Scleral Lens Use Not Associated With Meibomian Gland Dropout and Visibility

beautiful girl applying or removing a contact lens with mirror
closeup of beautiful girl looking at herself leaning forward to bathroom mirror to apply or remove her contact lens, holding one eye lid, female face in a blurred foreground
Meibomian gland visibility can be assessed in an objective and repeatable way, according to a report.

The use of scleral lenses does not affect meibomian gland dropout and visibility and could help with dry-eye symptoms after 1 year of lens wear, according to a study published in Contact Lens and Anterior Eye. Secondary findings also reveal that meibomian gland visibility can be assessed in an objective and repeatable manner. 

Researchers assessed 43 participants via infrared meibography, and categorized them into 1 of 3 groups: Group 1 exhibited good subjective gland visibility and gland dropout percentage was < 1/3 of the total meibomian gland area, Group 2 exhibited low subjective gland visibility and a gland dropout percentage < 1/3, and Group 3 exhibited low subjective gland visibility and gland dropout percentage > 1/3. Investigators used an algorithm to calculate meibomian gland visibility metrics based on the pixel intensity values of meibographies. They documented ocular symptoms of 29 scleral lens wearers at 1 year follow up and assessed repeatability of new metrics and their correlation with gland dropout. 

The researchers found no statistically significant difference in gland dropout percentages between groups 1 and 2 (P =.464). Group 1, however, demonstrated increased gray pixel intensity values compared with other groups. Investigators noted significant associations between gland visibility measures and drop-out percentage. Repeatability was acceptable for all metrics tested, and ocular symptoms abated with scleral lens wear (P <.001).

“A clinically and statistically significant reduction from 50.17 ± 22.40 to 25.69 ± 14.34 [Ocular Surface Disease Index] was found between Baseline (prior scleral lens fitting) and after 1 year of scleral lens wear,” according to investigators. “These results are also in agreement with previous studies that claimed that tear film stability, tear film volume, tear film osmolarity, dry eye symptoms, tear film temperature and volume are not altered or are even improved after scleral lens fitting.”

Study limitations include a small sample size, lack of a control group, and inability to assess whether meibomian glands improved after scleral lens wear.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please see the original reference for a full list of authors’ disclosures. 


García-Marqués JV, Macedo-De-Araújo RJ, Cerviño A, García-Lázaro S, González-Méijome JM. Assessment of meibomian gland drop-out and visibility through a new quantitative method in scleral lens wearers: A one-year follow-up study. Cont Lens Anterior Eye. Published online January 4, 2022. doi:10.1016/j.clae.2021.101571