The Dry Eye Zone

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Abstract: MGD screening in Singapore

Screening for Meibomian Gland Disease: Its Relation to Dry Eye Subtypes and Symptoms in a Tertiary Referral Clinic in Singapore.
Invest Ophthalmol Vis Sci. 2010 Feb 24. [Epub ahead of print]
Tong L, Chaurasia SS, Mehta JS, Beuerman RW.
Cornea and external eye disease, Singapore National Eye Center, Singapore, Singapore.

Background/aims: To study screening methods and associated factors of Meibomian gland disease and dry eye subtypes in a specialized eye clinic in Singapore.

Methods: This cross-sectional study involved 200 patients in a dry eye clinic and the outcome measures evaluated are Dysfunctional Tear Syndrome (DTS) level, Meibomian Gland Disease grade, Schirmer's test (ST), fluorescein tear break up time (TBUT), corneal fluorescein staining grade, and irritative eye symptoms.

Results: The Meibomian gland screening grade was associated with TBUT (p=0.007), especially in the upper eyelid, and correlated to reading difficulty (p=0.007), and reversibility of symptomatic blurring with lubricants (p=0.006). Abnormal ST was associated with early morning discomfort (p=0.001) and reduced TBUT was linked to discomfort in windy conditions (p<0.001). In all patients examined, evaporative dry eye (58%) was most common, followed by mixed evaporative and aqueous tear deficiency (30.5%) types. Fluorescein staining in the central and inferior cornea was most severe in the mixed type.

Conclusions: In dry eye patients, screening for Meibomian gland disease based on anteriorisation of Marx's line may predict decrease in TBUT and difficulties performing certain visual-function related activities. This facilitates better understanding of the Meibomian gland's contribution to multi-factorial dry eye syndrome, apart from routine conventional tests performed in clinics.