There are various modern office-based therapeutics for treating and managing dry eye disease and ocular surface disease. Meibomian Gland Probing (MGP) is an excellent option for patients struggling with their current condition and seeking breakthrough. MGP works by relieving scar tissue (fibrosis) surrounding the meibomian gland, which allows for proper flow of oil (meibum) and a healthier tear film.
During the session, the doctor will gently probe the opening of the oil gland to break-up the scar tissue and relieve the internal pressure of the oil duct. As the gland is being probed, patients may hear a ‘popping’ noise which indicates successful passage through the scar tissue. There are approximately 25-30 oil glands per eyelid, and each should be probed to optimize the post-treatment outcomes.
Although probing restores the integrity of the duct, we need to target other co-morbidities (or contributing factors) to alleviate patient discomfort and symptoms.
Common symptoms of DED may include one or more of the following: burning, stinging, light sensitivity, redness, vascularization, foreign body sensation, contact lens discomfort, eye pain, lid tenderness, and more.
The doctor will instill one drop of proparacaine anesthetic eye drop followed by a bandage contact lens. The chair may be slightly reclined for comfort, then a compounded numbing ointment will be applied to both the lower and upper eyelids (enough to gently coat the eyelids). After 10-15 minutes, another round of the same numbing ointment may be applied (for added comfort). If the ointment happens to burn, it typically last no more than 60 seconds. Another drop of Proparacaine may be added, if necessary. With this technique, almost all our patients can complete the procedure with minimal to no discomfort.
Although the probing session itself only takes about 15-20 minutes, we typically set aside 45-60 minutes to answer any questions pre/post-treatment, perform the numbing technique pre-treatment, and take any additional images (ie meibography). Probing can also be performed a separate visit or in combination with other office-based procedures (ie OptiLight IPL, Lipiflow, BlephEx, TearCare, iLux, ZEST, and others)
When the procedure is performed by a highly trained dry eye specialist, it is considered safe, effective and there is no downtime. Additionally, nearly all our patients drive themselves to/from their appointments. Patients with eyelid tenderness often feel immediate results and relief, while others may continue to notice improvement for months to come.
During the probing session, we can sometimes see a tiny drop of blood (usually one drop or a few drops) due to the highly abnormally vascularized eyelids. These unhealthy, telangiectatic, and leaky vessels run along the opening of the oil glands (gland orifices) or wrap the duct. As we release the invasive scar tissue, stem cell stimulation, proliferation, and activation occur.
It should be performed annually whether the patient has symptoms or just signs of the condition. Patients with ongoing inflammation, severe diagnosis, mechanical eyelid concerns, and significant co-morbidities may require more frequent treatments.
Probing was first performed in mid-2000 and the first paper was published by Dr Maskin in 2010. Since then, dozens of peer reviewed article have been published around the world to support the safety and effectiveness of MG Probing.
In a recent study (2019), three groups were compared: IPL vs MGP vs IPL+MGP. The study revealed the combination of MGP+IPL produced the best results in relieving signs and symptoms as well as helping patients attain longer-lasting relief