Making Tears Part 7 (the all-so-important oil glands!)
While there is no debate that water, salts and proteins are principle portions of the tears, it is the fine layer of oil floating on top, that seals in that moisture and lubricates - while supporting and protecting the eye. The production of oil involves a complex cycle of life from “mother cells” (called “stem cells”) who produce “daughter cells” (called “progenitor cells”) that in turn birth “oil cells” (called “meibocytes”). Mother cells exist near the surface of the lid margin and along the “tunnels” (ductules) leading to the “chambers” (acini - the “balloon-like” “rooms” off these passageways). Their progeny or daughter cells can migrate into these chambers and produce the oil cells or meibocytes, where they “hatch” into little puddles of oil.
While this sounds surreal, simply because it is a complex process, one can understand that there can be many pitfalls which can weaken the “supply chain” otherwise leading to this oil production. Add that it is necessary for the force of a blink to “flush out” and empty these chambers - and we begin to see the kind of trouble leading to “Meibomian Gland Dysfunction” (or MGD). I’ve posted much on the basics -the importance of oil and its production, as well as various tactics to improve oil production, in earlier blog posts: https://www.eyethera.com/blog/how-important-is-oil-to-our-tears , https://www.eyethera.com/blog/how-do-we-fix-the-oil-problem, https://www.eyethera.com/blog/you-are-what-you-eat, https://www.eyethera.com/blog/why-do-my-oil-supplements-not-work , https://www.eyethera.com/blog/why-do-expensive-dry-eye-treatments-fail-and-what-is-maskin-probing , https://www.eyethera.com/blog/more-on-mgs-the-tear-oil-glands , but to distill it down to the present level of discussion, I can add a few extra thoughts.
Remember the “peasant diet?” Fish, nuts and seeds, whole grains, and legumes - not only supply Tryptophan, leading to Serotonin and Melatonin (see earlier posts in this series), but also provide the (3) Essential Free Fatty Acids - the “oil building blocks” called Omega 3, 6 & 9. Without a steady supply of these essential oils in our diet, the mother and daughter cells making the oil cells are just as hampered as a mother trying to birth a healthy baby when they are malnourished. Toxins (potentially from pollution, makeup, medications like Accutane or other retinoids - or from germ warfare on our lid margins, among other stresses) can weaken and kill off these maternal cells. Inflammation can undermine the foundation of the walls supporting the tunnels and chambers, leading to strictures and “dead ends” that can block the passageways required for flushing out the oils produced in those chambers. Too much inflammation can weaken our troops and act like a fire that can burn down the village.
When oil doesn’t move along as it should - it becomes stagnant, rancid, nasty stuff that by degree tends to “gel up” and turn into the kind of waxy products better suited for making candles than it is for making tears. Once the lids become aware of just how bad the oil has become, it senses it as the “enemy” and inflammation will attempt to wall it off. From what I read about sanitation in the Middle Ages, walling off unsanitary stuff was about all they could do when modern plumbing didn’t exist - so maybe our lids aren’t all that different? Unfortunately, this can lead to our inadvertently damaging these oil producing glands. Caught early, it is often easy to “fix” this problem - but when allowed to progress, then styes and withering are the common outcomes - followed by ever decreasing amounts of oil production. I’ll direct readers to the above links for more clinical information on these topics and look deeper into the protein factories called “Goblet Cells” next time.
To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:
(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020
(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463