Background: Meibomian gland dysfunction is characterized by inadequate or defective oil production from the meibomian glands, resulting in unstable tear film; various treatments like IPL therapy, artificial tears, ointments, and warm compresses are utilized for its management.

Aim: This study aimed to assess the effect of hydra therapy on tear film stability in patients with meibomian gland dysfunction. The objectives were to evaluate the thickness of the lipid layer before and after the application of hydra therapy and to assess the grading of meibomian gland dysfunction before and after hydra therapy.

Methodology: Longitudinal experimental design was employed to investigate the relationship between variables over time at the Islamabad Eye Centre from August 2022 to May 2023. Thirty patients of sixty eyes with meibomian gland disorder, were selected using non-probability purposive sampling with 3 sessions including 2 followups. Both genders were included, with patients aged 18 to 50. Excluded were patients with mild or moderate dry eye, contact lens users, and those unwilling to participate. Data for all parameters were collected using the Ocular Surface Analyzer, while symptoms were assessed using the OSDI Questionnaire. The results were analyzed using repeated measure ANOVA in SPSS version 29.

Results: The mean score on the LLT assessment increased from 14.16 nm in the pre-therapy session to 26.86nm in session 2, and then to 54.50nm in session 3. The p values on the TBUT assessment, MGD score assessment and OSDI were calculated as 0.000 indicating improved subjective symptoms of dry eye following the intervention. These changes were statistically significant, with p-value less than 0.05.

Conclusions: Hydra therapy was found to improve tear break-up time (TBUT), alleviate dry eye symptoms, increase lipid layer thickness, improve meibomian gland scores, stabilize the tear film, and result in decreased Ocular Surface Disease Index (OSDI) scores, indicating significant improvement in dry eye symptoms. The efficacy of hydra therapy was thoroughly examined and firmly established, highlighting its favorable effects on patients with dry eye.

Keywords: Dry eye syndrome, Meibomian Gland Dysfunction, Evaporative Dry Eye, OSDI