This is an in office procedure following thermal heating of the glands, where the doctor manually expresses the upper and lower meibomian glands to allow secretions to flow easily. This prevents the glands from clogging and leading to atrophy and helps to clear up clogged glands.

This procedure is recommended every 3 to 4 months to allow the glands to properly flow and allow proper secretion to maintain a proper balance of the tear film structure.