How Much Does Meibomian Gland Probing Cost?

How Much Does Meibomian Gland Probing Cost?

At the request of a dear patient, I have edited my comments below to indicate my recommended protocol for severe Meibomian Gland Dysfunction and Loss.

Punch Line:
Meibomian Gland Probing does work and surprisingly has provided relief thus far in 99% of my patients. But it can be very uncomfortable/painful for some patients and may require a lidocaine injection of the eyelid prior to probing. I still recommend Lipiflow first and then IPL if Lipiflow does not help before trying probing. 
There are no studies to show Meibomian Gland Probing, Lipiflow, or IPL worsen the meibomian glands. On the contrary, there are new reports that each one does work and preserve meibomian gland function with Lipflow having the most number of research presented thus far, followed by Meibomian Gland Probing, and then IPL.
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!
 2010 Oct;29(10):1145-52. doi: 10.1097/ICO.0b013e3181d836f3.

Intraductal meibomian gland probing relieves symptoms of obstructive meibomian gland dysfunction.



To perform a retrospective evaluation of a new treatment for obstructive meibomian gland dysfunction (O-MGD) using invasive orifice penetration and intraductal probing.


Office-based ophthalmology private practice.


Medical charts of 25 consecutive patients with O-MGD (based on presence of lid margin or tarsal hyperemia, lid margin telangiectasia, thickening or irregularity, and meiboman gland orifice metaplasia) plus lid tenderness or symptoms of lid margin congestion were reviewed to evaluate the effect of probing on tenderness and congestion.


Twenty-four of 25 patients (96%) had immediate postprobing relief, whereas all 25 patients (100%) had relief of symptoms by 4 weeks after procedure. Twenty patients (80%) only required 1 reatment and had an average of 11.5-month follow-up. Five patients (20%) had retreatment at an average of 4.6 months. All patients had symptom relief at time of last follow-up. Of 56 symptomatic and treated lids, 42 (75%) were upper lids. Patients frequently reported improvement in newly recognized but previously subclinical symptoms.


Invasive orifice penetration and intraductal probing seems to provide lasting rapid symptom relief for patients with O-MGD. Probing findings in this study frequently included (1) mild resistance upon orifice penetration, (2) proximal duct gritty tactile and aural sensation suggestive of keratinized cellular debris, and (3) focal variable resistance deeper within the duct, which may be relieved with the probe, suggestive of fibrovascular tissue. Taken together, these findings may offer probing characteristics that may allow for a grading system for duct obstruction. The postprobing improvement of symptoms not previously appreciated supports the notion that meibomian gland disease exists subclinically.
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