The two major branches of the immune system are the 1) innate and 2) adaptive responses. In general terms, the former is fast-acting and nonspecific, whereas the latter is antigen-specific and long-lasting. While these two branches are considered distinct, functionally they can act in an inter-dependent fashion to carry out an immune process in disease states, which will be the focus of the current presentation. Additionally, I will show recent work from our lab demonstrating that the T helper cell compartment (adaptive) can orchestrate recruitment of neutrophils (innate) to drive ocular surface inflammation. Importantly, this coordinated response causes MGD in the ‘chronic-like’ AED model in mice. Similarly, MGD severity in patients is positively correlated with tear neutrophil quantity (Reyes NJ. 2018, Science Translational Medicine). Hence, the interplay between adaptive and innate immunity is an important area of study in ocular surface disease and may be key to better understanding the unresolved clinical problem of MGD in patients.