Meibomian Gland Morphology Suggestive of Dry Eye Disease in Contact Lens Wearers

Woman applying eye-drops into her eye
Woman applying eye-drops into her eye
Clinicians may find that DED is complicated by its detection through subjective clinical signs.

Abnormal meibomian gland morphology appears to be suggestive of dry eye disease in contact lens wearers, according to a study published in The Ocular Surface. However, the meibomian gland morphology metrics evaluated in the study had no clinically significant predictive value for detecting dry eye disease (DED) in current or previous contact lens wearers.

Researchers conducted a study to determine the utility of known meibomian gland morphology metrics for predicting DED in current and previous contact lens wearers. They performed meibography on 112 participants (mean age, 28.5±7.0 years, 60.7% women, 18.8% with DED) as 2 investigators subjectively graded images for the following 13 meibomian gland characteristics: distorted, tortuous, hooked, abnormal gap, overlapping, fluffy areas, tadpoling, thinned, thickened, ghost, no extension to lid margin, shortened, and atrophied. Investigators evaluated the predictive value of detecting DED for each metric using area under the receiver operating characteristic curve (AUC) analyses.

Researchers defined DED as the worst eye having a reduced tear meniscus height of <0.2 mm, or a non-invasive tear break-up time of <10 seconds and a Standardized Patient Evaluation of Eye Dryness score >5.0. They identified 3 morphology metrics that were marginally predictive of DED including thickened upper eyelid meibomian glands (P =.046), thickened mean upper plus lower eyelid meibomian glands (P =.007), and atrophy of upper eyelid meibomian glands (P =.043). However, the AUC for each of the 13 metrics was <0.70, indicating poor to no predictive value.

“None of the MG morphology metrics analyzed had the ability to predict DED disease in a mixed group of previous and successful CL wearers,” according to the researchers. “These data highlight the complexity of DED and its detection with evaluating subjective clinical signs.”

Limitations of the study include a different study definition of DED than the standard one provided by the DEWS II report, a limited age range of participants, and the use of only 2 primary graders.

Disclosure: This trial was supported by Alcon Research. Please see the original reference for a full list of disclosures.


von Ahrentschildt A, Hanenberg L, Robich ML, et al. Morphological characteristics of meibomian glands and their influence on dry eye disease in contact lens wearers. Ocul Surf. 2022;24:93-99. doi:10.1016/j.jtos.2022.01.002