Survey: MGD Treatment Experiences
NOTE: This is an ongoing survey (click here to participate).
The results below are based upon the first 124 participants. We will refresh these results periodically.
Question #1: What have you tried? What helped?
What have you tried?
What helped? (a little or a lot)
AT HOME treatments: What helped?
IN OFFICE treatments: What helped?
In the charts below, look for the green (helped a little) and purple (helped a lot).
Omega 3 EFAs
Oral antibiotics (e.g. doxycycline)
Other at-home treatment
Eyelid hygiene products
Topical antibiotics (e.g. Azasite)
My doctor expresses my glands
Other in-office treatment
Question #2: Please describe any treatments that you have tried that are not listed above.
Restasis, Pazo, sunglasses that cup and protect my eyes.
Self help blogs like The dry eye zone have been a tremendous help in reducing my stress. I no longer feel alone or crazy:) Anti anxiety drugs have also helped reduce my stress level. Stress seems to contribute to my problems.
None. I would love to try lipflow, but I can't afford it.
Restasis and autologus serum= i can cry again!
MiboFlo Thermaflow followed by gland expression.
I am new to this diagnosis, so I don't have a lot of experience. I am currently on the 3rd round of Rx drops since September. I have a few more days of Lotemax, and then I guess we'll see what the next step is. I can see by what I've read that I am not as severe as others. I'm currently using Cetaphil to wash, although I'm open to trying other products going forward.
night goggles, drops, not wearing mascara, changing makeup brands & routine
Every morning I press hard along upper and lower lids with pointy q-tip, after hygiene & hypochlor lid cleaning.
Using an artificial tear with an oil component; eliminate dairy from diet
expressing the eyelids after warm compresses
Systane ultra, systane complete, a little bit of retaine mgd, wearing swim goggles outdoors whenever it’s windy
Exercise and diet (gluten, dairy, and sugar free)
I use an Eyeecho mask at night and Systane PM thick gel
Tear duct cauterization helped a lot. The treatment that helped the most was corneal resurfacing with amniotic implant surgeries.
Proper blinking training, night goggles
ice packs every morning help a bit
eyelid massage after warm/hot compresses; various preservative-free eye drops
Testosterone cream topical application, punctal plugs
Autologous Serum Tears - helped a little
Added Avenova to Occusoft Plus routine
Xiidra twice a day
Lotemax, (helped briefly) Restasis didn’t help) Xidra (didn’t help) scleral lenses (help a lot) Arricept (didn’t help) Lacriserts (didn’t help) plugs (helped for several days only)
Injecting autologous serum into Meibomian glands; non preservative steroid drops only when really needed
I also "roll" my finger up toward my bottom eyelid after using the warm compress every night.
Manual expressing of the glands at home
I use Soothe PM ointment at night to sleep. In the morning and afternoon I wash my face with Stanhexidine but not my eyes. I leave the oiointment on the upper lids. As the day progresses that ointment on the lids and lashes goes into my eyes, allowing it to mix with the Celluvisc drops. My eyes feel great and I go much longer between artificial tear applications. My eyes used to burn and feel prickily but no more. At night I wash my face again in the shower with the Stanhexidine. This time I wash my lids and lashes very carefully with my eyes shut. So I wash my face 3 times a day but only my lids and lashes once per day. I do have oily skin so I need to wash it that much. I'm 50. And my dry eyes started after a bad bout with mono when I was 20. It seemed to attack my eyes and pancreas. I have pancreatic exocrine insufficiency and malabsorption problems.
Have all 4 tear ducts cauterized
Retaine MGD help more than anything else.
Serum Tears and amniotic membrane application
Eyelid massage, squeezing
Serum tears. At home manual expression. Moisture chambers
One problem that has occurred with me related to lid hygiene products is that my lids become sensitized, and using the product then begins to irritate more than help.
Currently taking Restasis drops
steaming closed eyes for 6-10 min daily then gently running fingers down the length of the gland (toward the margin) on both upper and lower lids
Evening Primrose Oil
Castor oil, manual gland expression
Every drop on the market, most current FreshKote this one burns a lot initially but does seem to have a little more staying power, very expensive at $30 for .33 fl oz can only get it online so shipping adds to cost. My doc says it works on all 3 layers of the eye. HydroEye supplement been using this for 1 1/2 months don't know if it helps, also very expensive and only online
Xiidra appears to be helping a lot after 2 weeks.
Question #3: How long do you think is a fair trial for an MGD treatment?
Question #4: How do you decide when to stop a treatment?
When you don't notice any improvement.
My eyes make that determination... I’ve slacked off before thinking things were better. Unfortunately MGD tears it’s ugly head with a vengeance!
