Ocular surface changes and discomfort in patients with meibomian gland dysfunction.

OBJECTIVE To determine the importance of meibomian gland dysfunction (MGD) on the ocular surface. DESIGN Prospective study. SETTING A university-based referral practice. PATIENTS Patients with ocular discomfort (147 eyes) and without ocular discomfort (54 eyes) were examined. In the total 201 eyes, MGD was defined as the presence of an obstruction of the meibomian orifices (obstruction group [n = 54]) or the absence of a gland structure (gland dropout group [n = 36]), or both of these findings (combined group [n = 38]). There were not any findings of MGD in 73 eyes (non-MGD group). MAIN OUTCOME MEASURES Scores that were obtained from fluorescein and rose bengal staining, the breakup time of the tear film, the rates of tear evaporation and tear production, and meibography. RESULTS Of the 147 eyes with ocular discomfort, 95 (64.6%) had either an obstruction of an orifice or gland dropout, or both. The combined group had higher scores for staining with fluorescein (P = .002) and rose bengal (P = .021) compared with that in the non-MGD group. The rate of tear production was increased more in the gland dropout group than in the non-MGD group (P = .002). The rate of tear evaporation was significantly increased in the gland dropout group (P = .017). CONCLUSION Meibomian gland dysfunction is a major cause of ocular surface abnormalities and ocular discomfort.

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