Although meibomian gland structure and function can be assessed through meibography and lipid layer thickness (LLT), the role of blink parameters on the tear film is not as clear. A recent study, presented at ARVO’s virtual meeting, suggested blink patterns may be able to predict which parameters of the tear film correspond to dry eye and can potentially guide treatment.

The single-center, retrospective cohort study assessed 456 eyes and evaluated the relationship between LLT, meiboscore and blink rate, including the total number of blinks in 20 seconds, partial blinks and time between blinks.

The team found a decrease in LLT was tied to an increase in meibomian gland dropout, which was reflected in the meiboscore. For every one-point increase in the meiboscore, the average LLT declined by 1.31nm and the total blink rate decreased by 4%. Still, these findings weren’t statistically significant, the researchers noted.

Additionally, patients who had more complete blinks—or an incomplete blink rate less than 50% of the time—had shorter inter-blink intervals. “We speculate that in patients with an increase in partial blinks, the longer inter-blink interval results from impaired corneal sensation related to the chronic exposure,” the researchers wrote in their paper.

Considering disease states, including floppy eyelid syndrome, obstructive sleep apnea, meibomian gland dysfunction, ocular graft-vs.-host disease and Stevens-Johnson syndrome, the authors noted the LLT and inter-blink interval didn’t drastically differ between individuals with the various conditions.

The study also found no major difference in LLT in subjects with a partial blink rate greater than 50% vs. those whose partial blink rate was less than 50%.

On the other hand, the investigators observed an association between the inter-blink interval and the partial blink rate. Specifically, partial blink rates ranging from 0% to 50% showed inter-blink intervals that were 0.73 seconds shorter, on average, compared with those with no partial blink rate.

“By carefully studying blink patterns associated with dry eye signs and symptoms, we may be better able to predict which parameters of tear film composition and blink function correspond to DED and potentially guide treatment,” the researchers wrote in their ARVO abstract.

Brahmbhatt P, Brahmbhatt S, Adams W. Lipid layer thickness, blink parameters and meiboscore in patients with dry eye disease: a retrospective cohort study. ARVO 2021 annual conference.