Contact Lens Wear Is Associated with Decrease of Meibomian Glands

Purpose: Approximately 30% to 50% of contact lens (CL) wearers report dry eye symptoms. Meibomian gland dysfunction has been recognized as a possible cause of CL-related dry eye. This study investigated the influence of CL wear on the meibomian glands using a newly developed meibographic technique. Design: Cross-sectional observational case series. Participants: Contact lens wearers (n = 121; 47 men, 74 women; mean age standard deviation, 31.8 +/- 8.0 years) and healthy volunteers (n = 137; 71 men, 66 women; mean age +/- standard deviation, 31.4 +/- 15.1 years). Methods: The following tests were performed: slit-lamp examinations of the eyelids, corneal and conjunctival staining using fluorescein, measurement of the tear film breakup time, evaluation of the rneibomian glands using noncontact meibography, and measurement of tear production using the Schirmer I test. Partial or complete loss of the meibomian glands was scored for each eyelid using 4 grades (meiboscores): grade 0 (no loss of meibomian glands) through grade 3 (the area characterized by gland dropout was more than 66% of the total area containing the meibomian glands). The meiboscores for the upper and lower eyelids were summed for each subject. Main Outcome Measures: Score of meibomian gland changes (meiboscore), tear film breakup time, and Schirmer test value. Results: The meiboscore was significantly higher (P<0.0001) in CL wearers (mean, 1.72; 95% confidence interval, 1.47-1.96) than in the control group (mean, 0.96; 95% confidence interval, 0.73-1.19). The average meiboscore of CL wearers was similar to that of a 60- to 69-year-old age group from the normal population. A significant positive correlation was observed between the duration of CL wear and the meiboscore. Conclusions: Contact lens wear is associated with a decrease in the number of functional meibomian glands. This decrease is proportional to the duration of CL wear. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2009;116:379-384 (C) 2009 by the American Academy of Ophthalmology.