Which treatment does what
LipiFlow — for obstruction. Heats the glands from the inner lid surface while pulsing pressure along the lid to express the softened oil. The most direct mechanical answer to blocked glands, in a single sitting.
IPL — Intense Pulsed Light — for inflammation. Pulses of light close the abnormal surface vessels that feed inflammation into the lid margin, and warm the glands. The treatment of choice where rosacea-type inflammation is driving the disease. Given as a course.
Tixel — for the lid tissue. Controlled thermomechanical energy applied to the lid skin to stimulate tissue remodelling around the glands.
Rexon-Eye — for gland cell metabolism. Quantum molecular resonance delivered over a course of sessions, aimed at the gland and surface cells themselves rather than at the blockage.
Low-level light therapy — for gentle warming and photobiomodulation. Often paired with IPL, and an option where IPL is not suitable.
BlephEx and lid-margin treatment — for the foundation. Clears biofilm, debris and Demodex from the lash line so every other treatment works on a clean surface. Frequently the first step rather than an afterthought.
Not every member practice offers every treatment — find your nearest practice and what it offers.
What happens at a dry eye assessment
An MGD appointment with a member practice is a measurement appointment, not a five-minute look with a torch. Depending on the practice and your symptoms it will include most of:
- Symptom scoring — a standardised questionnaire, so change can be measured later rather than remembered.
- Tear film break-up time — how many seconds your tear film stays intact after a blink, measured without dye touching the eye. A healthy film holds for around ten seconds; an evaporative dry eye often breaks in three or four.
- Meibography — infrared imaging that photographs the glands through the eyelid. This is the picture that changes the conversation: you see your own glands, their length, and how many are still there.
- Lid margin and gland expression — what the openings look like, and what actually comes out under controlled pressure.
- Tear osmolarity — the salt concentration of your tears, which rises as the film destabilises.
- Ocular surface staining — dyes that reveal where the surface has been damaged.
- Demodex and blepharitis check — lash-base examination, because lid-margin disease has to be treated alongside the glands.
You leave with a picture of your own glands, numbers rather than impressions, and a plan built on both.
What you can do at home
Home care will not clear established obstruction on its own, but it protects the result of in-clinic treatment and slows progression.
- Use a real heat mask, properly. A microwavable mask held at temperature for eight to ten minutes, followed immediately by firm massage along the lid toward the lashes. Heat without expression achieves very little.
- Clean the lid margin. A dedicated lid cleanser on the lash line, not soap in the eye.
- Fix your blink. Every twenty minutes of screen work, look away and make five slow, deliberate, complete blinks — hold the lids closed for a count of two.
- Lower your screen. A monitor below eye level means less exposed eye surface and less evaporation.
- Deal with the air. Move the heat pump or car vent off your face; add humidity in winter.
- Omega-3: be realistic. Supplements are widely recommended, but the largest randomised trial found no benefit over placebo. Some patients do report improvement, and it is low-risk to try — just not a substitute for treating the blockage.
Drops still have a place. They replace water, not oil, so they soothe rather than correct — but the right formulation genuinely helps between treatments. Which eye drops actually help.
MGD questions we're asked most
Is meibomian gland dysfunction curable?
It is manageable rather than curable. Blocked glands can be reopened and the tear film restored, often dramatically — but the underlying tendency remains, so treatment is maintained rather than finished. Glands already lost to atrophy do not regrow, which is the argument for treating early. More on this: can dry eyes be cured?
How is MGD different from blepharitis?
Blepharitis is inflammation of the eyelid margin — the skin, lashes and lash follicles. MGD is dysfunction of the oil glands inside the lid. They sit millimetres apart, frequently occur together, and each makes the other worse, but they are treated differently. Blepharitis treatment.
Why do my eyes water if they're dry?
Because a dry surface triggers reflex tearing — a flood of watery, oil-poor tears that spill over rather than coat the eye. It is the most misunderstood symptom in dry eye. Watery eyes explained.
How long before I notice a difference?
It varies by treatment and by how advanced the obstruction is. Single-session mechanical treatments are often felt within a few weeks as the tear film stabilises. Course-based treatments are usually judged after the full course. Anyone promising an overnight result is overselling.
Will drops fix it?
No — but they help. Drops replace the watery part of the tear film; MGD is a shortage of the oil part. They relieve symptoms without changing the cause, which is why relief lasts minutes rather than hours.
Does MGD affect my vision?
It blurs it intermittently. An unstable tear film scatters light between blinks, so vision fluctuates and clears momentarily on blinking — most noticeably when reading or on screens. It does not cause permanent sight loss, but it can make an otherwise perfect spectacle prescription feel wrong.
Can I have MGD without dry-feeling eyes?
Yes, and it is common. Early MGD is often silent, and some people with significant gland loss report irritation, watering or lens intolerance rather than dryness. This is why imaging finds disease that symptoms miss.
Is it linked to screen use?
Indirectly but strongly — through blink rate. Screens do not damage glands directly; the halved, incomplete blinking they cause leaves the glands unexpressed for hours at a time.
Should I stop wearing contact lenses?
Usually not. Most people with MGD keep wearing lenses once the tear film is treated. Comfort problems are a reason to have the glands assessed, not automatically a reason to stop.
What does treatment cost?
It varies by treatment and by practice — member practices set their own fees. The assessment comes first in every case, because the plan depends on what the imaging shows. Contact your nearest practice.
