Dry EyeFebruary 18, 2026
You've tried every brand of artificial tears on the pharmacy shelf. You've invested in a humidifier, adjusted your screen habits, and started taking omega-3 supplements. Yet your eyes still burn, feel gritty, and blur your vision at the worst possible moments. If this sounds familiar, there's a strong chance that your dry eye symptoms are being driven by something more specific than simple tear deficiency: Meibomian Gland Dysfunction, or MGD.
What Are the Meibomian Glands?
The meibomian glands are tiny, specialized oil glands embedded in the upper and lower eyelids. There are roughly 25 to 30 glands in the upper lid and 20 to 25 in the lower lid. Their sole purpose is to secrete meibum — a complex lipid oil that forms the outermost layer of the tear film. This oil layer is essential because it prevents the watery component of your tears from evaporating too quickly. Without a healthy lipid layer, tears evaporate in seconds rather than minutes, leaving the corneal surface exposed and irritated.
How MGD Develops
Meibomian Gland Dysfunction occurs when the glands become blocked, inflamed, or structurally damaged. The meibum thickens and hardens, clogging the gland openings along the lid margin. Over time, chronically blocked glands can atrophy — essentially shrinking and losing their ability to produce oil altogether. This process is often gradual, which is why many patients don't realize they have MGD until symptoms become significant.
Several factors increase the risk of developing MGD. Age is the most common — gland function naturally declines over time. Hormonal changes, particularly during menopause, can significantly accelerate the process. Extended screen use reduces blink rate, which means the glands are expressed less frequently. Contact lens wear, certain medications (including antihistamines and antidepressants), and environmental factors like dry or windy climates also contribute.
Recognizing the Symptoms
MGD symptoms overlap significantly with other forms of dry eye, which is why a proper clinical evaluation is essential. Common signs include a burning or stinging sensation, a feeling of grittiness or sand in the eyes, redness along the lid margins, blurred vision that fluctuates with blinking, and eyes that feel worse as the day progresses. Some patients also experience excessive tearing — a paradoxical response in which the eyes produce reflex tears to compensate for the poor-quality tear film.
Why Early Detection Matters
The most important thing to understand about MGD is that gland loss is irreversible. Once a meibomian gland atrophies, it cannot be regenerated. This makes early detection and treatment critical. Advanced imaging techniques like meibography allow eye care professionals to visualize the glands directly, assessing their structure and identifying dropout before symptoms become severe.
Modern Treatment Options
Treatment for MGD has advanced dramatically in recent years. While warm compresses and lid hygiene remain important components of daily maintenance, in-office procedures now offer far more effective results. Intense Pulsed Light (IPL) therapy, such as the Lumenis OptiLight, targets the inflammation that drives MGD and softens hardened meibum for more effective gland expression. Radiofrequency treatments like OptiPLUS deliver deeper thermal energy to further improve gland function. For patients with eyelid laxity contributing to poor blink mechanics, OptiLIFT offers a non-invasive solution.
Take the First Step
If you've been managing dry eye symptoms with drops alone, it may be time to look deeper. At The Last Optical, our comprehensive dry eye evaluation includes meibomian gland assessment, tear film analysis, and a personalized treatment plan designed to address the root cause — not just the symptoms. Schedule a visit to our Dry Eye Spa in Montgomery, NY and discover what your dry eyes have been trying to tell you.
