In office eyelid debridement is performed by the optometrist during a dry eye exam. In patients with moderate to severe MGD, lid debris debridement improved clinical findings, subjective symptoms, meibomian gland function, along with ocular surface MMP-9 level. This is an effective clinical strategy for treatment of moderate to severe MGD. Mechanical debridement/scaling of the line of Marx and the lid margin removes keratin from the meibomian gland orifices that can obstruct lipid expression to the ocular surface; these keratin deposits can also predispose the patient to blepharitis. One study found that debridement on its own provided statistically significant symptom relief and improved meibomian gland function. The technique can have a synergistic effect when combined with other treatments that heat or express the glands.
