You can go for Meibomian Gland Probing for instance:

https://www.notadryeye.org/all-about-dry-eye-syndrome/treatments-for-dry-eye-syndrome-and-related-conditions/intraductal-meibomian-gland-probing/

But you have to find a doctor who does it and does it well unless you are ready to travel.

My Current Daily Routine for Managing Dry Eye:

• Upon arising wash eyelids with soap/water and spray with hypochlorous acid…brand is Eye Love’s Heyedrate see here: https://eyelovethesun.com/collections/best-sellers/products/heyedrate-lid-lash-cleanser-subscription-plans

• Take 2 capsules at breakfast of Hydroeye (dry eye formula recommended by Dr. Ward OD which includes GLA/Omegas, etc.); another one at noon; last one at dinner. See here: https://www.sciencebasedhealth.com/HydroEye-Powerful-Dry-Eye-Relief-P43.aspx

• 1000mg Vitamin C at breakfast… per my other eye doctor Dr. Lu D.O.

• Use a heated eye pad and massage eyes sometime during the day. I use this one but there are other options:

https://www.amazon.com/DRY-EYE-MASK-Wizard-Research/dp/B07X58XS45

• Use Regener-Eyes Professional strength 2x per day (breakfast time and dinner time)…made up of proteins, cytokines and growth factors… see here for more info: https://mydryeyes.org/

• Use Restasis 2x per day…after breakfast and 9PM (prescription drug)

• Use Thera Tears brand as needed…usually I don’t have to do much if any of that daily.

• Just before bedtime wash eyelids and spray with hypochlorous acid…when dry, wipe with lid wipes currently using OcuSoft Lid Scrb Allergy Eyelid Cleanser that you can find here:

https://www.amazon.com/Ocusoft-Scrub-Allergy-Eyelid-Cleanser/dp/B07RGX3PZ2/ref=sr\_1\_4?crid=RYA1N8AFL1K7&keywords=OcuSoft+Lid+Scrub+with+Tea+Tree+Oil&qid=1642035306&s=hpc&sprefix=ocusoft+lid+scrub+with+tea+tree+oil+%2Chpc%2C74&sr=1-4

• In bed use preservative free “Refresh Optive Mega-3” and then put on night goggles to cover my eyes since I am quite sure I sleep with them at least partially open. I use this type of goggles: https://www.eyeeco.com/onyixsupsup-hydrating-sleep-mask-black-onyix-black.html?cat-id=43

I have done these two treatments 3x in the last 5 years that worked well for me:

BlephEx treatment: https://blephex.com/patients/index.php

Lipiflow treatment: https://www.jnj.com/innovation/lipiflow-thermal-pulsation-system-a-new-dry-eye-treatment

Also in the last part of 2021 I did 4 IPL treatments using the method that also gets the eye lids not the method with the eye lids covered…see here starting at 13 minutes and 40 seconds into the video:

https://www.youtube.com/watch?v=j4fmCnCgvJ4

I also follow two dry eye doctors (husband and wife team) who run this support community:

https://www.facebook.com/groups/dryeyesupport/about

You can get these doctors free eBook here if you are willing to give them an email address:

https://eyelovethesun.com/pages/free-dry-eye-book/?fbclid=IwAR1Z97teiICKn9MN1jtTlI4eHLEykWFEXHcAjpMJN285MPvLuy-wrPVWPto

I do use some of the doctors’ products so that is what is in it for the doctors but I am just a customer. They don’t see patients any longer, they just run their dry eye company now.

Here is the Amazon link for the specific eye mask I use https://www.amazon.com/gp/aw/d/B07X58XS45?psc=1&ref=ppx_pop_mob_b_asin_title