Why the glands need expressing
Each blink squeezes the meibomian glands slightly and should release a little clear oil. When the oil has thickened, a blink cannot move it, the gland fills and dilates behind the blockage, and eventually the gland atrophies. Expressing the gland under enough pressure to clear the blockage lets it empty and refill with fresh secretion, and glands that have been static for months often resume normal function once cleared.
How it is done
The lids are warmed first, because cold thickened oil does not move. Numbing drops are placed. At the slit lamp, the clinician uses a paddle-shaped instrument or forceps to apply steady pressure across the lid from behind the lashes, working along the whole margin and watching the gland openings. The consistency and color of what emerges (clear, cloudy, toothpaste-like or nothing) is recorded gland by gland. Both lids of both eyes are treated in about ten minutes.
What it feels like and afterward
Firm pressure, sometimes uncomfortable for a moment on a badly blocked gland, but brief. The lids may be slightly tender and pink for a few hours. Vision is briefly blurred by the released oil. There is no downtime.
Where it fits in treatment
Expression is the second half of every thermal treatment, whether the heat came from LipiFlow, TearCare, radiofrequency or IPL. On its own, after a heated compress, it is a useful maintenance treatment for patients between device sessions and a first step for patients with mild disease. Home expression after compresses, which can be taught at the evaluation, keeps glands flowing between visits, though it cannot apply the pressure the clinician can.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is the right choice for you is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