When no improvement symptoms
If I have side effects for example warm compress make my lids feel awful
Haven't stopped anything
If the symptoms seems to get worse
If no changes after 6 months
If I am consistent in using the treatment and it just doesn't seem to make any difference. I think Xiidra needs to be used for at least 4 months before you can make a judgement.
When course is finished or cost or ease of storage difficult,...no fridge
No sign of improvement
See no results. Quit trying.
I am still searching always doing something
When there is no change.
When it didn’t help
Not sure what u mean with this
If I have complied 100% with no results
Have not stopped
When u understand what the root cause is and your meds are not treating that.
If no improvement or feeling worse
Time, or doesn’t help
When it makes things worse
When negative side effects arise.
I just add more and haven't stopped anything really.
With Lipiflow I decided because symptoms didn't improve. After research I figured my glands were too blocked for Lipiflow to work. Stopped Doxy after 6 months because had stomach issues and it wasn't helping symptoms. Then tried Zpack and it was no help. I continue IPL , probing and gland expression (my Dr. does all 3 at same visit) even though they haven't helped my symptoms because I think they help keep my glands from deteriorating anymore. I go every 6 months. My oil is thick and many glands shortened or atrophied. I need drops every 10 minutes and I don't want to get worse. I am grateful my Dr. can do this and at a reasonable price compared to what I see people on Dry Eye Talk are charged. My Dr. charges $561 per IPL and probing. I would never be able to afford even one of Dr. Maskins probings. For me the cost matters also when deciding to stop. Lipiflow is too much.
I haven't had enough experience to say.
Seems like enough time to be able to tell.
When I feel that the hassle and amount of time I do it are more than the benefit.
If after several months there was no substantial improvement (or in some cases there was regression).
I only change ONE component at a time, if my eyes don't "feel better" after around 2 months, I drop it and wait a couple weeks. Then I reevaluate to see if it improves, stays the same, or worsens.
No improvement after months or I actually am doing worse on it
when it isn't working
If its benefits are outweighed by the effort or side effects
When my eyes still bother me at work
I only took Doxychline when I had an chalazion and didn't want want to stay on it for more than a few months
When it is obvious that the treatment makes my symptoms worse.
When it just doesn't help.
No change at all.
When there is no change in my situation.
Based on how eyes feel
when doctor tells me to
If I feel that there's no noticeable improvement within a month
Azasite is the worst medicine know to man. All it does is sting the hell out of your eyes. Doesn’t help with dryness at all. Warm compresses only work if you keep an intense amount of heat on your lids for at least 30 minutes. Doxycycline turned the cartilage in my ears blue and my Dermatologist told me to stop taking it. Gland expression really didn’t work for me; it was time consuming and expensive, since I had to pay for a doctors’ visit. I had three lipiflow treatments. The first one was great! The next two really didn’t do anything. So I was out a large amount of money for nothing. The only thing that helps me is Xiidra, Oasis tears and PRN omega capsules.
Doctor reports no change
when the treatment doesn't work after a fair trial
If I think it's helping I don't stop it.
When it seems not to have helped!
when it seems to make no difference
After 1 to 3 months if nothing gets better, or it depends on the cost.
If I have had no benefit
The expense is a factor. I consult my eye doctor. I also check The Dry Eye Shop. Comments from other readers are helpful.
Well, if I have a bad reaction, I stop it right away. Otherwise, I continue if my doctor has asked me to do it, but make inquiries/suggestions at follow up appointments regarding if it is worth it to continue. If my doctor asks me to stop it, I will. If it is something I'm trying on my own and it doesn't seem to be working, I stop doing it.
It causes irritation
It's 3 times treatment. Stopped after that.
When my eyes feel normal.
when doesnt help at all
If eyes continue to hurt and be red after a week or so. Any slight improvements I give it some what longer.
Symtomps are the same or worse
After seeing no difference in 3-4 weeks
About 3-4x per year, had manual Dr. treatment in office to express glands & some scrub with a strange tool which was sometimes irritating afterward & always a creepy experience but helped somewhat. All of the over the counter eyelid “scrubs” irritated me a lot & immediately and so were intolerable. I haven’t tried many other items mentioned above.
When no improvement after several months or new doctor says it’s vad or useless treatment or cost is greater than result
When no results after long trial.
When there is no response to the treatment.
If it’s not helping after 2-3 months
when the cost outweighs the benefits
when I have not seen any consistent positive results after few weeks
When the time devoted to it is not proportional to the results.
I had allergic reactions to doxy and anti biotic drops but the doxy helped my eyes.
Conversation with my optometrist who specializes in dry eye, who actually is amazing. (after seeing a bunch that did not care/or try to learn the latest)
I really do not know.
If I feel NO difference after 3 months, I would quit.
I haven’t stopped a treatment
No improvement and the cost/benefit ratio.
