The Dry Eye Zone

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MG Expressor Kit

...And in that same EyeWorld article, there was mention of a new kit for doctors to express those glands for the rest of us. Personally I don't see why a kit's needed (rice anyone? and fingers?) but hey, the more medical devices around for it the more doctors will, hopefully, be learning about the need to be conversant in meibomian gland manipulation. WAKE UP, DOCTORS. The population is aging. MGD is booming. Patients are shopping around for doctors on the basis of how meibomianitis literate they are. Are you? And by the way, stock analysts care about dry eye. Do you? Well, OK, if you're reading this blog you probably do. Maybe you could forward a link to a colleague who doesn't... yet.

For less severe cases of meibomian gland dysfunction, Mario Gutierrez, OD, FAAO, has developed the MG Expressor Kit (Gulden Ophthalmics), which combines the traditional therapies of warm compresses and massage, though in a more rigorous form. The kit includes a gel mask that can be warmed, the expressor tool and sanitary caps that can be placed over the roller. Dr. Gutierrez described the technique.

“Once the lids are warm, it liquefies the contents of the meibomian glands,” he told PCON. “Then, we basically roll the tool on the eyelid near the eyelid margin, and that helps express the liquefied meibomian gland content.

“I typically warm up the eyelids, use the roller, really work the nasal eyelids — the glands — a little bit more,” he continued. “This seems to help the patient become less symptomatic if we can get the nasal meibomian glands working well. Then I’ll go back and warm the lids a little bit more, maybe for a minute or two more, and then go back and roll it one more time to try and liberate as much of the expressions as possible.”

According to Daniel Adams, OD, the expressor is best used at a horizontal angle, working from the lash line upwards.

“The gel pack should only be used for 3 minutes to warm the glands, and then the expressor tool should be rolled horizontally — not vertically — over the eyelid, forcing the meibum upwards,” Dr. Adams said in an interview. “You want to soften the oil that’s congealed in the gland, and once you are able to get it to a ‘soft butter’ stage, roll the glands and try to express it out.”

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