Hawaiian Eye session features updates on meibomian gland dysfunction and unmet needs for patients
Francis S. Mah, MD, of Scripps Clinic and an Editorial Advisory Board Member of Ophthalmology 360, provided insights from his presentation at the Hawaiian Eye meeting, focused on the current state of meibomian gland dysfunction (MGD). He underscored that “industry has realized that [MGD] is a valid and a true issue” for patients and offered a look at the treatment options for MGD and dry eye disease.
Francis S. Mah, MD:
Hello, this is Francis Mah, I’m at Scripps Clinic in La Jolla, California. I’m speaking to you about my presentation at the Hawaiian Eye 2026 in beautiful Waikoloa, and I had the honor of presenting on the state-of-the-art for meibomian gland dysfunction on Thursday morning.
As far as the big overview, I think the biggest highlight is the fact that I think for years, decades, we’ve been talking about dry eye. I think all of us understand that dry eye is multiple different entities that we’re treating. But for simplicity’s sake and for the patient’s sake, kind of all lump it into dry eyes. Many of the scientific organizations like TFOS, many of the researchers are delineating the various different aspects. One of the aspects that was highlighted by TFOS was evaporative dry eyes.
When you talk about MGD or meibomian gland dysfunction, this is one of the most common causes of evaporative dry eyes. What we’re talking about in terms of the affecting eye physiology is the meibomian glands, obviously, in the eyelids. The meibomian glands obviously produce a lipid which helps to prevent evaporation on the ocular surface. The state-of-the-art management for MGD is to try to optimize the meibomian glands. There’s various different ways. I think researchers and industry alike have been addressing this area, which, by many accounts, is upwards of 90% of the cause of the symptoms of dry eye disease.
One of the first medications that got FDA-approved, at least in the United States, is perfluorohexyloctane, which is 100% of the component. It’s a semifluorinated alkane, and it helps prevent evaporation of the tears. The FDA registration trials to get it approved were done in dry eye disease patients who had more MGD in terms of their dry eye disease.
We also have various different procedures which help. We know about the thermal pulsations, which are heated and which are typically mechanized. We know about the home warm compresses. We know about intense pulse light therapy or IPL. I go through the various different ways of trying to maximize and the literature as far as what might benefit patients most.
In addition, there are some new drugs which are being looked at and going through the registration process. One is by a company called Azura, and this one helps with the keratin on the surface. Another one actually helps with Demodex, that company is called Aperta. Obviously, we have a Demodex blepharitis drug that’s available that’s made by Tarsus. Again, I think the industry has realized that this is a valid and a true issue with patients as well as offering new unmet needed devices as well as medications for patients with MGD.
So I hope you were able to join us in Hawaii. If not, hopefully you’ll read about some of the highlights which I’ve just delineated that came from my talk. Appreciate everybody’s attention and hope everybody has a great 2026.
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