Understanding Meibomian Gland Dysfunction

Not exactly. “Dry eye” is an umbrella term that covers multiple causes. MGD is the most common type — responsible for the majority of dry eye cases — but there are other types, such as aqueous deficiency, where the problem is tear volume rather than tear quality. Your assessment at UDEI will identify which type (or combination) you have, so treatment targets the right mechanism.

MGD is a chronic condition, meaning it can be managed very effectively but typically requires ongoing attention. With the right combination of in-clinic treatments and home care, most patients experience significant, lasting improvement in comfort and tear stability. The key is catching it before irreversible gland loss occurs — and maintaining your results with a home care routine.

Several factors contribute: age (gland function naturally declines), hormonal changes (particularly in women during menopause), prolonged screen use (reduced blink rate lets glands stagnate), environmental factors (dry air, air conditioning), certain medications (antihistamines, antidepressants, isotretinoin), contact lens wear, and chronic eyelid inflammation (blepharitis). Most patients have multiple contributing factors.

Artificial tears can provide temporary symptom relief by supplementing your tear film, but they don’t address the underlying gland dysfunction. Prescription anti-inflammatory drops can help reduce the inflammation driving MGD, but they work best as part of a comprehensive plan that includes direct gland treatments like UltraView DEL or meibomian expression. Drops alone rarely resolve moderate-to-severe MGD.

Most patients notice initial improvement within the first two weeks of treatment. Full benefit typically develops over four to eight weeks as gland function recovers. Your follow-up visits allow us to track measurable progress through gland imaging and tear film analysis. Your UDEI clinician will explain the specific timeline based on your assessment findings.

Once a Meibomian gland has fully atrophied — shrunk, truncated, and dropped out — current evidence is that it does not regenerate. What’s reversible is the dysfunction in glands that are still structurally present: blocked ducts can be cleared, inflammation can be calmed, and meibum quality can be restored. This is why early assessment matters. The glands we can still see on meibography are the ones we can work with. Treating MGD earlier preserves more of the glands you have; waiting often means losing tissue we cannot get back.

Often yes, but the relationship between contact lenses and MGD runs both ways. Lenses can worsen gland dysfunction by disturbing the lipid layer and shortening tear break-up time, and MGD in turn makes lens wear uncomfortable. For mild to moderate MGD, most patients can continue wearing lenses once the underlying gland disease is treated — sometimes with a change in lens material, replacement schedule, or daily wear time. For more advanced MGD, we may recommend a lens holiday while glands recover, then reintroduce wear carefully. The goal is healthy glands first, comfortable lens wear second.

Meibography uses infrared imaging to look through the back of the eyelid at the Meibomian glands, which would otherwise be invisible. Healthy glands appear as long, parallel, finger-like structures running from the lid margin upward. On the images we can see which glands are full-length and functional, which have started to truncate or shorten, which look distorted or tortuous, and which areas of the lid have lost glands entirely — what we call gland dropout. We grade the dropout, compare it across visits, and use those images to explain exactly what we’re seeing and why a particular treatment plan makes sense for your glands specifically.

Home care is the foundation that makes in-clinic treatment stick. The core routine is a warm (not hot) compress for 10 minutes once or twice daily, followed by gentle lid massage toward the lash line to help express softened oils, and a dedicated lid hygiene wipe or foam to keep the lid margin clean. On top of that, we’ll often recommend a high-quality omega-3 supplement, conscious blinking exercises during screen work, and a humidifier in dry indoor environments. We build you a specific regimen during your visit — generic routines pulled from the internet are usually either too much or too little for the glands you actually have.

OHIP covers standard ophthalmic examination; advanced diagnostics and in-office procedures such as UltraView DEL and meibomian gland probing are specialised services not covered. Extended health insurance often covers some prescription drops and in-office treatments. UDEI provides itemised receipts.