Do environmental stresses worsen your meibomian gland dysfunction (MGD) and dry eyes?
Yes, they certainly do.
If you are in a dry atmosphere with low humidity, there are going to be abnormalities in your meibocytes (cells in your Meibomian glands) and an alteration in the quality of the meibum that you produce. In other words, environmental stress causes the actual cells within the meibomian glands to alter.
The protein to lipid ratio in the meibum alters, the meibocyte differentiation becomes irregular, and even the meibocyte stem cells become depleted.
All these factors become interrelated and worsen the Meibomian Gland Dysfunction (MGD)
The meibum that you produce with environmental stress contains more protein than it should because of increased proliferation of some of the cells within the gland and ductal dilation.
However, in the long term, the number of functioning meibocytes depletes, and the dilated gland subsequently atrophies and produces less oil. A higher protein to lipid ratio within the meibum increases its viscosity, and this has an adverse effect, i.e. an adverse impact on your tear film stability.
Essentially, thicker oil with more protein on it is less efficient, causing its role of being a fine layer of lipid across your aqueous tear film in front of your cornea and conjunctiva to be compromised. Therefore, dry spots appear more easily, and dry eye disease ensues, which can be quite symptomatic.
Together with ageing, environmental stress leads to a depletion in the meibocyte stem cells which leads to loss of the meibocyte numbers within the acinar gland and meibomian gland drop out.
When I examine a patient with meibomian gland dysfunction, I start on the right side with the upper lid, then the lower lid, then the left side upper lid and lower lid. I look at all the gland openings all the way along the lid margin to give an estimate of not only what proportion of functioning meibomian glands there are, but how thick or fluidly the meibum is.
I can often report finding a combination of very thick inspissated plugging of meibomian glands together with areas of meibomian gland drop out. There is even a relationship between meibomian gland dysfunction, dry eyes and the formation of chalazion.
When a meibomian gland becomes dilated, the oil or meibum in it becomes more stagnant, and if its opening is blocked, inflammatory cells can enter into the gland causing an inflammatory response which creates the accumulation of cells which form a chalazion.
The triad of meibomian gland disease, dry eyes and chalazion are closely related
Whenever I have a patient with a chalazion, I go back over their lids and the surface of their eye to determine how much meibomian gland dysfunction and dry eye they have. I urge the patient to treat this underlying cause of the chalazion to have a quicker recovery from their existing chalazia, especially after surgery, and to reduce the risk of them forming new chalazia in the future.
Environmental stresses do worsen your Meibomian gland dysfunction and dry eyes.