I first hear about meibomian gland probing years ago when an attending surgeon at New York Eye and Ear Infirmary would come to our ER after a long run on the streets of Manhattan and ask us to unclog his meibomian glands with a needle. At first we were all super suspicious. He said he had terrible pain in his eyes from time to time but especially when he would run a few miles thru NYC. So we would take our 30g needle and pop open the tops of his meibomian glands, some of which were pouting with oil. He would feel relief and we would go on our way until next time. That was 2000. 

Fast forward to 2010 when Dr. Steven Maskin published below report. The field of Meibomian Gland Studies took off and now patients can get much needed relief from Meibomian Gland Probing. 

At first I was suspicious if it would work on my patients but I have been shocked by how many patients feel relief from the probing. Even patient who are down to less than 5 visible glands on Lipiview with severe Sjogren’s Syndrome have felt relief. 

Few eyeMDs do this procedure likely because it is time-consuming and is not comfortable for the patient and most MDs I know really do not like causing pain. But the procedure does work. It is worth the discomfort and pain for patients who have not found relief from warm/hot compresses, Omega 3 2000-400mg, IPL, and Lipiflow which currently are the proven ways to keep the meibomian glands flowing with olive oil type oil as opposed to toothpaste secretions. If I had chronic eye pain and Meibomian gland dilation and loss on Lipiview I would have it done ASAP if Lipiflow and IPL did not work. 

Lipiflow has more published data on its benefits compared to IPL, but IPL does help in most patients as well. Still, I would have Lipiflow done first on my eye as it is not painful and we have good studies showing its benefit. Then I would have IPL even though we do not have great long-term studies on its benefit: but it does not cause significant pain. Lastly, I would have Meibomian Gland Probing if the above did not help. 

The risks are very few as the natural process of Meibomian Gland Dysfunction is to worsen over time. Thus the theoretical risk of damaging the glands with probing is very likely not more than would happen with the natural progression of the disease. In fact, the opposite has been shown in one paper which I will post soon: MGP helps long-term gland health. 

Dr. Steven Maskin charges, as seen above, $5730 for probing of 4 eyelids. It is expensive, but there have been hundreds of patients who have noted relief from probing and/or PRP insertion into the meibomian glands. While it is not 100% guaranteed, most patients benefit from probing. 

We are all still looking for a cure for Meibomian Gland Disease and Dry Eye Disease!