What is Meibomian Gland Probing (MGP)? Who would benefit from MG Probing?
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 patient 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.
What are symptoms associated with dry eye disease (DED)?
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.
How is the patient is prepped for Probing? Is the procedure painful?
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.
How long does the procedure take?
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 an 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)
What to expect post-treatment?
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.
What are the side effects?
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.
How frequently should we perform probing or repeat probing?
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.
How long has the procedure been around?
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.
Is there a benefit of combining treatment such as OptiLight IPL & Probing (MGP)?
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.
Erin W: I’ve been seeing Dr Silani for years for his dry eye services. He has really changed my life. A few month ago, he recommended another treatment for my eyelids called gland probing. After the procedure, I felt an instant improvement and happy to report (months later) that my eyes are still doing great.
Geo K: Wanted to share my gland probing experience with Dr Silani. For me, it was easier than I expected. His numbing cream worked well. During the procedure, I just felt some slight tugging and pinching but no pain. I had no pain or soreness afterwards. i even ended up driving myself home from the appointment (3 hour drive) with no problem.
Zizi G: I performed IPL of the face/eyelids with gland probing on my left eye yesterday. Both treatments were like going to a relaxing spa, felt fantastic. My left eye is doing much better, less swollen eyelid and eye. I'm looking forward to doing probing on the other eye next month! Thank you so much Dr Silani!
Larry C: I’ve been struggling with Blepharitis and ocular rosacea for years. My symptoms were not easily controlled so my primary eye doctor referred me to see Dr Silani for his expertise in dry eye. After my consult, the doctor shared great insight into my condition and recommended a personalized treatment plan. After reviewing my options and doing some of my own research, I decided to schedule to see him back for OptiLight IPL and Gland Probing. Ive only had 3 IPLs and Probing on my left eye only but I already feel so much better. In fact, I’m scheduled to have Probing on my right eye next week and my fourth IPL next month. Thank you so much Dr Silani, you’ve given me back control of my eyes and my life. Forever grateful.