June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Risk Factors for Meibomian Gland Morphology Changes in Children Aged 4 to <18 years
Author Affiliations & Notes
  • Manisha Parikh
    Illinois College of Optometry, Chicago, Illinois, United States
  • Yi Pang
    Illinois College of Optometry, Chicago, Illinois, United States
  • Lindsay Sicks
    Illinois College of Optometry, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Manisha Parikh None; Yi Pang None; Lindsay Sicks None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 425. doi:
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      Manisha Parikh, Yi Pang, Lindsay Sicks; Risk Factors for Meibomian Gland Morphology Changes in Children Aged 4 to <18 years. Invest. Ophthalmol. Vis. Sci. 2022;63(7):425.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : The purpose of this study was to evaluate the meibomian gland (MG) morphology (atrophy and tortuosity) in children aged 4 to <18 years. In addition, risk factors were identified for MG atrophy and tortuosity.

Methods : A total of 160 children (4 to 18 years) presenting at the Illinois Eye Institute from Sep 2020 to July 2021 were recruited into the study. All children had a comprehensive eye exam as well as height/weight was measured for BMI. Tear film parameters was collected with the Keratograph 5M (Oculus), including non-invasive tear film break-up time and tear meniscus. The upper and lower eyelids were everted and the meibomian glands imaged with the Keratograph 5M (Oculus). MG dropout scores were assessed by two masked graders using a validated 4-point JENVIS scoring system. Tortuosity of MG were evaluated by two masked graders using a 5-point HALLERAN scoring system. Both children and their parents were surveyed on electronic screen time, diet, and outdoor activities. To determine relationships between MG morphology and potential risk factors (including age, gender, race/ethnicity, refractive error, screen time, diet, outdoor activities, and BMI), linear multiple regression analyses were performed.

Results : Among 160 children recruited into the study, 76 were males and 84 were females (mean age = 10.9 years, ranged from 5.7 to 17.8). Mean tear meniscus were 0.23mm and 0.36mm, OD and OS respectively. Mean NI-TBUT were 15.60 sec and 15.96 sec, OD and OS, respectively. Severe MG atrophy (MG score of 2 or greater) presented in children: 6.8% of upper eyelid OD, 19.7% of lower eyelid OD, 5.6% of upper eyelid OS, and 19.7% of lower eyelid OS. Severe MG tortuosity (Score of 2 or higher) presented in children: 72.7% of upper eyelid OD, 3% of lower eyelid OD, 65.6% of upper eyelid OS, and 4.4% of lower eyelid OS. Significant risk factors for MG atrophy and/or tortuosity were identified including BMI (OD MG atrophy: β=0.36, p < 0.001, OS MG atrophy β=0.25, p=0.007), diet (lower eyelid tortuosity: β=0.23, p = 0.011), and outdoor activity (OD MG atrophy: β= -0.21, p = 0.022). No association was found between MG morphology and screen time.

Conclusions : High BMI, decreased outdoor activities, and unhealthy diet are the significant risk factors for the MG morphology change in children aged 4 to 18 years. Eye care practitioners should consider evaluating MG morphology routinely in children during eye exam.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.


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