Meibomian Gland Probing

For severe blepharitis and dry eye

Dry Eye and Blepharitis
Floppy Eyelid Syndrome
Meibomian Gland Probing
Autologous Serum Tears

What is Meibomian Gland Probing?

During meibomian gland probing, your doctor uses a small 1-2mm metallic filament to break open the meibomian glands. Sometimes, a patient may feel/hear a “pop”-like sensation as the metallic filament breaks open a blocked meibomian gland duct. Treatment involves probing of all meibomian glands on the eyelid margin.

Research Highlights of Meibomian Gland Probing

Restores function of atrophic meibomian glands

Greater than 75% reduction in dry eye symptoms

92% of patients report improvement in eye comfort and symptoms after 1 week

Probing leads to 90% reduction in lid tenderness

Most patients require probing at most once/year

Safe and effective
Probing does not harm glands or lids

Who may benefit from Meibomian Gland Probing?

If someone has had blepharitis for a long period of time (months-to-years), the oil gland ducts may become scarred and/or atrophy.  Chronic inflammation from blepharitis may lead to scarring, which will then cause the gland to narrow or block off completely. A patient may feel that, in spite of using warm compresses, their eyelids are still red, tender, sore, and their eyes are still dry, raw, or suffer an intermittent burning sensation. Probing can restore the anatomic integrity of a clogged meibomian gland, and relieve all causes of obstruction.

How can Meibomian Gland Probing help with dry eyes?

The goal of Meibomian Gland probing is to improve the overall health of your eyelid margin, and make your eye more comfortable. Your eye(s) may not feel better for the first few weeks. Your eye(s) may not feel completely better if you have some diseases, have longstanding dry eye disease, or other ongoing eye conditions. In general, most patients feel improvement for months, depending on the severity of disease. Many patients need only one treatment to break all scar tissue inside the meibomian gland ducts, after which regular treatment for blepharitis will suffice. Patients may have recurrence after a year, and may require repeat probing.

Probing can restore the anatomic integrity of a clogged meibomian gland, and relieve all causes of obstruction. After meibomian gland probing is done, your doctor may also using heat and manual expression to accelerate a more complete removal of previously trapped, now liberated meibum (oil), while together promoting an improvement in health meibum formation and outflow.

The benefits/efficacy of Meibomian gland probing has been validated in numerous medical studies. Patients have reported significant relief, leading to enhanced comfort and quality of life.

FAQs regarding Meibomian Gland Probing

What are some of the signs that you may benefit from Meibomian Gland Probing?

  1. Lid tenderness, redness, and/or soreness, suggesting a buildup of oil (meibum) behind an obstructed gland.

  2. Non-expressible and poorly-expressible glands with signs of Meibomian Gland Dysfunction (MGD), as seen by your ophthalmologist at the slit lamp microscope. Similarly, your ophthalmologist may note a reduced number of expressible glands.

  3. Signs of MGD that include lid margin or tarsal hyperemia (redness), lid margin telangiectasia (microscopic blood vessels around the base of the eyelashes), thickening or irregularity of the eyelid margin, irregular and/or poorly visible meibomian gland orifices.

  4. A history of blepharitis, dry eyes, or eye irritation that has been ongoing for months-to-years, in spite of diligent usage of warm compresses or in-office blepharitis treatments.

  5. Lids showing signs of MG obstruction on infrared meibography or transillumination including dilated ducts, cystic changes, and gland atrophy.

Does insurance cover Meibomian Gland Probing?

Insurance coverage for this procedure is variable. Though the procedure has been substantiated by multiple medical studies, given that it is ultimately a NEW procedure, many insurance policies have not included Meibomian Gland Probing amongst their covered procedures.

For all of our patients, regardless of coverage, we provide an invoice and clinical documentation, which may be submitted for insurance claims.

Meibomian Gland Probing is meant for severe blepharitis

For those with severe meibomian gland dysfunction, or blepharitis; meibomian gland probing can make a meaningful, and lasting improvement in a person’s eye pain, quality of vision, and quality of life.

 

Meibomian Gland Probing in the Medical Literature

  1. Magno M, Moschowits E, Arita R, Vehof J, Utheim TP: Intraductal meibomian gland probing and its efficacy in the treatment of meibomian gland dysfunction. Surv Ophthalmol 2021, 66(4):612-622.
  2. Maskin SL, Alluri S: Meibography guided intraductal meibomian gland probing using real-time infrared video feed. Br J Ophthalmol 2020, 104(12):1676-1682.
  3. Kheirkhah A, Kobashi H, Girgis J, Jamali A, Ciolino JB, Hamrah P: A randomized, sham-controlled trial of intraductal meibomian gland probing with or without topical antibiotic/steroid for obstructive meibomian gland dysfunction. Ocul Surf 2020, 18(4):852-856.
  4. Maskin SL, Alluri S: Expressible Meibomian Glands Have Occult Fixed Obstructions: Findings From Meibomian Gland Probing to Restore Intraductal Integrity. Cornea 2019, 38(7):880-887.
  5. Maskin SL, Alluri S: Intraductal meibomian gland probing: background, patient selection, procedure, and perspectives. Clin Ophthalmol 2019, 13:1203-1223.
  6. Incekalan TK, Harbiyeli, II, Yagmur M, Erdem E: Effectiveness of Intraductal Meibomian Gland Probing in Addition to the Conventional Treatment in Patients with Obstructive Meibomian Gland Dysfunction. Ocul Immunol Inflamm 2019, 27(8):1345-1351.
  7. Huang X, Qin Q, Wang L, Zheng J, Lin L, Jin X: Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial. BMC Ophthalmol 2019, 19(1):211.
  8. Maskin SL, Testa WR: Growth of meibomian gland tissue after intraductal meibomian gland probing in patients with obstructive meibomian gland dysfunction. Br J Ophthalmol 2018, 102(1):59-68.
  9. Syed ZA, Sutula FC: Dynamic Intraductal Meibomian Probing: A Modified Approach to the Treatment of Obstructive Meibomian Gland Dysfunction. Ophthalmic Plast Reconstr Surg 2017, 33(4):307-309.
  10. Sik Sarman Z, Cucen B, Yuksel N, Cengiz A, Caglar Y: Effectiveness of Intraductal Meibomian Gland Probing for Obstructive Meibomian Gland Dysfunction. Cornea 2016, 35(6):721-724.
  11. Ma X, Lu Y: Efficacy of Intraductal Meibomian Gland Probing on Tear Function in Patients With Obstructive Meibomian Gland Dysfunction. Cornea 2016, 35(6):725-730.
  12. Nakayama N, Kawashima M, Kaido M, Arita R, Tsubota K: Analysis of Meibum Before and After Intraductal Meibomian Gland Probing in Eyes With Obstructive Meibomian Gland Dysfunction. Cornea 2015, 34(10):1206-1208.
  13. Fermon S, Zaga IH, Alvarez Melloni D: [Intraductal meibomian gland probing for the treatment of blepharitis]. Arch Soc Esp Oftalmol 2015, 90(2):76-80.
  14. Wladis EJ: Intraductal meibomian gland probing in the management of ocular rosacea. Ophthalmic Plast Reconstr Surg 2012, 28(6):416-418.
  15. Maskin SL: Intraductal meibomian gland probing relieves symptoms of obstructive meibomian gland dysfunction. Cornea 2010, 29(10):1145-1152.

An eye exam is the best way to screen for, and evaluate any eye conditions affecting your health, comfort, and quality of vision.