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Meibomian Gland Dysfunction2021-04-29T10:56:39+00:00

Meibomian gland dysfunction (MGD)treatment to help you focus on what matters

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What is meibomian gland dysfunction (MGD)?


Everything you need to know about meibomian gland dysfunction (MGD)


Meibomian Gland Dysfunction (MGD) refers to inflammation of the eyelids and is by far the most common cause of dry eyes.

MGD can lead to red, flaky skin on the eyelids and sore, red, gritty eyes. Often patients will feel as though their eyes are stuck together in the morning due to the sticky deposits on their lids and lashes.

You may also experience:

• Blurred vision
• Recurrent corneal infections or erosions
• Persistent eye fatigue
• A pressure feeling behind the eyes
• Watering eyes

Each eyelid contains a row of meibomian glands. Their job is to secrete the critical oil layer of the tears.

In MGD, the secretions from the meibomian glands become thick and viscous, so not enough is secreted in the tear film. This creates an imbalance and unhealthy tear film that is ineffective in moisturising the eyes. This leads to dryness, blurred vision, redness and pain.

There are three essential layers in our tears. They must all be present in balanced quantities for our tears to moisturise the eyes effectively.

  1. The innermost layer
  2. The aqueous layer
  3. The outermost layer

The outermost layer is the layer that is deficient in the oil that is secreted by the meibomian glands.

Risk factors

  • Age: the number of meibomian glands goes down over time.
  • Ethnicity: Asian people are three times more likely to get MGD than people with European ancestry.
  • Wearing contact lenses

Common medical issues linked to MGD include:

  • High cholesterol and triglycerides
  • Allergic conjunctivitis and other eye diseases
  • Inflamed or damaged eyelid or cornea
  • Bacterial infection
  • Autoimmune diseases like rosacea, lupus, rheumatoid arthritis, and Sjögren’s syndrome

Some medications can cause problems with oil production, including:

  • Estrogen replacement therapy
  • Drugs that reduce androgen
  • Retinoids, from acne medication to anti-ageing creams

We will closely examine your eyelids to inspect the meibomian gland openings. Applying pressure to your eyelid will enable us to observe the contents of the meibomian glands and enable us to determine if you have meibomian gland dysfunction.

Treatment of your meibomian gland dysfunction will help to restore all of the layers of the tear film to a normal healthy state. 

E-Eye (IRPL) Treatment

At Eye Clinic London, we are excited to announce the E-Eye. The E-Eye is a revolutionary device for the treatment of dry eyes due to blepharitis/meibomian gland dysfunction (MGD). We are the very first ophthalmologist led clinic to offer this treatment it in London.

The E-Eye uses intense regulated pulsed light, or IRPL, which has been designed precisely for treating dry eyes caused by MGD. It is the first and only medical device in the world to do this.

The E-Eye device creates polychromatic pulse light using the new IRPL (intense regulated pulsed light) technology.

The E-Eye releases a flash of light that is made up of a pulse train, which we flash on the treatment area (cheekbone and temple area around the eye). Nerve branches are within this treatment area. These nerve branches connect to meibomian gland nerves. When we flash these nerve branches with the E-Eye (IRPL), it causes a stimulatory response within the meibomian glands. The glands resume secretion of the healthy oil layer again, and symptoms of eye dryness will disappear.

Accordingly, it is effective in 80% of patients affected by dry eye disease.

From a single flash of IRPL, it is possible to produce sub-flashes of varying intensities. That offers unparalleled therapeutic potentials, especially with the treatment of MGD, which is impossible with conventional IPL.

The E-Eye emits a ‘cold light’, and it is non-invasive, totally painless and entirely harmless to the eyeball.

The E-Eye is useful in all cases of dry eye disease that is related to MGD.

The length of the treatment’s efficacy increases with the number of procedures completed. Sufficient for one week after the first treatment, 2-3 weeks after the second treatment and six months to more than two years after the third or fourth treatment. We can genuinely say it is a long term relief of MGD.

