Characteristics of the Meibomian gland in a population without dry eye symptoms

This prospective cross-sectional study examined morphological and functional changes of the meibomian glands in 60 healthy volunteers without dry eye symptoms, stratified into age groups of 31- 40, 41-50, and 51-60 years. Participants were screened using the DEQS questionnaire (score≤14) and underwent ocular assessments, including slit lamp examination, fluorescein tear breakup time (FTBUT), Schirmer test, lipid layer thickness (LLT), blink quality, meibography, evaluation of meibomian gland expressibility, and meibum quality. The results showed an abnormal morphology of the meibomian gland (Meiboscore ≥1) in 71% of the upper lids and 51% of the lower lids, with significant age-related differences. Lid margin abnormalities, such as telangiectasia (82%) and gland plugging (84%), were common in the normal population, while lid margin irregularity (11%) varied significantly by age. Tear function tests revealed a median Schirmer I score of 10 mm. (P=0.01 between age groups) and FTBUT of 5.04 seconds. LLT averaged 61 ± 20 microns and corneal staining abnormalities, graded using the Oxford scale, were observed in 23.3% (grade 1) and 1.7% (grade 2). Expressibility and meibum quality abnormalities were found in 66% and 65% of the participants, respectively. The study highlights significant age-related degenerative changes in the meibomian gland morphology of individuals without dry eye symptoms. Although the tear film remains preserved, these findings suggest that awareness, along with early detection and treatment of MGD, might be necessary to prevent the onset of symptoms and the development of dry eye disease.