Evaluation of Dry Eye and Meibomian Gland Dysfunction in Teenagers with Myopia through Noninvasive Keratograph

Purpose. This study aims to evaluate dry eye and ocular surface conditions of myopic teenagers by using questionnaire and clinical examinations.Methods. A total of 496 eyes from 248 myopic teenagers (7–18 years old) were studied. We administered Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. The patients were divided into 2 groups based on OSDI dry eye standard, and their ocular surfaces and meibomian gland conditions were evaluated.Results. The tear meniscus heights of the dry eye and normal groups were in normal range. Corneal fluorescein scores were significantly higher whereas noninvasive break-up time was dramatically shorter in the dry eye group than in the normal group. All three meibomian gland dysfunction parameters (i.e., meibomian gland orifice scores, meibomian gland secretion scores, and meibomian gland dropout scores) of the dry eye group were significantly higher than those of the normal group (P<0.0001).Conclusions. The prevalence of dry eye in myopic teenagers is 18.95%. Meibomian gland dysfunction plays an important role in dry eye in myopic teenagers. The Keratograph 5M appears to provide an effective noninvasive method for assessing ocular surface situation of myopic teenagers.

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Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

European Journal of Ophthalmology ◽

10.1177/11206721211006579 ◽

2021 ◽

pp. 112067212110065

Author(s):

Pelin Kiyat ◽

Melis Palamar ◽

Bengu Gerceker Turk

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Surface Damage ◽

Meibomian Gland ◽

Drop Out ◽

Meibomian Gland Dysfunction ◽

Ocular Surface Disease Index ◽

Group 2 ◽

Group 1

Purpose: To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Materials and Methods: Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Results: Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant ( p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 ( p = 0.047, p = 0.003, p = 0.005, respectively). Conclusion: A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

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Meibomian gland dysfunction is highly prevalent among first-time visitors at a Norwegian dry eye specialist clinic

Scientific Reports ◽

10.1038/s41598-021-02738-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Reza A. Badian ◽

Tor Paaske Utheim ◽

Xiangjun Chen ◽

Øygunn Aass Utheim ◽

Sten Ræder ◽

...

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Predictive Value ◽

High Sensitivity ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Positive Symptom ◽

Ocular Surface Disease Index ◽

Gland Function ◽

First Time

AbstractTo investigate the prevalence of meibomian gland dysfunction (MGD) in patients presenting with subjective dry eye-related symptoms at their first-time consultation in a Norwegian specialized ocular surface clinic. Additionally, to explore the accuracy of the ocular surface disease index score (OSDI) as an extensively applied tool to assess the severity of dry eye symptoms and MGD diagnosis. Patients with subjective dry eye-related complaints (n = 900) attending the clinic for the first time, from 2012 to 2016, were included in the study. At the baseline, patients completed the OSDI questionnaire. Subsequently, objective clinical tests, including fluorescein break-up time (FBUT), Schirmer-I test, ocular surface staining (OSS), and meibomian gland function assessment using gland expressibility and meibum quality were performed. The association between MGD and its severity in relation to symptom severity defined by OSDI-score was examined. MGD was found in 93.8% of the study group. MGD prevalence was not significantly different between groups based on age (p = 0.302) or sex (p = 0.079). There was a significant association between severity of MGD and dry eye-related symptoms (p = 0.014). OSS was significantly higher in patients with severe symptoms (p = 0.031). Sensitivity and specificity of positive symptom-score (OSDI ≥ 13) for disclosing MGD were 85.5% and 30.4%, respectively. MGD was highly prevalent, not associated with age and sex. OSDI ≥ 13 had high sensitivity and high positive predictive value (PPV), but low specificity and negative predictive value (NPV) for disclosing MGD. This underscores the importance of meibomian gland assessment in patients with dry eye-related symptoms.

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Evaluation of Dry Eye after Implantable Collamer Lens Surgery

Ophthalmic Research ◽

10.1159/000511197 ◽

2020 ◽

Author(s):

Haiting Chen ◽

Xueyan Feng ◽

Guangzeng Niu ◽

Yuxiang Fan

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Case Series ◽

Meibomian Gland ◽

Quality Score ◽

Control Group ◽

Ocular Surface Disease Index ◽

Implantable Collamer Lens ◽

Lens Surgery ◽

Breakup Time

Objectives: To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. Methods: This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. Results: A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. Conclusions: ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

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A novel noninvasive ocular surface analyzer for the assessment of dry eye with Meibomian gland dysfunction

Experimental and Therapeutic Medicine ◽

10.3892/etm.2017.4364 ◽

2017 ◽

Vol 13 (6) ◽

pp. 2983-2988 ◽

Cited By ~ 9

Author(s):

Yuanyuan Qi ◽

Chen Zhang ◽

Shaozhen Zhao ◽

Yue Huang ◽

Ruibo Yang

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction

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Analysis of tear inflammatory molecules and clinical correlations in evaporative dry eye disease caused by meibomian gland dysfunction

International Ophthalmology ◽

10.1007/s10792-020-01489-z ◽

2020 ◽

Vol 40 (11) ◽

pp. 3049-3058

Author(s):

Xingdi Wu ◽

Xiang Chen ◽

Yajuan Ma ◽

Xueqi Lin ◽

Xuewen Yu ◽

...

