The tear film lipid layer is compromised in evaporative dry eye patients, resulting in less protection against tear evaporation.1 One of the most common causes is obstruction of the meibomian glands by stiffened meibum and cellular debris.1 Because patients with meibomian gland dysfunction (MGD) have a higher meibum melting point and lower eyelid temperature compared to healthy patients, heat therapy and gland expression are often the first treatments recommended for these patients to melt the oils and evacuate the glands.2-4