Meibomian Gland Expression: A Comprehensive Guide

Written and Medically Reviewed by Dr Leigh Plowman, Optometrist (updated Sept 2022)

Are your eyes often itchy and irritated? You might have the common eye condition known as dry eye disease.

Dry eyes may be caused by not having the right quality of tears to keep the eyes moist and nourished.

Even though dry eyes disease is a common eye condition, many affected individuals are unaware of the exact predicament they are in.

Some pass it off as simple eye irritation until it gets too severe.

Diagnosing and treating dry eyes during its early stage is essential and can help avert life-long complications and vision issues.

Now, let’s discuss the most common root cause of dry eyes – Meibomian Gland Dysfunction (MGD).

Read on to learn more about MGD, how it’s linked to dry eyes and one treatment you may want to consider – Meibomian Gland Expression.

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A Quick Insight to the Meibomian Glands

First of all, what exactly are meibomian glands?

Named after the German physician Heinrich Meibom who discovered them back in the 17th century, Meibomian glands are oil glands located in the rim of the upper and lower eyelids where the eyelashes are.

These glands are responsible for secreting oils onto the surface of the eye that keeps the tears from evaporating too quickly. Without these oils secreted by the Meibomian glands, the eye dries out and become irritated.

Meibomian Gland Dysfunction

Changes to the amount and quality of oil that the Meibomian Glands produce can cause MGD. Multiple factors can lead to MGD, but the most common cause is the blockage and clogging of the glands.

When less and less oil reaches the eye, the tears evaporate too quickly. This is why MGD is highly associated with dry eye disease.

Like dry eyes, the risk of developing meibomian gland dysfunction increases with age. Compared to children and young adults, people aged 40 and above have a significantly higher risk of developing MGD. Aside from dry eye disease, MGD is also connected to an eyelid condition called blepharitis.

It has similar symptoms as dry eyes as well, like burning sensation, itchiness and irritation. MGD can also cause redness, inflammation and irritation in the eyelids. Early diagnosis of MGD is vital since if left untreated, it can cause permanent damage to the eyes.

Meibomian Gland Expression

Eye specialists usually perform meibomian gland expression to diagnose if the patient is suffering from MGD. Eye doctors squeeze out the oil from the eyelids to determine if there’s clogging in the glands.

Aside from being a diagnostic procedure, meibomian gland expression is also a proven effective therapy for MGD. It can reduce the symptoms and improve signs of MGD. Meibomian gland expression is one of the most common procedures for MGD where you deal directly with the clogging and blockage of the glands.

How Does It Work?

The procedure for meibomian gland expression involves applying pressure to the eyelids to express the glands and squeeze out the oils.

Eye specialists use tiny forceps or paddle-like instruments to compress the lower and upper eyelids. Mastrota paddle is a standard tool for meibomian gland expression. It is designed to squeeze out the oil from the meibomian glands effectively. The eye doctor places the Mastrota between the eye and the inner eyelid, parallel to the glands. Then, he or she uses a finger or a cotton tip to apply pressure in the outer eyelid.

Eye doctors may also apply warm compress before the expression for the smooth secretion of the hardened oils that clog the glands. A topical anesthetic like proparacaine can also be used to both eyes before the procedure.

Meibomian gland expression is also usually performed alongside other eye treatments like Intense Pulse Light (IPL) treatment and Blephasteam.

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How Effective is Meibomian Gland Expression?

Successful meibomian gland expression helps increase the quality of oil production of the glands and decrease dry eyes symptoms.  Patients usually only need a single session, but you can benefit from regular treatments. Your eye doctor can diagnose if you need additional procedures. He or she can also teach you how you can do meibomian gland massage at your own home as a long-term MGD management.

Meibomian Gland Expression: The FAQs

  • Does meibomian gland expression hurt?

    The procedure can cause discomfort but it is usually an itchy sensation. Usually, a couple of anaesthetic drops are used in the eyes before expression.

  • What does the secretion should look like?

    The secretion can vary from patient to patient. They can be thick or thin, clear or cloudy, viscous, cheesy or toothpaste-like. In some cases, the hardened oil can also be expressed from the glands – generally, the thinner and more transparent the secretions the better.

  • Who can perform meibomian gland expression?

    In-clinic expression of the meibomian glands is highly advised, especially for the first-timers and for those with severe MGD. Optometrists and ophthalmologists can determine the right amount of pressure required to express a patient’s glands with proper diagnosis adequately. They can plan out a customize a treatment plan depending on the severity of the MGD.

  • Can you do meibomian gland expression at home?

    No, it is usually better to have it done in-clinic. Some eye specialists may also recommend regular expression at home as part of a continuous MGD management and treatment plan.

  • How much does meibomian gland expression cost?

    The cost of the procedure can vary from clinic to clinic. It can be included in your consultation fee if performed as a diagnostic procedure. It can also be included in the cost of other eye treatment like IPL and Blephesteam.

  • Why should you consider meibomian gland expression?

    Meibomian gland dysfunction, if not treated early and properly, can cause severe damage to your eyes and vision to the point that comfortably living your daily can be hard. Whether as a diagnostic procedure or as a treatment, expression of the glands can help patients with MGD. Since it promotes the healthy and adequate secretion of oil to the eye surface, meibomian gland expression provides excellent long-term benefits.

Key Takeaways: Meibomian Gland Expression

Meibomian Gland Dysfunction like dry eye disease is often ignored and passed off as simple eye irritation. Many patients don’t even realize they have it until it’s too late. It is essential to perform diagnosis and treatment for MGD in its early stages before it can lead to more severe eye conditions.

Getting right into the underlying cause of meibomian gland dysfunction is essential. Expression of the meibomian glands not only help diagnose the condition, but it also helps ensure that the meibomian glands are secreting the right amount and quality of oil to keep the eyes healthy.

To guarantee success and for better results, it is best to consult your optometrist or ophthalmologist on the best way to execute the procedure. You can also get a personalized treatment plan as needed.

Learn more about the dry eyes and other treatments you may want to check by reading more of our articles here.

Find a Dry Eye Professional near you and make an appointment. They can take the first step together with you. Find a Dry Eye Professional!

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