Dry eye disease often has multiple causes, making it a challenge to treat. In a recent study, researchers identified predisposing factors and the relative contributions of various ocular surface clinical signs to dry eye symptoms.

The team prospectively collected clinical data of 2,346 newly referred dry eye patients (mean age 46.2 ±14.8 years; 77.4% women, 87.1% Chinese).

The researchers found that a higher Ocular Surface Disease Index (OSDI) score was associated with a glaucoma diagnosis, glaucoma surgery, greater temporal corneal staining, reduced number of liquid meibum expressing glands and higher inferior forniceal papillary grade.

OSDI wasn’t significantly associated with gender, tear break-up time, Schirmer’s I test values or the use of cyclosporine eye drops; nor was OSDI significantly associated with glaucoma status and glaucoma surgery.

“Meibomian gland dysfunction and lower forniceal papillary reaction had significant contributions to the severity of symptoms, in contrast to traditional dry eye signs,” the researchers said. “MGD should be objectively assessed and treated to improve symptoms.”


Teo CHY, Ong HS, Liu Y, et al. Meibomian gland dysfunction is the primary determinant of dry eye symptoms: Analysis of 2346 patients. The Ocular Surface. 2020;18(4):604-12.