Meibomian Gland Dysfunction: Why Your Eyes Might Be Dry
If your eyes constantly feel gritty, burn by the end of the day, or water more than you'd expect from "dry" eyes, the root cause may not be a lack of tears at all. It may be a problem with the oil that's supposed to be in them.
What Is Meibomian Gland Dysfunction?
Every blink relies on a thin, three-layer tear film to keep the eye's surface smooth and protected. The outermost layer of that film is oil, produced by tiny glands along the edge of the eyelids called meibomian glands. That oil layer is what keeps tears from evaporating too quickly.
Meibomian gland dysfunction (MGD) happens when these glands stop producing enough oil, or produce oil that's too thick or poor in quality to do its job. Most cases are obstructive — the glands become blocked, and the oil can't get out the way it should. Once that oil layer breaks down, tears evaporate faster than they should, and evaporative dry eye is the result. In fact, research shows MGD is considered the leading cause of evaporative dry eye disease.
MGD is also far from rare. Estimates suggest over a third of people worldwide have some degree of it, and in the U.S., that number climbs to roughly 70% in adults over 60. It tends to affect men more than women, and rates vary by ethnicity as well.
Common Symptoms
MGD doesn't always come with obvious warning signs — some people have it without ever noticing. When symptoms do show up, they can include:
Itchy, burning, or red eyes
Swollen eyelids
Watery eyes (yes, watery — not just dry)
A gritty, "something's in my eye" sensation
Blurred vision
Recurring styes or chalazia
Crusty or sticky eyelids, especially in the morning
Discomfort wearing contact lenses
What Causes It
At the core, MGD comes down to blocked glands and poor-quality oil (meibum). Certain medications — including some glaucoma treatments, retinoids, and hormone therapies — can contribute. Risk climbs with age, hormonal changes, contact lens wear, and a personal tendency toward allergies.
MGD also shows up more often alongside other conditions, particularly ones that affect the immune system, such as rosacea, Sjögren's syndrome, lupus, psoriasis, and rheumatoid arthritis. Chronic blepharitis, high blood pressure, and high cholesterol are also linked to higher risk.
Left untreated, MGD isn't just uncomfortable — it can lead to chronic dry eye disease, ongoing eyelid inflammation, and in more serious cases, damage to the cornea.
How It's Diagnosed
Diagnosing MGD usually starts with a standard eye exam and a conversation about your symptoms and history. From there, your eye care provider may use a few targeted tests, such as:
Oil expression — gently pressing the eyelid to check the amount and quality of oil released
Tear film breakup testing — using a dye to see how quickly the tear film breaks apart
Schirmer testing — measuring tear production with a small paper strip
Meibography — imaging the glands themselves to assess their structure
Treatment Options
Treatment depends on how advanced the condition is and what's driving it, but many first-line approaches are simple, at-home habits:
Warm compresses over closed eyelids to loosen thickened oil
Gentle eyelid massage near the lash line
Regular eyelid hygiene, sometimes with a mild cleanser
Omega-3 supplementation (fish oil or flaxseed oil)
Limiting extended screen time and minimizing wind exposure
For more persistent cases, your provider might recommend lubricating eye drops, anti-inflammatory medications, or in-office procedures that use heat, lasers, or gentle probing to clear blocked glands.
The encouraging news: even though MGD can be a long-term condition to manage, the outlook is generally good with consistent care.
For patients who need more than at-home care, our practice offers MeiboThermoFlow, an in-office treatment performed by Dr. Annelise Kim that targets blocked glands directly to help restore healthy oil flow.
When to See Your Eye Doctor
Because early MGD often has no symptoms at all, regular eye exams are the best way to catch it before it progresses. If you're dealing with persistent dryness, recurring styes, or any sudden eye pain or vision changes, it's worth scheduling a visit — sudden vision loss or eye pain warrants urgent care right away.
This article is for general educational purposes and isn't a substitute for personalized medical advice. Schedule an appointment with our office if you're experiencing symptoms of dry eye or meibomian gland dysfunction.
