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The clinical diagnosis of obstructive Meibomian gland dysfunction (OMGD) should be considered when the standard, traditional, first line treatment modalities for Meibomian gland dysfunction have failed to provide sufficient relief of symptoms, the patients condition progressively worsens with continued loss of Meibomian glands as seen on meibography, or the patient continues to have recurrent infections of his/her eyelids (styes, hordeola, chalazia, cellulitis, etc.)

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While the aforementioned causes are common, several less frequent conditions can also lead to pain at the base of the skull

Blocking that enzyme, in the preclinical literature, appears to free up NAD+ and push adipocytes back toward burning energy instead of storing it