Guide · MGD
MGD eye drops: what they do, and why clearing the glands comes first
MGD, meibomian gland dysfunction, means the oil glands in your eyelids have blocked. Drops can stand in for the oil for a while. Only clearing the glands brings it back.
What MGD is
Each eyelid has around twenty-five tiny oil glands. Every blink squeezes a little oil onto the tears to stop them evaporating. In MGD the oil thickens and sets inside the gland, like butter in a cold pipe. The tears lose their seal, dry in seconds, and the eyes feel gritty, burn and blur.
The drops that help
Oil-based drops and lipid sprays, such as EvoTears and similar products, put an oil layer back on the tears for a while. For MGD they make more sense than watery drops. Use them preservative-free, and alongside warmth and lid cleaning at home.
Why drops are not the treatment
A drop replaces the oil for as long as it lasts. It does not open the gland. And a gland that stays blocked for months stops being asked for oil, and slowly wastes away. Lose enough glands and dry eye becomes something you manage for life rather than something we can clear.
What clears the glands
Warming the oil properly, then pressing each gland so the set oil comes out, under the microscope, in the chair. For glands that keep re-blocking because the lids are inflamed, IPL light melts the oil at the base of the gland and calms the inflammation at the same time. How the treatment works.
Find out how many glands you have
At the Full Dry Eye Assessment we photograph every gland with infrared, so you can count for yourself how many are full-length, shortened or gone, and we tell you which drops suit your eyes now.
The three types of dry eye, and what we do for each
Most people are told “you’ve got dry eyes” and handed drops. But there are three different causes, and each needs something different. Most people have a mix.
Blocked oil glands: meibomian gland dysfunction (MGD)
About 8 in 10 people with dry eye have this. Along the edge of each eyelid are about 30 tiny glands that put a thin layer of oil on your tears. When they block, your tears dry up in seconds, however much water your eyes make. It feels gritty, burning and tired, often worse on screens or by evening. Drops help for an hour, because they don’t unblock the glands.
What we do: photograph your glands so you can see them, warm and clear them in clinic, clean the lid edge, and use IPL or light therapy where it helps. Then we give you a simple routine for home.
Not enough tears
Your eyes don’t make enough of the watery part of tears. This is more common with age, some medicines, the menopause, and conditions like Sjögren’s.
What we do: measure your tear level, choose the right drops for you, and use tiny plugs to keep your own tears in where they help. We’ll write to your GP if something needs checking.
Inflamed eyelids: blepharitis, often with tiny mites called Demodex
Crusty, itchy, red lid edges, often worse in the morning.
What we do: deep-clean the lid edge in clinic, treat the mites, and show you how to keep the lids clean at home.
Not sure which one you have? That’s what the assessment is for. We look at your glands, tears and lids, and tell you which type, or which mix.
The short version
- MGD is oil set inside the eyelid glands
- Oil-based drops and sprays stand in for the oil, for a while
- A gland left blocked wastes away, which is why time matters
- Clearing the glands by hand, and IPL, is the treatment