Meibomian Gland Probing

Dr. Allison Landes is the only doctor in the area offering meibomian gland probing to her patients as part of her comprehensive approach to treating dry eye and its underlying causes.  Continue reading to find out why this is an essential tool to successfully treat this ubiquitous and challenging condition. 

What is meibomian gland probing?

Meibomian gland probing (MGP) is a safe and effective in-office procedure that treats the underlying cause of obstructive meibomian dysfunction by releasing scar tissue (periductal fibrosis) in and around the meibomian glands, freeing the glands from strictures that block the flow of oil (obstruction).  These strictures can occur at or near the opening of the gland, resulting in no expression of oil, or they can occur further away from the gland opening, allowing for partial expression of oil.  Studies show that expressible glands are just as likely to have nonobvious obstruction as nonexpressible glands are to have obvious obstruction and that these strictures occur in over 90% of glands in lids with meibomian gland dysfunction (MGD).  Depending on the location of the stricture, pressure build up behind the stricture can result in eyelid tenderness, reduced production of oil, gland wasting (atrophy), gland shortening, and even complete loss of the gland (dropout).  Following meibomian gland probing, patients can enjoy improvement in symptoms such as eyelid tenderness, burning, and light sensitivity and their meibomian glands can be restored, even regenerated.  Meibomian gland dysfunction is a progressive disease, and even after probing the meibomian glands are likely to become occluded again.  Meibomian gland probing can be repeated annually or as needed for maintenance to prevent and treat recurrent obstructions and works best when other contributing conditions are also being treated.

Commonly prescribed therapies for MGD are often ineffective, or only partially effective, because they don’t release the strictures found in the vast majority of glands with MGD.

What are the symptoms of meibomian gland dysfunction?

  • Pain and tenderness in eyelids
  • Burning in the eyes
  • Light sensitivity
  • Redness of the eyes and eyelids
  • Foreign body sensation

When is meibomian gland probing indicated?

  • For diagnostic evaluation – MGP confirms glands are open or reveals nonobvious disease
  • For therapeutic intervention – MGP breaks strictures and restores integrity of the glands
  • When patients complain of symptoms of MGD
  • When signs of MGD are visible on exam – whether or not the patient has symptoms
  • When there is a reduced number of expressible oil glands
  • When there are signs of oil deficiency
  • When patients develop early hordeolum or chalazion
  • When meibography (infrared imaging) shows signs of obstruction

How can some patients have MGD without symptoms?

  • In asymptomatic patients, periductal fibrosis invades the external duct wall leading to stem cell loss, gland atrophy, and oil deficiency, without causing obstruction or eyelid tenderness.
  • Meibomian gland probing can improve previously unrecognized, subclinical symptoms.

Can meibomian gland probing restore meibomian glands?

  • Meibomian gland probing can restore glands. MGP increases gland tissue and may lead to gland regeneration.  Thickening of glands walls following MGP suggests stem cell stimulation and MGP may prevent or minimize further stem cell loss.
  • One study comparing glands before and after probing found that more than 40% of lids showed increases in meibomian gland tissue after probing, even the appearance of new glands.

What are possible responses to meibomian gland probing?

Immediate relief (within 24 hours)

    • caused by the immediate release of stricture, normalization of pressure within the gland, and restored flow of oil
    • more common in patients complaining of eyelid tenderness

Gradual improvement in symptoms over months

    • more common in patients complaining of other symptoms of MGD such as burning or stinging and light sensitivity
    • caused by restored gland health and function, specifically the growth of gland cells suggesting stem cell activation

To learn more about meibomian gland probing, please visit:

For a comprehensive resource dedicated to patients suffering with meibomian gland dysfunction and dry eye, written by Dr. Maskin, the creator of meibomian gland probing, Dr. Allison Landes encourages you to read Your Dry Eye Mystery Solved – Reversing Meibomian Gland Dysfunction, Restoring Hope.