Example #1: The index finger is rolled up the lower lid to the lid margin. Pressure is applied inwards as the finger is rolled up to express the secretion from the gland. Lid massage should be done 20 to 30 times on each eye. There are 23 glands in each eye, running upwards to the lid margin, behind the eyelashes. Ensure that you do 3 rolls to cover the entire lower lid and all of the glands. Research has shown that as few as 2 glands blocked can have a detrimental effect on tear film performance. Think of your finger being like a steam roller. Pressure must be kept in against the eyeball to keep the gland blocked as your finger rolls up the lid and the fluid inside is pushed out.
Example #2: Pinch the lower eyelids between thumb and forefinger to express the meibomian glands and bathe the eyes with saline solution to remove excess material. Squeezing the upper lids is not advised
Example #3: Take a Q-tip and gently but firmly roll it from a position about 1/4 inch below the eyelid upwards until you reach the lash line. Repeat this for different positions on the lower lid.