In the past, it was largely believed that Dry Eye was caused by a lack of tear production, or Tear Film Insufficiency. Over the past 20 years, we have discovered that most people who present with Dry Eye symptoms are actually suffering from Meibomian Gland Dysfunction, or MGD. The Meibomian glands are the vessels that supply lipids to the tear film, allowing your tears to function properly. Untreated MGD can lead to the glands beginning to atrophy, like what happens to muscles if they are not used. Gland loss can present a serious long-term problem, as there is no way to restore gland function once they are no longer functioning.