In many cases of meibomian gland dysfunction the glands are so blocked that hot compresses and lid massage are ineffective. At the Dry Eye Centre we prefer to perform meibomian gland expression manually to clear the blockage. We believe that this method is more controlled compared to LipiFlow and comes at a much lower cost, which also means we can repeat the treatment more often.
An additional benefit of expressing the gland manually is that we can see the type and quality of meibum produced by each gland. Normal meibum should have the consistency of olive oil. When there is meibomian gland dysfunction, the meibum may be thicker than usual and sometimes even like a thick paste.
In order to better understand how the glands are functioning, it is important to know what the meibum quality is like. For this reason, we perform gland expression at every initial visit as part of the diagnostic routine.
Regular meibomian gland expression is also important for continual treatment the blocked glands.
We gently heat the lids before expression is performed. This helps to open up the gland openings and to soften the meibum making it easier to express. We then gently squeeze each gland to express the blocked material. Meibomian gland expression is also performed straight after each Intense Pulsed Light treatment.
After the treatment we may give some medical treatment and home exercises to help keep the glands functioning.