Vision Care Services

Meibomian Gland Dysfunction (MGD)

Meibomian Gland Dysfunction

Blocked eyelid oil glands, the most common cause of dry eye.

Your eyelids have about 25 to 40 tiny oil glands each, called meibomian glands. Every blink spreads their oil over your tears to keep them from evaporating. In meibomian gland dysfunction (MGD), the glands become blocked or make thick, poor-quality oil, so tears evaporate too fast.

MGD is the leading cause of evaporative dry eye. Left untreated, glands can shrink and stop working, so finding and treating it early matters.

MeibographyInfrared images of your oil glands at our East Lake office, to see blocked or missing glands.

TearCareIn-office heat and expression to clear blocked glands.

Prescription treatmentMiebo, anti-inflammatory drops and oral doxycycline or azithromycin.

Symptoms of MGD

Burning, gritty or tired eyes, often worse later in the day
Blurry vision that clears when you blink
Red or thickened eyelid edges
Watery eyes
Repeat styes or chalazia
Contact lenses that become uncomfortable

What causes it

Age and hormones, including menopause
Screen time and less complete blinking
Rosacea and other skin conditions
Blepharitis and Demodex
Contact lens wear
Some medications, such as isotretinoin (Accutane)

How we diagnose it

We press gently on the eyelids to see how the oil flows, check your tear breakup time and tear meniscus, and examine the gland openings at the slit lamp. At our East Lake office, meibography shows the glands themselves, so you can see how many are working. We record images with SLEYECAM to compare over time.

Treatment

TearCare: controlled heat applied to the eyelids, followed by in-office expression of the glands
Daily warm compresses and lid hygiene at home
Miebo, a prescription drop that helps slow tear evaporation
Prescription anti-inflammatory drops, such as cyclosporine or lifitegrast
Oral doxycycline or azithromycin for inflamed glands and ocular rosacea
Xdemvy if Demodex is involved
Punctal plugs and amniotic membranes for more severe dry eye

Common questions

What is meibomian gland dysfunction?

MGD is a condition where the oil glands in your eyelids become blocked or make poor-quality oil, so your tears evaporate too quickly. It is the most common cause of dry eye.

Can MGD be reversed?

Blocked glands can often be cleared and work better with treatment. Glands that have already shrunk may not come back, which is why early treatment helps.

What is meibography?

Meibography takes infrared images of the oil glands inside your eyelids, showing whether they are healthy, shortened or missing. It is available at our East Lake office.

Do warm compresses help MGD?

Yes. Warm compresses soften thickened oil so it can flow. For blocked glands that don’t respond, in-office treatment like TearCare delivers steady heat and lets us clear the glands.

What is Miebo?

Miebo (perfluorohexyloctane) is a prescription eye drop for dry eye that helps reduce tear evaporation. It is often used for evaporative dry eye from MGD.