Common glaucoma treatments may worsen ocular surface disease and meibomian gland dysfunction, leading to discomfort, redness, and even poor treatment compliance. The data on glaucoma and meibomian gland dysfunction (MGD) are compelling: 80% of patients on the typical first-line therapeutic class, prostaglandin analogs (PGAs), have Grade 2-3 MGD, and their level of ocular surface disease (OSD) is much worse than that of age-matched patients who are not on any glaucoma medications.1.