Here are a few facts directly from the makers of the E-Eye device:

  • No. 1 dry eye solution to treat Meibomian Gland Dysfunction (MGD).
  • In 2015, over 35,000 patients were treated with the E-Eye worldwide
  • 84% efficiency from the first session
  • + 86% satisfaction rate, proven capability on mild, medium and severe dry eye
  • Three clinical studies conducted on over 300 people
  • Up to 18-month relief for the patient
  • More than 100% increase in the break-up time
  • 100% satisfaction amongst users

MiBoThermoflo treatment

Eye Clinic London is also one of the few practices in the world to give special attention to dry eye disease with MiBoThermoflo.

With the MiBoThermoflo device, we apply continuous controlled heat to the outer skin of the eyelids along with ultrasound gel for a gentle massage. The heat is absorbed deep into the tissue and breaks down the hardened oils in the meibomian glands. 

With a specific prescribed therapy regimen, the ducts of the meibomian glands will secrete thinner and clearer oils which will allow for a healthier tear film. 

Benefits of the treatment include: 

  • No pian
  • No downtime
  • No side effects
  • Very relaxing
  • Wonderful for eye strain
  • Great therapeutic massage with lasting benefits
  • 98% patient satisfaction
  • Most patients feel immediate relief after the first treatment

Dry eye lifestyle advice

Omega-3 capsules

Taking a high dose of Omega-3 oils (such as fish oil) helps MGD and other dry eye conditions significantly. There are two essential benefits. The essential fatty acids in Omega-3 capsules are crucial in producing potent anti-inflammatory prostaglandins. This anti-inflammatory effect reduces the inflammation that occurs in blepharitis and other dry eye conditions. The high dose of Omega-3 fatty acids also improves the health of the oil secreted by the meibomian glands. That leads to a healthier and more effective tear film and more comfortable eyes.

High doses of Omega-3 fatty acids are required to achieve a significant improvement in MGD and dry eye. General pharmacy bought fish oil capsules are rarely potent enough to help dry eye. Dr Cronin will suggest an appropriate brand and dose depending on the severity of your condition.

Dry eyes make eyes dryer

When your eyes are dry, the tears become too salty. This high salt concentration can damage some of the cells that help to produce tears, thus making your eyes drier. It is important to use lubricating drops to reduce the salt concentration and break this cycle. Your eyes need a chance to recover and return to a healthy, comfortable state.

Drink more water

Remember that if you are dehydrated, your eyes will be as well. So make sure you drink plenty of water and avoid excessive tea and coffee.

Control your environment

The environment around you plays a significant role in dry eye treatment. Wind, fans, cold air-conditioning and warm heating all have a drying effect, which means that you will have excessive evaporation of your tears.

Increasing the relative humidity and protecting your eyes from the direct flow of air will reduce the drying of your tears.

Follow these simple steps:

  • Wear glasses or wraparound sunglasses when outside in the breeze, this will stop the wind blowing directly into your eyes. If you need spectacles, choose frames with thicker arms to “enclose” your eyes more and protect them from the wind.
  • Ensure you are not near a fan or air-conditioning vent. The ‘gentle’ flow of air from heating or cooling systems are not gentle on your eyes – it can be very drying. Create a barrier between your eyes and the flow of air by moving your chair or desk. That is also important in your sleep, as many people with dry eyes sleep with their eyes very slightly open.
  • Go green! Consider using plants to raise the humidity in your work area. Plants not only form an excellent barrier to stop the direct flow of dry air-conditioning air into your eyes, but they also raise the local humidity. Pick water-loving plants with big leaves as they will release more moisture into the atmosphere than a cactus!
  • Make an oasis. Florists use a product called ‘oasis’ or floral foam in flower arrangements. It is excellent for creating a large surface area for water to evaporate and raise the local humidity. Put some oasis into a bowl of water with most of the oasis sitting out of the water. That will cause the water to evaporate and raise the humidity. You can still put real or artificial flowers in the foam to make it look appealing.
  • Avoid smoking and smoky environments.

