At CARE Clinic, the optometrist assesses Meibomian gland function (oil quality, blockage, damaged glands) and then discusses treatments according to your case: manual gland expression, OptiLight IPL, iLux, or home care routines.
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Tears are not only made of water. They contain a thin layer of oil that helps keep the eye surface smooth and comfortable.
The Meibomian glands, located in the eyelids, produce this oil. If it becomes too thick, flows poorly, or if the number of glands decreases over time, tears may break up quickly — this is known as Meibomian gland dysfunction (MGD)The optometrist examines the eyelids, the Meibomian glands, tear quality, and the surface of the eye. The next steps are then tailored to what is observed.
MGD is now considered the most common cause of evaporative dry eye in adults.
"The result may feel like dry eyes: burning, sandy sensation, reflex tearing, or blurry vision that clears after a blink."
THE CARE EXPERIENCE
The optometrist observes the eyelid margin, the appearance of the glands, and the stability of tears between blinks.
The optometrist checks if blepharitis, rosacea, screens, contact lenses, the environment, or certain medications contribute to your case.
Treatment is discussed based on the condition of the eyelids, tear film, your symptoms, and any potential contraindications.
Symptômes
MGD doesn’t always present the same signs. Symptoms may vary with screens, wind, contact lenses, or at the end of the day.
01
A burning or stinging sensation appears when tears evaporate too quickly, especially in front of a screen or at the end of the day.
02
Vision that blurs and then clears after blinking often indicates unstable tears.
03
A gritty feeling in the eye can accompany irritation of the surface or edge of the eyelids.
The eye can water in response to an irritated surface, even when the problem stems from too rapid evaporation.
The eyelid margins may feel thicker, sensitive, or sticky upon waking.
Redness near the eyelashes may accompany inflammation or associated blepharitis.
When using a screen, we blink less often, which makes symptoms more noticeable during reading or close-up work.
Contact lenses become less comfortable when tears lack stability.
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Meibomian glands are not just about a clogged gland. The optometrist observes whether the oil from the tears is released properly, if the eyelids are irritated, and whether the ocular surface remains stable.
Dr. Francesca Olinga, optometrist
Overview
Two people with similar symptoms may have very different gland conditions. These indicators show what the optometrist looks for before discussing next steps.
How to use these indicators
Four indicators to guide the evaluation
These indicators describe what can be observed: thicker secretions, obstructions, loss of glands, or associated inflammation.
01
Secretion
The oil produced by the glands may become less fluid and harder to express.
Signs
•
Thicker discharge upon expression
•
Tear film that breaks down faster
•
Symptoms often more noticeable by the end of the day
02
Obstruction
The small openings at the eyelid margin may be blocked or less visible.
Signs
•
Less open gland openings
•
Irregular eyelid margins
•
Possible chalazia if a gland becomes blocked
03
Structure
Imaging may show areas where the glands are less dense or fewer in number.
Signs
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Shortened or less visible glands
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Symptoms sometimes discordant with the appearance
•
Helpful follow-up to compare progress
04
Context
Rosacea, blepharitis, or Demodex may contribute to irritation of the eyelid margins.
Signs
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Reddish eyelid margins
•
Deposits or crusts near the lashes
•
Possible context of ocular rosacea or blepharitis
Why tears become unstable
01
The glands produce oil that is thicker, less abundant, or harder to expel.
02
The oily layer provides less protection to the eye's surface between blinks.
03
Friction, redness, watery eyes, or fluctuating vision perpetuate inflammation of the eyelid margins.
Causes
Meibomian glands can produce thicker oil, release it less easily, or diminish in number as obstruction becomes chronic. The eyelid margin may also be inflamed, irritating the eye surface and enhancing discomfort.
MGD often coexists with posterior blepharitis, ocular rosacea, a dry eye or episodes of chalazion. The optometrist looks for what exacerbates symptoms based on your profile — chronic inflammation, Demodex, prolonged contact lens wear, screens, dry environments, or hormonal changes.
Perspective
MGD is often chronic and fluctuating. Clinic follow-up aims to stabilize tears, reduce eyelid irritation, and adjust treatment as needed.
Symptoms may improve and then recur, especially when triggering factors persist: screens, dry air, contact lenses, rosacea, blepharitis, or eyelid inflammation.
Clinic follow-ups allow us to check whether the discussed actions or treatments are still helpful, or if other options should be considered based on the progression.
An evaluation is helpful when symptoms persist, frequently return, or interfere with screens, contact lenses, driving, or reading.
A sudden loss of vision or very blurry vision that doesn't clear up with blinking warrants a prompt evaluation.
Urgent
Significant eye pain or eyes very sensitive to light warrant a rapid evaluation — these signs may indicate something other than AMD.
Urgent
Intense redness in one eye warrants a rapid evaluation.
Urgent
Immediately remove contact lenses and seek immediate medical attention if the eye becomes red and painful: risk of infection or corneal damage.
Immediat
Abundant purulent discharge or a very swollen eyelid requires prompt evaluation.
Urgent
The optometrist checks if the eyelids, tear oil, or inflammation are contributing to the symptoms.
Heat, cleaning, expression, or light do not target exactly the same problem. The discussion will depend on what is observed and what bothers you the most.
Schedule an assessment
An optometrist and founder of the CARE Clinic, Dr. Francesca Olinga understands dry eye because she has experienced it. Experienced in the management of complex cases (neuropathic pain, demodex, chalazions), she uses innovation and attentive listening to guide you toward improved eye comfort.
Optometrist with over 30 years of experience and speaker for eye care professionals. Dr. Nguyen has experience in improving visual quality affected by dry eye. She supports her patients in reconciling their aesthetic goals (makeup, cosmetics) and optimal eye comfort.
An optometrist and member of theOOQ, Dr. Daniel Nguyen splits his practice between eye exams in an optometry clinic and advanced management of dry eye conditions at the CARE Clinic. This dual practice provides him with a comprehensive view of his patients' visual health, from routine screenings to cutting-edge therapeutic protocols. dry eye Biography of Karine Charbonneau
