Can Meibomian Glands Recover or “Grow Back”? How do the Meibomian Glands Disappear?

Can Meibomian Glands Recover or “Grow Back”?

The short answer is, likely yes, to some extent. There is still a great deal of work needed, though, to see how much the Meibomian Glands can recover. For now, the below paper demonstrates warm/hot compresses can make the Meibomian Glands “grow back” or fill up with more oil..

Meibomian gland dysfunction (MGD) is a chronic diffuse, potentially debilitating meibomian abnormality, which is fairly common but easily neglected in daily clinical practice, even by great eyeMDs and ODs.
Patients with MGD mainly have symptoms of eye irritation,
 and some severe cases with complications like blepharokeratoconjunctivitis will possibly end up with permanently blurred vision for corneal scarring: something I am seeing in younger and younger patients. I just saw a 7 year old and 16 year old with corneal scarring from MGD from, we think, staring at electronic devices and video games for years. Their blood test for Sjogrens syndrome and diabetes were negative to date. 

How do you loose your Meibomian Glands?
These little organs inside each eyelid have their orifice/opening at the base of the eyelashe and are crucial to producing precious oil for your tear film.

This is how it happens in most patients;
1. If the opening gets obstructed from bacteria or mites or from make-up, then the oil cannot get out.
2. If the oil cannot get out, it can sometimes produce a stye or chalazion. But often, the oil gland likely down regulates (the same way it does if you stop breast feeding your baby or milking a cow: less milk is produced) and less oil is produced.
3. When less oil is produced, the gland begins to atrophy (ie, die away),
4. If not caught early, the gland will form permanent scar tissue that we cannot revive.

In some patients, direct toxic effects of radiation or certain chemotherapy will internally destroy the gland.

We assess gland dropout noninvasively by noncontact infrared meibography, which makes it possible to monitor gland dropout during and after treatment. However, whether reversibility of gland dropout exists is still a controversial issue, and research focusing on this topic is lacking: I think many cases of meibomian gland drop out is irreversible but I have seen it reverse in some patients who have Lipiflow, IPL, or Probing.

Therefore, in this retrospective study, did the following (1) observe the reversibility of MG dropout and analyze correlated factors, (2) compare different treatment efficiencies with and without eyelid hygiene, and (3) calculate the proportion of the patients with compliance to eyelid hygiene.

Sandra Lora Cremers, MD, FACS

 2017 Mar;36(3):332-337. doi: 10.1097/ICO.0000000000001042.

Reversibility of Gland Dropout and Significance of Eyelid Hygiene Treatment in Meibomian Gland Dysfunction.



To observe reversibility of meibomian gland (MG) dropout and analyze correlated factors and to compare the treatment efficiency with and without eyelid hygiene in patients with meibomian gland dysfunction (MGD).


Consecutive 78 eyes of 78 MGD (stage 2-3) patients who finished follow-up examination after 1-month of treatment were recruited in this retrospective study. All patients were treated with artificial lubricant and eyelid hygiene. Related ocular surface evaluation and meibomian gland assessment were examined.


There were 26 (33%) patients (included in group 1) who ignored doctors’ order for eyelid hygiene, and 52 (67%) patients (included in group 2) were compliant. There was no statistical difference between group 1 (age, 44.4 ± 12.2) and group 2 (age, 38.9 ± 16.6) in characteristics and pretreatment clinical indexes. However, after 1-month of treatment, only the ocular surface disease index of group 1 improved (P = 0.048), whereas all clinical indexes of group 2, except the Schirmer test result, improved (including expressibility, all P < 0.05). A 5% decrease in MG dropout of both upper (5.4%) and lower (4.6%) eyelids in group 2 was observed. Improvement in upper-eyelid dropout and expressibility were the predictors of lower-eyelid dropout improvement. The reversibility had no correlation with age, sex, pretreatment MGD stage, disease duration, and use of topical antiinflammation medication.


With expressibility-improving treatment, MG dropout was reversible to some extent. Eyelid hygiene is an efficient treatment of MGD; however, there is a need for ophthalmologists to instruct patients on conduct and supervise patients’ compliance.
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