What Is Meibomian Gland Expression?
Meibomian Gland Expression is a clinical procedure used to evaluate and treat dysfunction of the meibomian glands—tiny oil-producing glands located along the upper and lower eyelids. These glands produce meibum, an essential oil that forms the outer layer of the tear film.
When functioning properly, meibum slows tear evaporation and helps keep the eyes comfortable and well-lubricated. When the glands become blocked or the oil becomes thickened, the tear film becomes unstable, leading to symptoms of Dry Eye, irritation, and fluctuating vision.
Meibomian Gland Expression involves the controlled application of pressure to the eyelids to gently release stagnant or thickened oils from the glands, restoring healthier oil flow.
Why Are the Meibomian Glands Important?
The tear film is made up of three layers:
- Mucus layer (helps tears spread evenly)
- Aqueous layer (the watery component)
- Lipid (oil) layer produced by the meibomian glands
The lipid layer plays a critical role by:
- Preventing rapid tear evaporation
- Maintaining tear film stability
- Improving visual clarity
- Reducing inflammation of the ocular surface
When the meibomian glands are not functioning properly—known as Meibomian Gland Dysfunction (MGD)—the lipid layer becomes deficient, which is one of the most common causes of evaporative dry eye.
How Meibomian Gland Expression Helps Dry Eye
Meibomian Gland Expression directly addresses the underlying cause of evaporative dry eye by:
Clearing Blocked Glands
Over time, meibum can become thick, toothpaste-like, or completely blocked. Expression removes this stagnant material, allowing the glands to resume normal oil secretion.
Improving Tear Film Quality
By restoring oil flow, the tear film becomes more stable, reducing evaporation and improving overall eye comfort.
Reducing Inflammation
Blocked glands can lead to chronic eyelid inflammation. Clearing the glands helps reduce inflammatory by-products that contribute to redness, irritation, and burning.
Enhancing the Effectiveness of Other Treatments
Expression often improves the effectiveness of other dry eye therapies such as warm compresses, artificial tears, prescription eye drops, or in-office thermal treatments.
Who Benefits From Meibomian Gland Expression?
This procedure may be recommended for patients who experience:
- Burning, stinging, or gritty sensations
- Red or irritated eyes
- Fluctuating or blurry vision
- Symptoms that worsen with screen use
- Poor relief from artificial tears alone
- Diagnosed Meibomian Gland Dysfunction or evaporative Dry Eye
A dry eye specialist will determine if gland expression is appropriate based on clinical evaluation and diagnostic testing.
How Meibomian Gland Expression Is Performed
Step 1: Comprehensive Dry Eye Assessment
Before the procedure, the dry eye specialist performs a detailed assessment, which may include:
- Eyelid and gland evaluation
- Tear film analysis
- Meibomian gland imaging (meibography)
- Ocular surface examination
This allows the treatment to be tailored to your specific condition.
Step 2: Preparation of the Eyelids
In many cases, the eyelids are first warmed using a warm compress or heat mask. Heat softens thickened oils, making them easier to express and improving comfort during the procedure.
Step 3: Gland Expression
The specialist uses either:
- Specialized handheld instruments, or
- Gentle digital pressure
to apply controlled pressure along the eyelid margins. This encourages the glands to release trapped oils. The procedure is precise and performed under magnification to protect the eye and eyelid structures.
Step 4: Post-Treatment Care
After expression:
- The eyelids may be gently cleaned
- Lubricating drops may be applied
- Additional treatments may be recommended as part of a long-term dry eye management plan
What Does the Procedure Feel Like?
Patients describe Meibomian Gland Expression as:
- Mild to moderate pressure
- Well tolerated when glands are properly warmed
Any sensitivity typically resolves quickly after the procedure.
How Often Is Meibomian Gland Expression Needed?
The frequency depends on:
- Severity of gland dysfunction
- Chronicity of dry eye disease
- Response to treatment
- Ongoing lid hygiene and home care
Some patients benefit from periodic expression as part of a maintenance program, while others require it only occasionally.
Is Meibomian Gland Expression Safe?
When performed by a trained dry eye specialist, Meibomian Gland Expression is:
- Safe
- Minimally invasive
- Clinically well-established
It is a standard component of modern Dry Eye care and is often combined with other therapies for optimal results.
Long-Term Benefits
With appropriate follow-up and maintenance, patients experience:
- Improved comfort
- More stable vision
- Reduced dependence on artificial tears
- Better control of chronic Dry Eye symptoms
