Purpose: The purpose of this study was to determine how race, ethnicity, and lifestyle choices were associated with meibomian gland atrophy (MGA) in a diverse convenience sample of optometry conference attendees.
Methods: This was a cross-sectional study open to all participants who attended the American Academy of Optometry’s 2015 annual meeting in New Orleans, LA. Subjects self-administered a study-specific survey that queried demographics, ocular history, symptoms, and lifestyle. MGA was assessed photographically with an infrared camera (OCULUS Keratograph 5M) by imaging the upper and lower eyelids. All images were then subjectively evaluated with Arita et al.’s 0 to 3 grading scale per eyelid by two masked examiners. Associations between the above variables and MGA of combined eyelids, upper eyelids, and lower eyelids were analyzed after taking the mean of the two examiners’ scores.
Results: A diverse group (67.6% white, 2.5% black, 25.0% Asian, 4.9% other) of contact lens (CL) (n = 151) and non-CL (n = 134) wearers were recruited. The population was 61.4% female. Significant combined eyelid MGA (upper plus lower eyelid scores >2 out of 6) was associated with age (P=0.006), female gender (P=0.03), and self-reported MG dysfunction (P=0.04). Significant combined atrophy was not associated with years of CL use (P=0.78), hours of exercise (P=0.64), time outdoors (P=0.19), race (P=1.0), ethnicity (P=0.45), or use of omega-3 fatty acid supplements (P=0.60). When eyelids were analyzed individually, significant upper eyelid MGA (scores >1 out of 3) was only associated with age (P=0.001) while significant lower eyelid MGA was only associated with time outdoors (P=0.05) and female gender (P=0.05).
Conclusions: This study primarily found an association between MGA and age; however, associations between MGA and factors depended upon which eyelids were analyzed indicating that a subanalysis by eyelid may be important for understanding MGA.