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Jennifer P Craig, Dabin Kim, Amy Lee, Michael T.M. Wang; Factors predisposing the Asian eye to meibomian gland dysfunction (MGD) and evaporative dry eye. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5667.
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© ARVO (1962-2015); The Authors (2016-present)
To differentiate the anatomical and ethnic factors involved in the pathogenesis of MGD in Asian and Caucasian eyes.
Right eyes of 74 Asian and Caucasian participants, born in New Zealand and aged between 15 and 35 years, were subdivided into 3 age-matched groups; Asian single lid (ASL), with no eyelid crease, (n=23), Asian double lid (ADL), with eyelid crease (n=28) and Caucasian double lid (CDL) with eyelid crease (n=23). Dry eye symptoms, palpebral aperture, eye area, tear meniscus height, evaporation rate, non invasive tear break up time, meibomian gland drop out (MGDO), gland expressibility, anterior blepharitis, lid margin telangiectasia, lid wiper epitheliopathy, lid parallel conjunctival folds, lipid layer grade, tear osmolarity and ocular surface staining were evaluated in an observational, cross-sectional study.
MGDO was significantly greater in both the ASL and ADL groups relative to CDL (p<0.001). A greater proportion of ASL and ADL participants exhibited incomplete blinking than CDL participants (p=0.01). There were no significant differences in tear film quality and dry eye symptomology between the three groups (all p>0.05). Exposed ocular surface area, lissamine green staining, and lid wiper epitheliopathy were significantly greater in the ADL group relative to CDL (all p<0.05). The CDL group displayed more significant anterior blepharitis and lid margin telangiectasia grades, than both ASL and ADL groups (all p<0.05).
Asian eyes, with or without an eyelid crease, exhibit greater levels of MGDO and incomplete blinking than age-matched Caucasian eyes, while anterior blepharitis and telangiectasia are more common in Caucasian eyes. Although symptoms and functional signs of dry eye were not found to vary with ethnicity or lid anatomy between groups in this study of young individuals, the findings highlight a potential predisposition of the Asian eye to dry eye through dysfunctional blink dynamics and may indicate modifiable risk factors related to blinking for ageing individuals.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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