Meibomian Gland Dysfunction in a Hospital-Based Population in Central India

Abstract

Purpose: To estimate the prevalence of meibomian gland dysfunction (MGD) in a hospital-based population in India.

Methods: This cross-sectional study screened 3410 subjects ≥20 years or older attending the outpatient department by systematic random sampling. The patients were subjected to a comprehensive eye examination, Ocular Surface Disease Index questionnaire, fluorescein tear film breakup time, Schirmer I test, lissamine green stain, lid margin changes, and meibomian gland expression. MGD was diagnosed when 1 or both of the following was present in at least 1 eye: reduced or absent meibum secretion and cloudy to inspissated toothpaste-like secretion on digital pressure over the eyelids.

Results: The study included 570 subjects with a mean age of 49.3 ± 16.2 (20-84) years. MGD was diagnosed in 317 (55.61%) subjects, of whom 272 (47.7%) had only MGD and 45 (7.9%) had coexisting MGD and aqueous tear deficiency. The age-adjusted prevalence rate of MGD was 48.4% (95% confidence interval: 43.9-52.1). This rate increased significantly with age (P < 0.001) in both men (P < 0.001) and women (P < 0.001). The crude and age-adjusted prevalence of symptomatic MGD (Ocular Surface Disease Index score ≥13) was 26.1% (71/272) and 32.9% (95% confidence interval: 27.4-38.6), respectively. The prevalence of symptomatic MGD significantly declined with increasing age (P = 0.003), and this was reflected in both men (P = 0.013) and women (P = 0.179) but was not statistically significant in the latter.

Conclusions: The prevalence of MGD was higher in Indian subjects than that previously reported. Although the total MGD prevalence increased with age, the prevalence of symptomatic MGD decreased. Asymptomatic MGD was more common than symptomatic MGD.