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Justin Timothy Kwan, Dominick L Opitz, Milton M Hom, Jerry R Paugh; Gender Differences in a Meibomian Gland Dysfunction-Specific Symptom Questionnaire. Invest. Ophthalmol. Vis. Sci. 2014;55(13):22. doi: https://doi.org/.
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Meibomian gland dysfunction (MGD) is a common cause of the signs and symptoms of dry eye, yet a symptom survey specific for MGD has not been developed. A refined MGD questionnaire was administered to an independent sample of patients presenting to two clinics to explore how each gender responds differently. We also wanted to determine if dry eye severity per OSDI is different among females and males in the moderate and severe groups.
Subjects over age 18 were enrolled and classified as MGD dry eye or aqueous deficient (AD) dry eye based on accepted tests (meibum quality and Schirmer I). The refined instrument contained 18 items targeting the frequency and intensity of 9 symptoms. Possible responses were marked from 0 (never, or not intense) to 9 (all the time, or extremely intense). Subjects were also asked to respond to the Ocular Surface Disease Index (OSDI) to classify their symptom severity. Two-tailed, unpaired t-tests were performed to analyze the responses between genders.
75 females and 47 males were classified as having dry eye. The average age was 45.7±16.3. Females responded with higher frequency and intensity respectively when compared to males for two symptoms: dryness (p=0.021, 0.026) and vision fluctuation (p =0.009, 0.005). For females, 49.33% categorized themselves as having moderate to severe symptoms versus 25.54% of males. This entire cohort had at least one dry eye sign but 23 females and 22 males answered with normal, non-dry eye level symptoms.
A few other publications have reported that females experience more frequent symptoms than males but this questionnaire also examined intensity of symptoms. Our results confirm this gender difference with proposed mechanisms being hormonal and autoimmune states that are more prevalent in the female gender. Further work entails the evaluation of this instrument at more centers and finding symptoms that may distinguish between MGD and AD. From there, a decision may need to be made whether to customize symptom surveys to gender.
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