What Is Meibomian Gland Dysfunction (MGD)?

Meibomian gland dysfunction, commonly called MGD, is a condition in which the oil-producing glands inside the eyelids do not function normally.

These glands produce an oily substance called meibum. Each blink spreads this oil over the tears, creating a protective layer that slows evaporation and helps maintain clear, comfortable vision.

When the glands become obstructed, inflamed or damaged, they may produce too little oil or oil that is too thick to spread properly. The tears can then evaporate too quickly, contributing to hyperevaporative dry eye.

Where Are the Meibomian Glands?

The meibomian glands are arranged vertically inside the upper and lower eyelids. Small openings along the eyelid margins release their oil into the tear film.

Healthy glands produce clear, fluid oil that can be expressed with normal blinking. With MGD, the gland openings may become capped or obstructed, and the oil may become cloudy, thickened or difficult to express.

Over time, chronically obstructed glands may shorten, deteriorate or disappear. This structural loss is called gland dropout.

What Are the Symptoms of MGD?

MGD may cause:

Burning, stinging or irritated eyes
A gritty or sandy sensation
Redness along the eyes or eyelid margins
Excessive watering
Blurry or fluctuating vision
Vision that briefly improves after blinking
Contact lens discomfort
Light sensitivity
Eyelids that feel tender, heavy or inflamed
Recurrent styes or clogged glands

Some patients have significant gland changes before developing severe symptoms. Others experience substantial discomfort despite relatively subtle visible findings.

What Causes Meibomian Gland Dysfunction?

MGD can develop through several interacting processes. Contributing factors may include:

Aging
Ocular rosacea
Chronic eyelid inflammation
Demodex blepharitis
Incomplete blinking
Prolonged digital device use
Contact lens wear
Hormonal changes
Certain medications
Eyelid-position abnormalities
Previous eye procedures
Environmental exposure
Sjogren’s Syndrome

The glands can also become less functional when thickened secretions remain trapped for extended periods.

Is MGD the Same as Dry Eye?

MGD and dry eye are not identical, but they are closely related.

MGD is a disorder of the eyelid glands. The resulting oil deficiency can cause excessive tear evaporation and tear film instability. When this leads to symptoms and loss of ocular surface homeostasis, the patient may have dry eye associated with MGD.

A patient may also have MGD combined with inadequate tear production, blepharitis, ocular rosacea, exposure or another ocular surface condition.

Can MGD Cause Watery Eyes?

Yes. Rapid evaporation and ocular-surface irritation can trigger reflex tearing. These watery tears may overflow onto the cheeks without forming a stable, protective tear film.

A patient can therefore have blocked oil glands, excessive tear evaporation and watering at the same time.

Can MGD Cause Blurry Vision?

Yes. The tear film forms the first optical surface that light passes through when entering the eye.

When the protective oil layer is inadequate, the tear film may break apart between blinks. This creates an irregular optical surface and causes vision to fluctuate. Blinking may temporarily restore clarity before the tears begin to break apart again.

Can Meibomian Gland Damage Be Reversed?

Obstructed glands may sometimes regain better function when the obstruction and associated inflammation are addressed. However, glands that have significantly shortened or disappeared may not fully regenerate.

The goals of treatment may therefore include:

Improving the function of glands that remain
Restoring healthier oil flow
Reducing obstruction and inflammation
Stabilizing the tear film
Improving symptoms and visual quality
Limiting additional gland deterioration

Individual response depends on the extent of structural damage and the other conditions affecting the ocular surface.

How Is MGD Diagnosed?

MGD cannot be fully evaluated by symptoms alone. A comprehensive examination may include:

Meibography: Images the structure of the glands and identifies shortening or dropout.
Gland expression: Evaluates how easily oil can be released and assesses its quality.
Eyelid margin examination: Looks for obstruction, redness, vascular changes and inflammation.
Noninvasive tear breakup time: Measures how long the tear film remains stable after a blink.
Tear osmolarity: Evaluates tear film concentration and homeostasis.
Ocular surface staining: Identifies areas affected by dryness or exposure.
Blink assessment: Determines whether blinking is complete and effective.

These findings help distinguish early obstruction from more advanced structural damage.

How Is MGD Treated?

Treatment depends on the severity of the obstruction, gland structure, inflammation, associated eyelid disease and previous response to care.

A personalized plan may include:

Consistent heat and eyelid hygiene
Strategies to improve blink completeness
Tear supplements selected for excessive evaporation
Treatment of blepharitis, Demodex or ocular rosacea
Anti-inflammatory or antimicrobial therapy when indicated
In office heating and gland expression procedures
Intense Pulsed Light therapy
Tixel thermomechanical treatment
TearCare
Red light therapy

Not every patient needs every treatment. A person with early obstruction and preserved gland structure may need a different approach than someone with advanced gland dropout and significant ocular surface inflammation.

Schedule a Meibomian Gland Evaluation

If your eyes burn, water or become blurry despite frequent artificial tears, meibomian gland dysfunction may be contributing.

At EnVision Dry Eye Center, Dr. Jason Besecker uses meibography and tear-film testing to assess gland structure and function. Treatment is then directed at the findings identified during the examination.

EnVision Dry Eye Center
3752 E Amity Avenue, Suite 103
Nampa, Idaho 83687
(208) 490-8823

Request a Comprehensive Dry-Eye Evaluation

Medically reviewed by Jason Besecker, OD, MS
Last updated: October 2026