If you've been told you have dry eye and given artificial tears that never quite solve the problem, there's a good chance the real culprit is meibomian gland dysfunction — a condition most patients have never heard of, despite being the root cause of over 80% of dry eye disease. At Harnos Optometry in New Paltz, NY, understanding MGD and treating it properly is at the core of our dry eye care approach.
What Are Meibomian Glands?
Your eyelids contain 25–30 tiny glands along each margin called meibomian glands. These glands secrete meibum — a specialized oil that coats the surface of your tears and prevents them from evaporating. Every time you blink, a fresh layer of meibum is spread across your tear film, creating a stable, protective surface over your cornea.
When these glands become blocked, inflamed, or begin to atrophy, the oil layer thins or disappears. Tears then evaporate rapidly — often within seconds — leaving the corneal surface exposed, inflamed, and uncomfortable. This is evaporative dry eye, and it's why simply adding more tears with drops rarely provides lasting relief.
Risk Factors for MGD
Certain factors significantly increase your risk of developing meibomian gland dysfunction, including:
- ◆Extended screen use (reduced blink rate starves the glands of normal stimulation)
- ◆Contact lens wear (particularly monthly lenses worn without proper hygiene)
- ◆Age — gland dropout increases significantly after age 40
- ◆Certain medications including antihistamines, antidepressants, and oral contraceptives
- ◆Rosacea — ocular rosacea and MGD are closely linked
How We Diagnose and Treat MGD
During a dry eye evaluation at Harnos Optometry, we can assess your meibomian glands directly — evaluating gland dropout, expressibility, and the quality of meibum secretion. This gives us a clear picture of how advanced your MGD is and guides your treatment plan.
Treatment typically begins with a consistent warm compress regimen to liquefy and express the thickened gland secretions, combined with lid hygiene protocols. For more advanced MGD, prescription anti-inflammatory drops and omega-3 supplementation play important roles. In cases where dry eye has led to contact lens intolerance or severe discomfort, scleral lenses offer a remarkable solution by creating a fluid reservoir directly over the corneal surface.
The good news is that MGD is highly treatable when caught early and managed correctly. Don't wait until your glands have atrophied — schedule a dry eye evaluation at our New Paltz office today.