Meibomian Gland Expression: What's That?

A few months ago during a visit to my eye doctor, we talked about what more could be done in-office to improve my chronic dry eye. Although I was doing warm compresses and lid scrubs at home, it was clear I needed more help. His first suggestion was something called meibomian gland expression.

Meibomian gland expression

What on earth is "meibomian gland expression" you may wonder? This basically means that the eye doctor attempts to squeeze oil from the tiny glands along the edge of the eyelids. This can be done as a diagnostic or to help remove some of the thicker oil so that the glands can function better.

The oil these glands produce is really important to your eyes. It helps to create a healthy layer of tears across your eyes that don't dry up too quickly. When the oil glands are clogged up, not enough oil ends up on the surface of your eye, and then you can have burning, irritation, foreign body sensation, and all the unpleasant symptoms of chronic dry eye.

The procedure

This process started out similar to what I already do at home with warm compresses. First, they applied a heated mask to soften the oils and help the procedure go a little better. They used a plug-in mask, which provided better, more consistent heat than my microwaveable Bruder mask that I use at home. In fact, at one point I had to ask them to turn the temperature down a bit as it was getting a little too hot to handle.

After about 15 minutes of the heat I was ready for the procedure. The doctor applied numbing drops to my eyes and had my sit forward with my forehead and chin resting at the slit lamp, just as it would during a regular eye exam.

The procedure itself is not particularly comfortable but I didn’t find it too much to handle. The doctor uses special forceps to squeeze the eyelid margins just enough to get oils out without damaging the glands. I think it took about 20 minutes at most to go all around my eyelids, including a few breaks for both of us.

Procedure results and aftercare

The first time I had expression done my eye doctor just had one word to describe the oil coming out of my meibomian glands: thick. What should come out is something closer to olive oil, but there's hope that over time I will get there.

Each time I have had this procedure done my eyes have been more dry for about a week afterward. That is because most of the oils have been squeezed out and it takes a few days for the meibomian glands to produce more oil. The hope is that better oil of a thinner consistency will be produced after this is done, along with continued good hygiene like lid scrubs and regular warm compresses.

The doctor has also prescribed a mild steroid for me to use at least a week afterward. This helps reduce inflammation right after the procedure and until my tear film is better. For a relatively easy and low-cost procedure, I feel like expression has been worth it.

Have you had this procedure done or discussed it with your doctor? Share your experience and thoughts in the comments below!