What Is a Meibomian Gland Expression Assessment?

A Meibomian Gland Expression Assessment is a clinical evaluation used to assess the function and health of the Meibomian glands—tiny oil-producing glands located along the upper and lower eyelids. These glands play a critical role in maintaining a stable tear film by producing the oil (meibum) that prevents tears from evaporating too quickly.

During this assessment, a dry eye specialist applies gentle, controlled pressure to the eyelids to evaluate how well the glands are functioning and the quality of the oil they produce.

Why Meibomian Gland Assessment Is Important in Dry Eye Diagnosis

Meibomian Gland Dysfunction (MGD) is one of the leading causes of Dry Eye, yet it often cannot be fully diagnosed based on symptoms alone. Many patients have significant gland dysfunction even when their eyes appear relatively normal.

A Meibomian Gland Expression Assessment allows the specialist to:

• Determine whether glands are blocked or producing abnormal oil
• Identify early gland dysfunction before permanent damage occurs
• Classify the severity of MGD
• Guide appropriate treatment selection

This assessment provides direct, functional information that imaging or questionnaires alone cannot supply.

What the Meibomian Gland Expression Assessment Evaluates

During the assessment, the specialist evaluates several key factors:

1. Gland Patency

• Whether the glands are open or obstructed
• How easily oil is expressed from the glands
• Presence of partial or complete gland blockage

2. Meibum Quality

The expressed oil is carefully evaluated for:

• Clear, healthy oil (normal)
• Cloudy or granular secretions
• Thick, toothpaste-like material
• Absence of secretion

Poor meibum quality is a hallmark of Meibomian Gland Dysfunction.

3. Gland Responsiveness

The amount of pressure required to express oil

• Whether glands respond uniformly or inconsistently
• Signs of gland fatigue or advanced dysfunction

4. Eyelid Margin Health

• Inflammation around gland openings
• Redness or thickening of the eyelid margin
• Signs of chronic irritation or scarring

How the Assessment Helps Guide Dry Eye Treatment

Findings from the Meibomian Gland Expression Assessment help the specialist:

• Confirm a diagnosis of evaporative dry eye
• Decide whether gland expression therapy is needed
• Determine suitability for treatments such as IPL, LLLT, or thermal therapies
• Establish a baseline for monitoring treatment progress

This ensures that dry eye treatment is targeted, effective, and personalised.

How the Meibomian Gland Expression Assessment Is Performed

Step 1: Dry Eye Assessment

The assessment is typically performed as part of a comprehensive dry eye examination, alongside slit lamp evaluation, imaging, and tear film analysis.

Step 2: Preparation

• The eyelids may be gently warmed to improve comfort and oil flow
• The specialist positions the eyelid for safe and controlled assessment

Step 3: Gland Expression

Using either gentle digital pressure or a specialised handheld instrument the specialist applies controlled pressure along selected areas of the eyelid margin to observe gland output.

Only a small number of glands are assessed—this is diagnostic, not full therapeutic expression.

Step 4: Clinical Interpretation

The specialist evaluates the results in real time and integrates them with other diagnostic findings to guide treatment planning.

What Does the Assessment Feel Like?

Most patients describe the assessment as:

• A sensation of pressure
• Well tolerated when glands are gently warmed

How the Meibomian Gland Assessment Complements Other Diagnostics

While imaging technologies show gland structure, expression assessment shows gland function. Together, they provide a complete picture of meibomian gland health.

This assessment complements:

• Meibography
• Tear film analysis
• Slit lamp examination
• Dry eye questionnaires

Is a Meibomian Gland Expression Assessment Safe?

When performed by a trained dry eye specialist, this assessment is:

• Safe and minimally invasive
• Clinically well established

Suitable for repeated evaluation when monitoring progression or response to treatment

Long-Term Benefits of Regular Assessment

For patients with Dry Eye, periodic Meibomian gland assessments help:

• Detect early gland dysfunction
• Monitor treatment effectiveness
• Prevent progression to irreversible gland loss
• Support long-term ocular comfort and vision quality

A Key Diagnostic Tool in Dry Eye Care

The Meibomian Gland Expression Assessment is a critical component of modern dry eye diagnosis, providing direct insight into gland function and oil quality. By identifying dysfunction early and guiding targeted treatment, it plays an essential role in achieving lasting dry eye relief.

When combined with advanced diagnostics and in-office therapies, this assessment ensures patients receive comprehensive, evidence-based dry eye care.