Dry eye guide
Meibomian Gland Dysfunction (MGD)
The most common cause of dry eye. What it is, why it happens, and how to care for it at home, starting today.
Watch the warm compress videoYour tears need oil to last.
Along the edge of each eyelid sit about 20 to 40 tiny meibomian glands. Every time you blink, they release a thin layer of oil that floats on top of your tears and keeps them from evaporating.
In meibomian gland dysfunction, the glands get clogged or the oil turns thick, like butter instead of olive oil. Your eyes still make tears, but without a good oil layer they dry up too fast. Experts consider MGD the most common cause of dry eye.
MGD is often a long-term condition. Without proper care, the glands can be damaged over time. Early, steady treatment helps keep them working.
Signs and causes.
Does this sound like you?
- Burning or stinging
- A gritty, sandy feeling
- Tired eyes by the afternoon
- Blurry vision that clears when you blink
- Watery eyes
- Red or crusty eyelid edges
- Eyes that hate wind, heaters and air conditioning
- Contact lenses that feel worse every year
What makes it more likely
- Age
- The glands slowly make less oil, and thicker oil, as we get older.
- Screens and reading
- We blink less, and less completely, while we focus. Every full blink is what squeezes fresh oil out.
- Contact lenses
- Long-term lens wear is linked to changes in the glands.
- Skin conditions
- Rosacea, seborrheic dermatitis and Demodex mites along the lashes often go with MGD.
- Hormones
- Lower androgen levels, menopause and some hormone therapies affect oil production.
- Some medications
- Isotretinoin (for acne), antihistamines, some antidepressants and anti-androgen drugs.
- Eye makeup
- Liner on the inner lid margin can sit right on the gland openings.
- Dry, windy air
- Our dry Eastern Washington and Oregon climate makes a thin oil layer show up faster.
At-home care, part 1
Artificial tears, the right kind.
Use preservative-free lubricating drops whenever your eyes feel dry, such as Refresh Plus or Systane preservative-free. Preservatives can irritate the eye when drops are used several times a day.
Good to know: artificial tears relieve dryness, but they do not unclog the glands. That is the job of warm compresses, and if needed, in-office treatment.
At-home care, part 2
How to do a warm compress.
Gentle, steady heat softens the thick oil so the glands can drain. It takes 42 seconds to learn.
- 1
Warm it up
Heat a microwavable eye mask as the package directs, or soak a clean washcloth in warm water and wring it out.
- 2
Test it on your wrist
It should feel comfortably warm, never hot.
- 3
Close your eyes for 10 minutes
Rest it over your closed eyelids. A washcloth cools within a few minutes, so rewarm it as needed. A mask holds heat longer.
- 4
Gentle lid massage
Right after, with a clean fingertip, gently roll the upper lid down toward the lashes and the lower lid up toward the lashes. Light pressure only.
- 5
Once or twice a day, every day
Consistency matters more than heat. Most people notice a difference over a few weeks.
Always test the temperature on your wrist first. If you have had recent eye surgery or have an eye infection, ask your doctor before using heat.
Small habits that help.
- Blink on purpose. On screens, every 20 minutes look 20 feet away for 20 seconds and do a few slow, full blinks.
- Add moisture to the air. A humidifier helps in heated rooms and our dry summers.
- Take off eye makeup every night, and keep liner off the inner lid edge.
- Point vents away from your face, in the car and at your desk.
When home care is not enough
The Dry Eye Trifecta.
If you have done warm compresses and preservative-free tears every day for a few weeks and your eyes still burn, it is time for an evaluation. Our doctors may recommend the Trifecta, three in-office technologies in one visit to help the glands work again.
IPL
Intense pulsed light helps calm inflammation around the eyelids.
Learn more ›MiBo Thermoflo
Steady, controlled heat and massage, far more consistent than a compress at home.
Learn more ›Low-level light therapy
Gentle light as an added step to support the eyelids.
Learn more ›$1,700 for the recommended 4-treatment program. Save $700.
Questions? Answers.
What is meibomian gland dysfunction?
Meibomian gland dysfunction (MGD) is when the tiny oil glands along the edges of your eyelids get clogged or make thick, poor-quality oil. That oil normally keeps your tears from evaporating, so without it tears dry up too fast and your eyes feel dry, gritty, burning or tired.
Is MGD the same as dry eye?
MGD is the most common cause of dry eye. Dry eye is the symptom picture; MGD is often what is behind it. It causes the evaporative kind of dry eye, where you make tears but they do not last.
Can MGD be cured?
MGD is usually a long-term condition that is managed rather than cured. Without care the glands can be damaged over time, which is why early, steady treatment matters. With good care most people get real, lasting relief.
How long should I do warm compresses?
About 10 minutes, once or twice a day, every day. Give it a few weeks before judging whether it is working.
What kind of artificial tears should I use?
Preservative-free lubricating drops, such as Refresh Plus or Systane preservative-free. Preservatives can irritate the eye when drops are used several times a day.
Why do artificial tears only help for a little while?
Drops add moisture, but they do not unclog the glands or fix the oil layer. That is why they relieve symptoms for a short time, and why warm compresses and, if needed, in-office treatment go after the cause.
What if warm compresses and drops are not enough?
Book a dry eye evaluation. If your glands need more than home care, our doctors may recommend the Dry Eye Trifecta: IPL, MiBo Thermoflo and low-level light therapy in one visit. The recommended 4-treatment program is $1,700.
Is it safe to use a warm compress?
Yes for most people, as long as it is comfortably warm and not hot. Always test it on your wrist first. If you have had recent eye surgery or have an eye infection, ask your doctor before using heat.
Where can I get checked for MGD?
At any of our offices in Pasco, Sunnyside and Hermiston. Dry eye evaluations are booked by phone so we can set aside the right appointment.
Still dry, gritty or burning?
Book a dry eye evaluation. Call the office closest to you.
This page is general health information, not medical advice, and does not create a doctor-patient relationship. Your doctor will recommend care based on your own exam. Background: International Workshop on Meibomian Gland Dysfunction (Investigative Ophthalmology & Visual Science, 2011) and TFOS DEWS II (The Ocular Surface, 2017). Last reviewed October 14, 2026.