What the glands look like
Each upper lid holds around 25 to 40 glands and each lower lid 20 to 30, running vertically from deep in the lid to openings just behind the lashes. Under infrared light, the oil-filled glands reflect brightly against the surrounding tissue. A healthy lid shows a full row of straight glands reaching the lid margin. Dysfunction shows first as dilation and tortuosity as oil backs up behind blockages, then as shortening as the deep portions atrophy, and finally as dropout, where glands have disappeared altogether.
The imaging
The clinician gently everts each eyelid to expose its inner surface and the imaging system photographs it in infrared, in a second or two per lid. Software maps the glands and calculates the percentage of the gland area that is missing, which grades the disease. The images are saved and compared at each visit.
What the grade means for treatment
Blocked but intact glands recover with thermal treatment and expression, and patients at this stage respond best. Shortened glands have partly atrophied; treatment preserves what remains and improves function in the surviving portions. Lost glands do not return, and the aim becomes protecting the survivors and supplementing the oil layer with drops such as perfluorohexyloctane. Seeing the images explains to patients why treatment is urged early, and why home care matters between treatments.
Meibography before surgery
Patients preparing for LASIK, cataract or lens surgery may be imaged because gland dysfunction destabilizes the tear film that the pre-operative measurements and the post-operative result depend on. Treating the glands beforehand is increasingly common in refractive and cataract practice.
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.
