a dry eye condition. You will then experience burning and sandy feeling in the eye and the eye will be red.In the US, approximately 60% of meibomian gland dysfunction is caused by a condition of vasomotar instability called ROSACEA. Meibomian gland dysfunction can be controlled but not cured. The mainstay of treatment is to give systemic antibiotics - tetracyclines or doxycycline -for about 6 weeks and then to taper the dose down slowly. You may either come off the antibiotics or may require a low dose for several months. Tetracyclins are contraindicated in pregnant women and in children below 10 years of age. In addition to tetracyclins, warm compresses and scrubbing the eyelid margin with a gentle shampoo (diluted Johnsons baby shampoo) to remove the oily secretions will reduce the burning sensation. You may also need preservative free artificial tears or a brief course of steroid eyedrops. In general antibiotic eyedrops are not needed because the underlying problem is inflammation - not infection. The use of erythromycin eye ointment at bedtime once a day is all that is needed in terms of antibiotics. Talk to your ophthalmologist about this treatment.It is important to differentiate Meibomian gland dysfunction from seborrheic blepharitis. In this condition systemic tetracyclines are not that important - but the rest of the treatment stays the same.

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