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Healthy Subjects ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Surface Parameters ◽

Tnf Α ◽

Evaporative Dry Eye ◽

Ifn Γ ◽

Inflammatory Molecules

Abstract Purpose To compare the levels of inflammatory molecules in tear samples between patients with meibomian gland dysfunction (MGD)-related evaporative dry eye (EDE) and healthy subjects and to analyze the correlations between the levels of tear inflammatory molecules and ocular surface parameters. Methods A total of 30 MGD-related EDE patients (48 eyes) and ten healthy volunteers (15 eyes) were enrolled. Dry eye-related examinations and questionnaires were obtained from all participants. The levels of nine inflammatory molecules were determined through multiplex bead analysis. Results Inflammatory molecules including ICAM-1, IFN-γ, CXCL8/IL-8, IL-6, TNF-α and IL-12p70 were detected in 100% of the patients, while IL-1α, IL-1β and IL-10 were detected in 56.25%, 13.60% and 45.83% of the patients, respectively. Moreover, ICAM-1, IL-8, IL-6, TNF-α, IL-12p70 and IFN-γ were detected in 86.67–100% of the healthy subjects, and the detection rates of IL-10, IL-1α and IL-1β were below 50%. The levels of IL-8, IL-6, IFN-γ and ICAM-1 were significantly higher in the patient group compared with the control group. In addition, IL-8 and IL-6 were negatively correlated with Schirmer I test. Besides, IFN-γ was negatively correlated with tear film breakup time. Furthermore, ICAM-1 and IL-6 were positively correlated with meibography score. Conclusions Collectively, patients with MGD-related EDE had higher levels of inflammatory molecules in their tears, and some molecules were correlated with ocular surface parameters. These findings suggested that inflammation played an important role in MGD-related EDE, and several inflammatory molecules could be used in the diagnosis and the treatment of MGD-related EDE.

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A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.134 ◽

2022 ◽

Vol 7 (4) ◽

pp. 667-671

Author(s):

Prajwalli Reddy ◽

Wajeeha Umam

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Tear Film ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Control Group ◽

Dry Eyes ◽

Group A ◽

Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p < 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p<0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P<0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

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The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers with Myopia

Journal of Ophthalmology ◽

10.1155/2019/5142628 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Xiu Wang ◽

Jing Li ◽

Rui Zhang ◽

Na Li ◽

Yi Pang ◽

...

Keyword(s):

Ocular Surface ◽

Tear Film ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Ocular Surface Disease Index ◽

Time Points ◽

Meniscus Height ◽

Significant Difference ◽

Before And After

Purpose. The aim of this study was to investigate the effect of overnight orthokeratology (OOK) on ocular surface and meibomian gland dysfunction in teenagers with myopia. Methods. A total of 59 subjects were recruited in this prospective study. The following tests were performed before and after 1, 3, 6, 12, and 24 months of OOK lens wear, including ocular surface disease index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. Results. No infectious keratitis occurred during the study. OSDI scores increased gradually and reached the maximum at 6 months of OOK wear (P<0.001). The meniscus height was significantly increased at 1 and 3 months after the initiation of OOK (P=0.006, P=0.035). The corneal fluorescein staining at 1, 3, 6, 12, and 24 months after wearing OOK were all increased than the prewearing level with significant difference (P=0.014, P=0.036, P<0.001, P<0.001, and P=0.008, respectively). The first and the average tear film NIKBUT were all higher than the prewearing level, but there was no significant difference between every follow-up time points (P>0.05). The lid margin abnormalities were significantly increased (P=0.003, P=0.038, and P=0.015) at 6, 12, and 24 months after the initiation of OOK. There was no significant difference in the meibomian gland orifice scores at each follow-up time points compared to the prewearing level (P>0.05). The meibomian gland lipid secretion scores after wearing OOK were higher than those of the prewearing level, however, without statistically significant difference (P>0.05). No significant differences of the degree of difficulty of lipid excretions were detected after the initiation of OOK (P>0.05). There was no significant difference in meibomian gland dropout scores between all follow-up time points and the prewearing level (P=1.000). Conclusion. OOK increased the symptoms of dry eye and decreased the function of tear film by affecting the meniscus height and BUT. OOK did not affect the function of meibomian glands.Clinical Study registration number: ChiCTR18000185708.

