Pterygium May Alter Meibomian Gland Structure and Function, Lead to Dry Eye

Patients with pterygium may benefit from evaporative dry eye evaluation.

A pterygium can affect meibomian gland morphology and functioning, according to a study published in Optometry and Vision Science. This finding suggests that individuals with a pterygium may benefit from evaporative dry eye monitoring. 

Researchers enrolled individuals with a nasal pterygium (n=54; mean age, 54.0 years; 30 women) and age- and sex-matched control group participants (n=50; mean age, 52.3 years; 32 women) in the investigation and assessed meibomian gland functional and morphologic changes and dry eye parameters among the cohort. Participants underwent Schirmer 1, fluorescein tear film break-up time (TBUT) and ocular surface staining (Oxford score) evaluations and completed the Ocular Surface Disease Index (OSDI).

Changes in meibomian gland structure and function among individuals with pterygium were evidenced by lower Schirmer 1 (13.48 vs 16.86 mm; P =.007) and TBUT values (7.48 vs 12.31 seconds; P <.001) compared with control group participants. Higher Oxford (0.46 vs 0.21; P =.009), OSDI (33.43 vs 22.55; P <.001), and total meiboscore (2.64 vs 0.44; P <.001) were noted among participants with pterygium compared with control group individuals. 

Meibomian glands are affected both morphologically and functionally in patients with pterygium.

Individuals with pterygium had a higher prevalence of meibomian gland depletion (90.7% vs 32%;P <.001) compared with the control group participants. Participants with pterygium often had an asymmetric distribution of the meibomian gland loss region (75.5% of patients), and these asymmetries were most frequently located on the side of the eyelid nearest the pterygium (94.5%).

“Meibomian glands are affected both morphologically and functionally in patients with pterygium,” according to the researchers. “As these pterygium patients may face pterygium removal surgery, any present dry eye and [m]eibomian gland dysfunction should be managed prior to surgery to rebuild the ocular surface homeostasis and increase the surgery’s success.”

Study limitations include a small sample size.

References:

Devebacak A, Teker ME, Palamar M. The influence of pterygium on meibomian glands and dry eye parameters. Optom Vis Sci. Published online January 31, 2023. doi:10.1097/OPX.0000000000001996.