Ocular Rosacea Associated With Meibomian Gland Alteration in Children

Allergic reaction, skin rash, close view portrait of a girl's face. Redness and inflammation of the skin in the eyes and lips. Immune system disease.
Allergic reaction, skin rash, close view portrait of a girl’s face. Redness and inflammation of the skin in the eyes and lips. Immune system disease.
Children with meibomian gland dropout will likely experience worsening meibographies over time due to the meibomian gland’s inability to regenerate.

The severity of ocular rosacea may be associated with meibomian structural alterations in children, according to findings published in the American Journal of Ophthalmology.

Researchers conducted a prospective, case-control study to analyze clinical, meibographic, and interferometric signs in children with ocular rosacea. The study included 42 children with ocular rosacea and 44 control participants with median ages of 10 and 11 years, respectively. The outcome measures were clinical severity (graded on a 0-4 scale), meiboscores (0-4), and tear film lipid layer thickness (0-100nm). 

In total, 7 participants presented with a unilateral disease, 29 had an asymmetrical form, and 24 had associated cutaneous rosacea. A loss of vision <20/25 was observed in 10 out of 84 eyes, and mean clinical severity grade was 2.5±1.4. Meibographic abnormalities were more significant in children with ocular rosacea (mean meiboscore 2.1±1.36, P <.001) compared with healthy volunteers (mean meiboscore 0.61±0.78). Meibographic severity correlated with clinical severity (r=+0.44, P <.001), duration of the disease (r=+0.28, P =.011), and history of chalazia (r=+0.30, P =.006). No significant differences in mean lipid layer thickness were observed between the 2 groups (74.4±18.7nm and 76.6±18nm, respectively; P =.47). 

Meibomian gland dropout was of particular concern to investigators. “This study showed that meibomian gland dropout can be major. We observed meibographies with >75% gland dropout even in young kids,” according to the researchers. “This finding is very preoccupying, as meibomian glands are known not to be able to regenerate: these patients’ meibographies will only worsen with time.”

Study limitations include a single center design and a small sample size.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures


Audelan T, Martin G, Marciano E, et al. Clinical meibographic and interferometric evaluation in children with ocular rosacea. Am J Ophthalmol. Published online December 20, 2021. doi:10.1016/j.ajo.2021.12.004