Meibomian gland dysfunction (MGD) is one of the most common causes of dry, burning eyes. The tiny oil glands along the eyelid margins stop releasing healthy oil, and tears evaporate too fast. Most people improve with standard care. A recent Healio article focused on those who do not.
Two kinds of blocked glands
Jacqueline W. Muller, MD, an ophthalmologist who has treated ocular surface disease for more than 3 decades, described two patterns:
- Traditional MGD: the oil thickens, like butter instead of olive oil, and clogs the gland. Heat treatments can melt and express it.
- Mechanically obstructive MGD: the gland channel is physically blocked by keratin, debris, or scar tissue. Heat alone cannot clear it. It can cause lid tenderness, inflammation, and repeated styes or chalazia.
She noted that MGD affects an estimated 38% to 68% of people over 40 and is often underdiagnosed because it can be silent at first.
Usual steps, then probing
First-line care includes lubricating drops, warm compresses, lid hygiene, omega-3 supplements, and sometimes antibiotic or anti-inflammatory medicines, followed by in-office heat treatments if needed. When those fail, glands keep shrinking on imaging, or lid infections keep returning, Dr. Muller suggests checking for mechanical blockage with meibomian gland probing, in which a thin, blunt wire is passed into the gland opening to clear the channel.
What her practice reported, and the limits
In a retrospective review from her practice, where probing has been performed on more than 1,100 eyelids since 2018, probing followed by an in-office heat treatment and a 4-week anti-inflammatory regimen improved symptoms, and most patients’ gland images showed no further loss. Some showed regrowth, and no complications were reported. The authors themselves list key limits: a small sample, no control group, and the need for larger studies with longer follow-up. This is one practice’s experience, not proof.
My advice
- Give warm compresses and lid hygiene a fair, consistent trial of several weeks.
- If you keep getting styes or chalazia, mention it; it can be a clue to blocked glands.
- Ask whether your glands have been imaged, so changes can be tracked over time.
For more reading on dry eye, see best-lasik-surgeon.com.
Source: When first-line therapy fails: How to identify and treat mechanically obstructive MGD (Healio, 09/17/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.