Background <p>To evaluate the clinical efficacy of okra eyelid patch versus sodium hyaluronate combined with ofloxacin eye drop in the treatment of patients suffering from meibomian gland dysfunction (MGD).</p> Methods <p>40 patients included were randomly divided into 2 groups: okra eyelid patch group (<i>n</i> = 20) and control group (<i>n</i> = 20). Before treatment, on the 14th and 28th day of treatment, the following ophthalmic examinations were performed: symptoms and signs score, Schirmer I test (SIT), tear film break-up time (TBUT), corneal fluorescein staining (CFS), optical quality analysis system (OQAS II) and ocular surface interferometer examination. Ocular surface disease index (OSDI) questionnaire score and in vivo confocal microscopy (IVCM) were performed before treatment and on the 28th day of treatment. Adverse effects were reported during the treatment period. Results were analyzed by SPSS 25.0 software. <i>p</i> &lt; 0.05 was considered a statistically significant difference.</p> Results <p>On day 28, okra eyelid patch group had a better curative effect in symptoms score, signs score, total score, OSDI questionnaire score, TBUT, and CFS score, lipid layer thickness and MASD compared with control group (<i>p</i> &lt; 0.05). During the 28-day treatment, one patient in okra eyelid patch group reported eyelid redness, while the difference between the two groups was not statistically significant (<i>p</i> &gt; 0.05).</p> Conclusions <p>Okra eyelid patch has a more significant effect on MGD, especially in improving symptoms and signs, increasing lipid layer thickness, improving tear film stability, maintaining corneal epithelial integrity, and improving the quality of meibomian gland acini compared with artificial tears combining ofloxacin eye drops. It has few side effects, and provides a new therapeutic option for MGD associated with dry eye.</p>