How my eye care services work



To get the answers to all your questions, give us a call or click the button below to book a free video appointment with an optometrist or our Consultant Ophthalmologist, Samer Hamada.

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Samer Hamada and Eye Clinic London enable Londoners to experience relief from their eye problems so they can focus on what matters most.

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Happy patients from London and East Grinstead


Annabel Giles

“As soon as I met Mr Hamada, I knew I was in safe hands. He is an expert in his field, and very reassuring. His work was impeccable, and I would thoroughly recommend him to anyone wanting a professional, kindly, expert service.”

Tareq Kasshout

“I came all the way from the US to be evaluated by Mr. Samer Hamada who provided me with a world class experience. I was treated with technology that doesn’t exist in the United States. My vision improved significantly since the surgery. Mr. Samer Hamada is definitely a Keratoconus expert.”

Timothy Thompson

“Mr Hamada’s Eye Clinic London and his team are a delight. Nothing was too much trouble and the help, support, advice and guidance before during and after the surgery was all world class. I have worn glasses since the age of 13 years and had the onset of cataracts for the last five so it has all been very much a life changing experience to be free from glasses once more.”

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During this COVID period you don’t have to suffer with dry eyes. Get some relief by booking a video appointment with our Consultant. You’ll receive expert advice and a prescription (if necessary) to provide you with a soothing solution from the safety of your home

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“As soon as I met Mr Hamada, I knew I was in safe hands. He is an expert in his field, and very reassuring. His work was impeccable, and I would thoroughly recommend him to anyone wanting a professional, kindly, expert service.”

Annabel Giles, Lens replacement

“I came all the way from the US to be evaluated by Mr. Samer Hamada who provided me with a world-class experience. I was treated with technology that doesn’t exist in the United States. My vision improved significantly since the surgery. Mr. Samer Hamada is definitely a Keratoconus expert.”

Tareq Kass Hout, Keratoconus
“I am glad to be with Mr Hamada. I am glad to be examined by Mr Hamada who acts responsibly and professionally. I never had this experience before from a previous ophthalmologist. I am thankful to Mr Hamada for the successful diagnosis and treatment of my case.”
Ghiath Sumainah

“What a Consultant. Dr. Hamada is a man who was born for this profession. As soon as we walked into the room you felt that you had met a man who was gentle and kind. His demeanour was of a man who knew his trade. He speaks in a way that you will understand. He explains exactly what is wrong and the way he will help fix it for you.”

Sam Brock

“My eyes got really sore, tired and gritty feeling this year. It kept getting worse for about 6 months and every time I thought about it, I kept thinking it would eventually go away, but it just didn’t budge. So I want to say a big thank you to eye doctor Mr Samer Hamada who finally sorted me out! Apart from the eye tests I expected, he also took a really personal approach. I appreciate that he asked questions about my whole diet and lifestyle which helped him to quickly figure out why my eye surface was inflamed. I now have simple steps I can take to reduce the inflammation through diet and lifestyle changes which I’ve now been doing for 2 weeks. I also have been using the special non-preservative eye drops and gels that Mr Hamada provided. My eyes are already feeling so much better and I’m so relieved to have had help to sort this out. If you’ve been noticing your eyes getting dry – don’t wait to sort it out as it keeps getting continually worse and you can find relief very quickly with the right help.”

Laura Livesey, Dry eye

“Mr Hamada’s London Eye Care and his team are a delight. Nothing was too much trouble and the help, support, advice and guidance before during and after the surgery was all world class. I have worn glasses since the age of 13 years and had the onset of cataracts for the last five so it has all been very much a life changing experience to be free from glasses once more.”

