Figure 2: Massage (Part A of PBMP) of the lids. (i) Each patient is asked to close his or her lids under comfortably hot shower water and to massage, gently, both upper lids downwards and both lower lids upwards during those 30 seconds. This is done from a medial to lateral direction. (ii) The patient uses the thumb and index finger of the ipsilateral hand aiming to express the tarsal gland contents towards the lid margins.