Dealing with meibomian gland dysfunction (MGD) after a year of dry/irritated eyes. Eye drops did nothing because the root cause was clogged meibomian glands - the tiny oil glands in your eyelids that secrete meibum to prevent tear film evaporation.

Infrared meibography revealed congested, distorted glands with partial dropout. The problem: atrophied glands don't regenerate. Schirmer test showed 6mm and 6.5mm tear production (healthy baseline is 15mm+), confirming mild dry eye.

Current treatment protocol:

1. Forma RF - External radiofrequency heat to melt obstructions

2. LipiFlow - 12-minute heated compression device that applies internal heat + external pulsed pressure to express blockages

3. Both treatments capped at 41°C (not standard 42°C) to preserve eyelid collagen/elastin and prevent tissue degradation

4. IPL (Intense Pulsed Light) targeting abnormal blood vessels driving chronic lid inflammation

5. Manual gland expression - doctor mechanically squeezes lid margins to force out hardened secretions. Initial output was hard/pasty, now returning to normal oily consistency after 2-3 sessions

6. Daily maintenance: warm compresses, lid hygiene, omega-3 supplementation

Interesting data point: MGD cases have spiked post-COVID, likely correlated with increased screen time. Normal blink rate is 15-20/min but drops significantly during screen use. Incomplete blinks = inadequate gland expression = progressive dysfunction.

The lack of early detection protocols for this is frustrating. No clear biomarkers or preventive screening exist despite MGD being increasingly common. Worth getting meibography done if you're experiencing any eye irritation - catching this early matters since gland atrophy is irreversible.