Timothy Thompson

“We saw Mr Hamada after our 14-year-old son was diagnosed with keratoconus by another specialist. Mr Hamada talked us through the pros and cons of the cxl epi off and epi on procedures, he answered all our many and detailed questions without rushing us and as openly and honestly as possible. We opted to go ahead with cxl epi off with Mr Hamada. Our experience with Mr Hamada and his team, from his incredibly informative and supportive Secretary Joanna, nurse Mimi and Mr Hamada himself who was incredibly reassuring and put us and our son at ease both before, during and after the procedure, and at each follow-on appointment, has been the best possible. I would go so far as to say that he and his team are by far the best medical team I have ever experienced. I recommend him highly and would be happy to speak to anyone considering an expert in this field.”

Lisa & George, Keratoconus

“I would not hesitate to recommend Dr Hamada and his team. From the first call to inquire about booking an appointment to booking it, I was so impressed with his wonderful secretary Joanna- she really is worth her weight in gold, her lovely manner and care made me decide to go for this clinic. Dr Hamada was a lovely man with a very kind and thorougher way about him – he put my 4-year-old daughter at ease. The appointment was lengthy but at no point were we rushed and able to ask as many questions- things were explained so well. I would have no hesitation at all to recommend anyone to use Dr Hamada and his team- I have already recommended to some other parents.”


“Mr Hamada, his assistant Joanna and his ophthalmic technicians provide a caring, efficient and high quality service. From the admin through to the surgical aftercare we were very well looked after and we had a high degree of confidence in Mr Hamada’s abilities. Our daughter’s cataracts have been corrected (under general anaesthetic) and her quality of life has improved substantially. You also feel well cared for throughout – the human touch is vital in healthcare, but not always delivered, so well done and thanks to all of the team.”

Nat & Rich
“We were referred to Dr.Hamada by one of the UK experts. The expert himself admitted that Dr.Hamada was better than him!! We were not disappointed at all. Dr. Hamada was excellent with my child. His communication skills and knowledge were exemplary. He gave us clear management plan and would not hesitate to recommend him.”
V Nama
“Dr Hamada is an excellent, highly competent doctor with a very kind and sympathetic manner. His reputation for successfully treating dry eye patients seems unparalleled. His team are all extremely friendly and helpful, especially Dr Hamada’s PA Joanna, making the overall experience better than anywhere else I’ve been!”
Isla Cully, Dry eye
“Appointment setting and follow-up were very efficient and well managed. Mr Hamada was kind, reassuring, knowledgeable and had a very warm manner with my young son, making him instantly feel at ease. I feel that we can trust him and that he will finally be able to solve my son’s long-term eye problems that have stumped other eye doctors.”
“A real care provider – true in letter and spirit. After having seen few other consultants we were lucky to see Mr. Hamada. He treated my mother’s eyes and the prolonged inflammation finally went away. My mother went on to receive a corneal graft. Mr. Hamada and his clinic are simply wonderful. Their response is immediate every time even if it’s the weekend. Mr. Hamada puts a lot of personal attention answering every question very patiently and alleviating any fears. His manner is so kind that puts his patients completely at ease. This caring trait continues in the rest of his staff especially his assistant Joanna. I really can’t thank them enough. I thoroughly recommend anyone with eye problems to go to Mr. Hamada. You couldn’t be in better hands. He has treated my mother who is a long sufferer of eye problems. I am grateful always to Mr. Hamada and Joanna for all the support they have provided throughout.”
Charmaine Ghafur

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About the expert

Mr Samer Hamada | Consultant Ophthalmologist and Corneal Surgeon

MD, MSc, DO (hons), FRCSEd, FRCOphth I am Samer Hamada, founder and consultant ophthalmic surgeon with over 20 years’ experience in ophthalmology. I am a world-renowned specialist in cornea, cataract and refractive surgery. I’m not only a leading surgeon but also the only dual fellowship trained in corneal diseases in children from reputable institutions in the UK. At Eye Clinic London I work closely with other consultant ophthalmologists, optometrists and orthoptists to achieve the best outcomes for our patients. Our main aim is to make sure our patients get the safest and best treatments available to them. We put your safety before anything else so you can rest assured that if you choose us you will be in the best and safest hands.

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