Dysfunction and inflammation of the sebaceous glands in the palpebral margins (Meibomian glands) that causes a lower production of the oily substance necessary to keep the eye lubricated, thus the substance that is produced is denser and less effective in lubricating the eye. It gets worse with acne rosacea, blepharitis, and even changes in estrogen levels.

Treatment: a) Carefully clean the edges of the eyelids. b) Apply moist heat to the affected eye. c) Squeeze the meibomian gland to help clear secretions from the glands. d) Insert a small tube (cannula) into each gland opening to wash off the thick oil. e) Tetracycline antibiotic for several weeks. f) Using Lipiflow, a device that automatically warms the eyelid and helps unclog the glands. g) Use fish oil to improve the oil flow of the glands. h) Using hypochlorous acid on the eyelids can be very useful for people who have rosacea. i) Treat for any general skin condition like acne or rosacea.