When I don't see a measurable improvement in 3 months
Depends Something simple like cleansing eyelids trial time is shorter than taking Omega 3's - - and BRAND of Omega 3 made a huge difference for me
IPL helped me a lot but I had to stop because I couldn’t afford it. I wish it was covered by insurance!
I haven’t. the one that really helped was a heating device that was shaped to my fit my eye and they moved it back and forth for 8minutes on each eye.
After 2 months
I haven't been in a place to do this.
When I've tried for a couple months and I don't see any improvement.
I have given treatment ideas several months and not seen any advancement. I just keep hoping it would help then I gave up.
If issues occur. After approx 6 months with no improvement.
No results evident
Inverse relationship between difficulty and/or cost and time it takes to help.
After giving a fair amount of time with no benefit
No evidence that it works.
When it makes no difference
If it makes me feel worse
When it isn’t working - the time allowed would depend on the treatment
See my answer above about lid sensitization. Also, if they haven't produced any results in a month.
If no improvement within six months
Question #5: Overall, what treatment, or combination of treatments, do you feel has been the most helpful to you?
Warm compresses plus eyelid hygiene plus high quality fish oil caps and other omega 3 supplements are helpful. Lipiflow was helpful but I could have used one more treatment but didn't do so due to expense. Doxy was helpful but you can't take it indefinitely.
Sticking to my routine.
Hydration, restasis a little, decrease stress, sleep, gut health and diet, eye ointment, salmon or sardines
Doxy, omega, pro biotics, and plugs
Diet change and cleaning lids
Lubricating drops, Ziena sunglasses, Xiidra and reading The dry eyes zone.
Heat , IPL, Manuks honey, hyloforte, nanotears, vitapos .
Compresses, lid hygiene, azithromycin for flare ups, serum autologous tears
Warm compresses and Doxycycline
Lid hygiene and castor oil on lashes at night
When grittiness and irritation are really bad, combining eyedrops with a warm compress helps soothe symptoms until I remove the compress. The relief is brief. Treatments I have been able to try are futile and those that look like they may provide worthwhile results/relief, due to cost, are not an option for me.
IPL and Blephex with gland expression
Oral antibiotics and eye lubricant at night with goggles..
As warm as possible compresses with digital massage afterward, omega & flax oil supplements and limiting computer/phone screen time.
Lipiflow and warm compresses
Serum = most lubricating and less residue. Eyes are confortable longer. Apple cider vinegar in diet helps overall inflammation issue i have.
None so far
Warm compresses, massage, eye drops, omega 3, eyelid wipes maybe IPL
None really. Accutane and 23 years of wearing contact lenses killed my miebomian glands.
Xiidra, eye compress, Cliradex, Gental gel, debridement
Nothing has helped my symptoms but I recognize they may be worse without the treatments. That is why I continue them.
Steriods have done a lot to help with my inflammation. I have had a lot of swelling in my eyelids and the skin was quite raw. Warm compresses have also been very helpful although from time to time something cool feels good too.
goggles at night, not sure during the day - haven't figured it out yet
Restasis, until this last flair up. Now, I'm not sure :(
Lid hygiene and periodic expression of glands by doctor twice a year.
Heat and squeeze, heat and squeeze, heat and squeeze. And debride, every morning at home, and every time a doctor will do it for you.
The Ocusoft Plus lid wipes and no dairy.
warm compress, in combo with expressing, eye drops and staying out of AC.
Drops and environmental changes
lid hygiene and genteal gel
Humidifying my environment, systane complete, and warm compress followed by massage. But I was just diagnosed a month ago so not much experience
See above - diet and exercise... and time. My eyes feel better after dealing with this horrible condition after 3 years. I can wear contact lenses with no issues also.
Really, right after the warm compresses my eyes feel good; and sleeping with the mask has helped to keep them from drying out, but I am suffering from depression since I can no longer wear eyemakeup and feel so very self conscious about my ugliness
Tear duct cauterization, corneal resurfacing with amniotic implant surgeries and probing.
Eyelid cleaner twice a day, eye drops, moisture chambers glasses.
Taking TheraLife eye pills for autoimmune disorders. They help a lot for my runny eye.
MGD, goggles, compresses
still dealing with problem -- am considering lipiflow
lubricant eye gel and tranquileyes at night
Hot compresses and massage, serum drops and some gels, protective glasses with shields.
Warm eye mask, cleaning with Avenova or Heyedrate
Lipiflow, liquid tears
Doxycycline and Teatree oil lid scrub.
Eye hygiene, night ointment, celluvisc
Lipiflow seemed to make a big difference, but I think I need it again. I had it 3 years ago. Also I take fish oil that has the alcohol (use to clean the oil) removed. The process is called "Triglyceride" it allows your body to use the fish oil a lot better. That seemed to help my eyes. (I use WHC UnoCardio 1000 from Amazon). I also wear goggles at night to which I add preservative free eye drops.
