Contact Lens Use May Promote Meibomian Gland Dropout

Optometrist examining young woman's eye, contact lens on index finger
Optometrist examining young woman’s eye, contact lens on index finger
Clinicians may consider including meibography as a part of routine examination in CL wearers, a study suggests.

Contact lens use may cause meibomian gland dropout (MGD), particularly with rigid contact lens users, according to a study published in Contact Lens and Anterior Eye. Secondary findings show that duration of use in soft contact lens wearers is also associated with meibomian gland loss (MGL). 

Researchers conducted a prospective, multicenter, cross sectional analysis of 91 eyes of 91 patients. They assigned participants to a soft contact lens group (n=44, 34 women), a rigid lens group (n=21, 15 women), and a healthy control group that did not wear contact lenses (n=26, 15 women). Investigators administered the Ocular Surface Disease Index (OSDI) to all participants, and performed eye exams, tear break up time (TBUT) and Schirmer I tests, lid margin analysis, and meibography. The primary outcome measure was percentage of MGL (PMGL). 

Researchers note that OSDI scores correlated with PMGL. The mean values for OSDI and PMGL were lowest in the control group, followed by the soft lens and rigid groups (3.5±2.6, 18.4±9.2; 15.5±18, 25.3±12.5; and 29±18.6, 34±13.4, respectively, P <.001 for all).     

Multivariate analysis revealed that duration of CL use was the sole predictive variable of mean PMGL among soft CL wearers (P =.001), and there was no predictive variable for mean PMGL in rigid CL wearers. After adjusting for other variables, the researchers found that rigid CL material caused a significantly greater predisposition to MGL compared with soft material (P =.042). 

“This study is the first to show that CL material is an important parameter in CL-associated MGD,” according to the researchers. “This result demonstrates the importance of careful follow-up of rigid CL wearers in terms of ocular surface findings and development of evaporative dry eye.” 

Limitations of the study include possible confounding due to the role of keratoconus in participants with rigid lenses, and the evaluation of ocular symptoms with OSDI, which is not designed for CL wearers. 


Harbiyeli II, Bozkurt B, Erdem E, et al. Associations with meibomian gland loss in soft and rigid contact lens wearers. Cont Lens Ant Eye. 2022;45(1). doi:10.1016/j.clae.2020.12.005