Meibomian gland dysfunction is the leading cause of dry eye — and the condition every treatment offered by the Dry Eye Specialist Group is built around. If your eyes grate, burn, water on windy days or blur between blinks, this page explains what is most likely happening inside your eyelids, and what actually fixes it.
Around 25–30 oil glands sit vertically inside your upper eyelid, and 20–25 in the lower lid, opening just behind your lashes. With every blink they release meibum — a microscopically thin layer of oil that spreads over your tears and stops them evaporating. When the glands block, or the oil thickens to the consistency of toothpaste, the tear film loses its protective layer, tears evaporate too fast and the eye's surface dries between blinks. That is MGD — and international consensus research (TFOS DEWS) identifies it as the driver of most dry eye disease.
Gritty, burning or sandy eyes, especially later in the day. Vision that blurs briefly and clears with a blink. Eyes that water in wind or cold — reflex tearing triggered by a dry surface. Red, thickened or crusty lid margins. Recurring styes or chalazia. Discomfort that lubricant drops soothe for minutes rather than hours — because drops replace water, not the missing oil.
Chronically blocked glands shorten and waste away — and gland tissue lost to atrophy does not grow back. Infrared meibography, available across our member practices, photographs your glands through the eyelid and shows exactly how much functioning tissue remains. Early obstruction is highly treatable; late-stage atrophy limits what any treatment can achieve. The single worst strategy for MGD is waiting until drops stop working.
Blocked oil liquefies at around 40–42°C — held at that temperature, at the gland, for several minutes, followed by expression of the softened oil. A face cloth cools in under a minute, heats only the outside of the lid, and expresses nothing. Home heat masks help as maintenance, but established MGD usually needs in-clinic treatment.
Each of our in-clinic treatments targets a different part of the disease. LipiFlow heats the glands from the inner lid surface while pulsing pressure expresses the blocked oil — the direct answer to obstruction. IPL (Intense Pulsed Light) treats the inflammatory drivers, closing the abnormal vessels that keep the lids inflamed. Tixel rejuvenates the lid tissue itself. Rexon-Eye stimulates gland cell metabolism over a course of sessions. And BlephEx clears the lid-margin biofilm so every other treatment works on a clean surface. Which combination is right depends on gland imaging, tear-film measurement and lid examination — the assessment comes first, every time.
See Our TreatmentsRead our clinician-written guides: What is meibomian gland dysfunction?, how we diagnose dry eye, and which dry eye treatment is right for you.
Our experienced Dry Eye Specialists are here to assess your symptoms and recommend a personalised treatment plan tailored to your needs. Book your appointment today and take the first step toward lasting comfort and clearer vision.
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