Occasional LipiFlow, Xiidra, Doxycycline in the Winter, Daily Compresses and Lid Hygiene and regular visits to my Eye Doctor.
Lid expression and Blephex
Home treatment: warm compress, eyelid hygiene, drops
eye ointment and eye drops; eye bubble
compresses with expressing the oils
Xiidra and Lipiflow. Warm compresses with massage of eye lids right after. Also Ocusoft wipes.
MGD Retaine Eyedrops, warm compress and eyelids cleaning
Less compressing and more omegas and Borage oil
Pet peeve: preferred Dr who did manual treatment (above) used to take my insurance for treatment but he left for a new city. New Dr. has “machine” & she charges $1000 per treatment &it is NOT covered by insurance! So, forget it!
Hot compresses, scleral lenses, eye mask and humidifier at night, Lipidlow, quarterly gland expression at drs office, wrap around glasses
Doxycycline 40MG and warm compresses have helped me enormously. It takes a long time and patience and commitment is required.
Warm compresses at least twice daily. Occusoft Plus wipes twice daily. Azesite at bedtime.( a few days monthly) Refresh nite time gel, covering eyes with press and seal at bedtime.
Omega 3 supplements and warm compresses
I don't think any treatments that I've tried have been effective enough.
Lipiflow gave the best results, but is too expensive. In the affordable range, warm compresses (esp. Tranquileyes and lid washes/rinses have been the most helpful.
Warm compress , ipl, expression
IPL, Lipiflow and schelal lens
Probe & autologous serum injections & non preservative steroid drops used sparingly only when really needed
Lipiflow helped for a year or more. And warm compresses.
Antibotic gel/theraputic contacts/botox
daily doxycline and warm compress treatments with Occusoft Plus scrubs, AND last but not least, autologous serum eyedrops.
Compressed and lid scrub with manual expressing
Using Celluvisc and Soothe PM on my lids and lashes during the day. Warm compresses make things worse. Cold feels better to me. And moisture chambers and wrap around glasses are a must. No makeup. Drinking lots of water. And eating lots of albacore tuna and eggs - Born 3 brand.
Tea Tree oil eyelid/facial cleanser, Zocushield, iLux? (or a comparable one?), warm compresses
Cauterized tear ducts, PRN Omega 3's, eye lid hygiene, drops
IPL, wipes and over the counter eye drops
The one described above but it was a trial basis and the doctor didn’t purchase it.
IPL & warm compresses
probing, if it means what i think it is. (to unclog the glands at the dr office.
Twice daily hot compresses with Bruner mask and cleaning twice daily with Heyedrate Lid and Lash Cleaner/Occusoft.
warm compresses and the Scleral lens, but I have trouble with a film on the outside of them. Can't get my hands on the right cleaners/solutions.
Hot compress, lotemax, lid hygiene
Staying away from strong preservative eye drops and flooding my eyes with preservative free drops. Also using Muro 128 at night Staying too away from fans heat and any kind of moving indoor air.
As I said above, Retaine MGD helped more than anything. Just now trying a tea tree oil from you. It doesn't irritate my eyes which every other lid "scrub" I tried did. But only been using a week.
I'm not sure. I am in the process of trying serum tears and my Opthamologist said there are a few medications that might improve tear production. Lipiflow was an expensive bust for me.
Warm compress Eyeeco ,massage, eyelid hygiene. And Ziena eyewear
Warm compresses, massage, supplements.
Only restasis helps me function most days, not a cure-all but gives definite relief from extreme dryness generally (has to be imported at considerable cost from the US to Australia, via govt authority). During the day, systane drops, and wash/bathe with saline solution morning and night. IPL was a total disaster with no benefit from the treatment and permanent loss of most of my eye lashes as the optometrist (who lectured in optometry at a top uni) didn't read/follow the instructions for administering IPL. I had tattooed eyeliner at the time, and the IPL caused what was akin to third degree burns and then loss of my dark lashes. The prescribed protective goggles weren't used and the optometrist went too close to the eye lash line on top and bottom. The optometrist said he had successfully administered the treatment to around 50 people before me, including a lady with tattooed eye liner (not true!). He was called in for a counselling session at the NSW Optometry board, after I registered a complaint. I miss my lashes enormously...both functionally and aesthetically. So I caution those seeking MGD solutions....they can potentially make it all so much worse.
Diet. Sleep. Cliradex. Moisture chambers. Avoiding triggers.
xiidra, diet changes, humidifier while working on a computer and watching tv, avoiding overhead lighting and taking care of my mental health
Nothing. Very discouraged.
Self expression of glands eyelid hygiene and supplements
This survey was conducted by
February 18-26, 2019 (Survey is ongoing)
124 as of February 26
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