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Tear Film Break-Up Time and Dry Eye Disease Severity in a Large Norwegian Cohort

Journal of Clinical Medicine ◽

10.3390/jcm10040884 ◽

2021 ◽

Vol 10 (4) ◽

pp. 884

Author(s):

Mazyar Yazdani ◽

Jørgen Fiskådal ◽

Xiangjun Chen ◽

Øygunn A. Utheim ◽

Sten Ræder ◽

...

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Characteristic Curve ◽

Tear Film ◽

Correlation Coefficients ◽

Meibomian Gland ◽

Discriminative Power ◽

Ocular Surface Disease Index ◽

Significant Difference ◽

Break Up

This study evaluated to what extent tear film break-up time (TFBUT) could discriminate pathological scores for other clinical tests and explore the associations between them. Dry eye patients (n = 2094) were examined for ocular surface disease index (OSDI), tear film osmolarity (Osm), TFBUT, blink interval, ocular protection index (OPI), ocular surface staining (OSS), Schirmer I test, meibomian expressibility, meibomian quality, and meibomian gland dysfunction. The results were grouped into eight levels of break-up time (≤2, ≥3, ≤5, ≥6, ≤10, ≥11, ≤15, and ≥16) with or without sex stratification. Receiver-operating characteristic curve (ROC) analysis and Pearson’s correlation coefficients were used to study TFBUT’s discriminative power and the associations among the tests, respectively. Above and below each TFBUT’s cut-off, all of the parameters indicated significant difference between groups, except OSDI (cut-off 15 s) and Osm (cut-offs 5 s–15 s). At TFBUT cut-off of 2 s, sex difference could be detected for OSDI, Osm, and OSS. OPI presented the strongest discriminative power and association with TFBUT in sharp contrast to Osm, holding the poorest discriminative power with no significant correlation. The remaining parameters were within the poor to very poor categories, both with regard to discrimination and correlation. In conclusion, patients with lower TFBUT presented with more severe DED parameters at all four defined cut-off values.

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Meibomian Gland Dysfunction

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v35i1.866 ◽

2019 ◽

Vol 35 (1) ◽

Author(s):

Sameera Irfan

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Treatment Strategies ◽

Tear Film ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Meibomian Gland Dysfunction ◽

Eye Disease ◽

Treatment Protocols ◽

Dry Eyes

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.

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Prevalence and Risk Factors of Severe Dry Eye in Bangladesh-Based Factory Garment Workers

Diagnostics ◽

10.3390/diagnostics10090634 ◽

2020 ◽

Vol 10 (9) ◽

pp. 634 ◽

Cited By ~ 1

Author(s):

Mamunur AKM Rashid ◽

Calesta Hui Yi Teo ◽

Sumaiya Mamun ◽

Hon Shing Ong ◽

Louis Tong

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Age Groups ◽

Meibomian Gland ◽

Ocular Surface Disease Index ◽

Cross Sectional ◽

Garment Workers ◽

Severity Grading ◽

Eye Symptoms ◽

Dry Eye Symptoms

This study sought to evaluate the prevalence of dry eye and meibomian gland dysfunction (MGD) and the associated factors of severe dry eye symptoms (SDES) among garments worker of Gazipur, Bangladesh. We prospectively collected cross-sectional data for 1050 garments workers of a factory (70% response). All participants had an evaluation of the Ocular Surface Disease Index (OSDI), and a detailed ophthalmic examination including tear breakup time (TBUT), ocular surface fluorescein staining, and Schirmer’s I test. MGD grading was based on the viscosity/color and ease of manual expression of meibum. Mean age of participants was 35.5 ± 12.1 years; 53.8% were women. The prevalence of dry eye (OSDI > 12) was 64.2% (95% CI 61.2–67.1%). OSDI was not significantly different between sex or age-groups but associated with increasing MGD grade (p < 0.001), reduced TBUT (<5 s) [p < 0.001], and reduced Schirmer’s test (<5 mm) [p < 0.001]. Thirty-five percent had SDES (OSDI > 32). Using univariate logistic regressions, SDES was associated with older age (Odds Ratio (OR) 1.01, 95% Confidence Interval [1.005–1.03] per year increase) and male sex (OR 1.76, 95% CI: 1.36–2.27). When adjusted for age and sex, SDES were strongly associated with increase in MGD severity grading (OR 188, 95% CI: 91–390). However, in multivariate regression, TBUT, but not MGD severity, became the only significant determinant of SDES (OR 13.0, 95% CI: 6.3–27.0, for every 1 s decrease in TBUT). MGD is common in garments workers, contributing to dry eye symptoms in addition to other tear parameters. Reduced tear stability is associated with SDES.

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