Are Contact Lenses Bad When You Have Meibomian Gland Dysfunction (MGD)?

Many of my patients question whether their contact lenses are making their Meibomian Gland Dysfunction (MGD) worse. And should they continue to wear contact lenses full time?  It's a simple but complicated answer and really depends on the patient case. I'm a fan of prevention and long term solutions for better health. What you're about to read is how I talk to patients in the exam room. No sugar coating available:)

 

 

 

 

 

 

Understanding Meibomian Gland Dysfunction

 

What Is Meibomian Gland Dysfunction?

 

Meibomian Gland Dysfunction (MGD) occurs when the tiny oil glands (called meibomian glands) along your eyelid margin become plugged or inflamed. This is an inflammatory condition. Without a steady flow of lipids, your tear film destabilizes. The result can be dryness, irritation, and recurrent inflammation.

 

 

Why Inflammation Matters

 

Ongoing inflammation damages gland openings. Eventually, oils can thicken and clog. That leads to styes, chalazia, and persistent evaporative type dry eye.

 

 

 

How Contact Lenses Contribute to Flare Ups

 

Foreign-Body Response

 

A contact lens on the eye surface is interpreted as a foreign body no matter how you slice it. A contact lens just happens to be foreign object you are putting into your eye on purpose.  Your immune system is smart. It will perceive the contact lens as an intruder and release inflammatory molecules and cells such as cytokines, histamine, neutrophils and eosinophils. This is normal, even for a perfectly healthy eye. Add an eye with MGD which already has inflammation - now you have increased the inflammatory response. 

 

Mechanical and Depositional Factors

 

Over the course of a day, proteins (called lysozymes) and lipids deposit on the contact lens surface. The proteins and lipids come from your tears. Some patients "deposit" more protein and/or lipids than others. These deposits, especially with contact lenses that are replaced every 2 weeks or monthly - can rub against the eye causing even more foreign-body response (as mentioned above).  

 

These contact lens deposits can also contribute to inflammation. In particular, when tear proteins denature and accumulate on the contact lens surface - they can trigger an inflammatory response in the eye as explained above. 

 

 

Pollution & Allergy Consideration

 

Take all the information above and add sources of irritants that can also increase inflammation: dust, debris, pollen, bad air - your contact lens is a fly trap for these things! Love that clean, fresh feeling with a brand new contact lens? It's because a brand new contact lens doesn't have all this muck mucking up the lens yet. 

 

 

Eyelid Hygiene: Your First Line of Defense

 

This is the eye care routine I have my MGD patients use once a day before bedtime. It also helps their contact lenses feel more comfortable. The MGD Cleansing System  uses 2 cleanser and 2 tools to keep MGD signs and symptoms in a place of prevention. The goal is to have no more flare ups so that contact lenses can be comfortable and vision can be clear throughout the day. 

 

 

 

Contact Lens Strategies for Meibomian Gland Dysfunction

 

Choosing the Right Contact Lens

My go to choice for my patients with MGD is the very unpopular GLASSES ONLY route. Electing NO CONTACT LENSES will work the best. For my patients who insist on contact lenses, I have them use daily disposables ONLY. My daily disposable lens of choice is Dailies Total1. Imagine wearing a drop of water that corrects your vision. Yep that good. Plus NO MORE UNNECESSARY INFLAMMATORY RESPONSE.

 

Choosing the Right Contact Lens Cleaner Solution

Although Dailies Total1 are available in many prescriptions including astigmatism, they do not cover ALL prescriptions. For those unlucky patients, I do have them in a 2 week or 1 month planned replacement contact lens. My MGD patients are NOT allowed to use those multipurpose contact lens solutions for cleaning. ALL OF MY PATIENTS USE the most inconvenient but most effective contact lens solution for cleaning: Clear Care. It's a love-hate relationship lol.

 

Not perfect compared to a fresh, new lens everyday, but in my clinical experience - far superior when it comes to removing protein when compared to multi-purpose cleansers. Remember - you're just putting soap in your eye when using a multi-purpose - defeating the whole purpose of trying to reduce inflammation. 

 

 

 

 

Hi, I’m Dr. Tanya Gill, optometrist and founder of We Love Eyes. I started We Love Eyes in 2014 while trying to help one of my (stubborn) patients with contact lens discomfort. In 2016, I had 3 products. Fast forward to today - We Love Eyes has almost 30 SKUs. It’s been an amazing journey. Explore my life’s work at weloveeyes.com. Check out the GOT AN EYE PROBLEM section to discover my cleansing systems. I also have a ton of content at TIKTOK . See the profile page and see the playlists for STYES, STYE POP, STYE SURGERY, CHALAZION DRAINING, MGD and more. PS: my MGD doesn't allow me to wear contact lenses. I'm a glasses only gal, xo.

 

 

 

 

 

• Meibomian Gland Dysfunction MGD

• MGD Eye Care Cleansing System

• daily Dailies Total1 contat lenses

• eyelid hygiene routine

• posterior blepharitis treatment

• contact lens inflammation

• eyelid massage tools

• We Love Eyes eye care systems