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Huping Wu, Yuqian Wang, Nuo Dong; Meibomian Gland Dysfunction Determines the Severity of the Dry Eye Conditions in Visual Display Terminal Workers. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3055.
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To explore an interesting phenomenon and mechanism that meibomian gland dysfunction (MGD) may determine the severity of the ocular discomfort and dry eye conditions in visual display terminal (VDT) workers with normal tear volumes.
One hundred and six eyes of 53 consecutive patients working at a VDT for more than 4 hours a day were recruited for this study (Long VDT group). Eighty eyes of 40 age- and gender-matched patients working at a VDT for less than 4 hours a day were served as controls (Short VDT group). After completion of an Ocular Surface Disease Index (OSDI) questionnaire, the following tests were performed: tear film breakup time (BUT), corneal fluorescein staining score, tear production by Schirmer test without topical anesthetic, a slit-lamp examination of the lid margin abnormality and meibum expression, and an evaluation of the meibomian glands by noncontact meibography.
The dry eye indexes, OSDI and fluorescein staining score were significantly higher while the tear film BUT was dramatically shorter in the long VDT group than that in the short VDT group. However, the average of tear volumes measured by Schirmer test were in the normal ranges in both groups, 11.53±8.32 and 12.88±9.66 mm, respectively. Interestingly, the lid margin abnormality score, meibum score, and meiboscore were significantly higher in the long VDT group than the short VDT group (P<0.0001). When the low and normal tear groups were separated from the long VDT workers, 52 eyes with Schirmer <10mm, and 54 eyes with Schirmer ≥10mm, no significant difference was found between the two subgroups in OSDI, fluorescein staining and BUT, as well as the lid margin abnormality score, meiboscore, and meibum score. Spearman correlation analysis demonstrated that meiboscore significantly correlated with VDT working time (R=0.403, P<0.0001), fluorescein score (R=0.326,P<0.0001), and BUT (R= -0.168, P = 0.021) in VDT workers.
These findings demonstrated that the long VDT workers suffer a normal tear dry eye disease but with significant alterations in meibomian gland morphology and function, which suggests Meibomian gland function play a more important role in determine the severity of ocular discomfort and dry eye conditions than aqueous volume of tear film.
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