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With the singular exception of punctal or canalicular occlusion, when we are talking about in-office dry eye disease treatments, we are talking about treating meibomian gland dysfunction and evaporative dry eye.
For decades, meibomian gland dysfunction treatment began and ended with warm compresses and baby shampoo scrubs. Medical advice consisted of insisting that your patient use Johnson’s baby shampoo. Perhaps the first real breakthrough was the discovery of the presence of biofilm on the lid surface, typically associated with staph species. As is so often the case, research led by Hank

