Eyelid Disorders in Ophthalmology Practice: Results from a Large International Epidemiological Study in Eleven Countries

Abstract

Purpose: Anecdotal evidence suggests that eyelid disorders are common, although estimates of prevalence vary. The current study determines the prevalence of eyelid disorders, meibomian gland dysfunction (MGD) and related diseases (specifically ocular surface disease) in a population of patients presenting for routine ophthalmologic consultations.

Methods: This cross-sectional epidemiologic survey evaluated patients presenting for routine ophthalmic visits. During the consultation an ophthalmologist completed a questionnaire, and each patient underwent an ophthalmic examination and completed a quality of life questionnaire.

Results: Three hundred forty-nine ophthalmologists, recruited from 11 countries, provided data on 6525 patients. Patients were predominantly females (61.6%). The mean age of the study population was 57.0 ± 17.6 years. Eyelid disorders were diagnosed in 5109 (78.3%) patients and were statistically associated with: atopic dermatitis, seborrheic dermatitis, dry eye, age-related macular degeneration, diabetes, cataract, allergy and MGD (P < 0.05, all associations). Eyelid abnormalities were identified in 59.6% of patients; conjunctival or corneal abnormalities were observed in 64.9% and 28.1% of patients, respectively. MGD was diagnosed in 54.3% patients and was statistically significantly associated with the presence of eyelid disorders and eyelid margin abnormalities (P < 0.001, both comparisons). Dry eye was diagnosed in 61.8% of patients. Concurrent dry eye and MGD were present in 67.6% of patients. Most patients reported some degree of impaired vision and daily/work activities related to dry eye. Impact on contact lens usage, emotions and quality of sleep was also reported. The effects on daily life were associated with the presence of MGD.

Conclusion: In conclusion, eyelid disorders were highly prevalent in this 'real-world' population of patients from ophthalmology clinics. Routine ophthalmologic consultations provide an opportunity to improve patient quality of life and to modify topical therapy in patients who may be predisposed to eyelid disorders.

Keywords: Blepharitis; Dry eye; Eyelid disorders; Meibomian gland disorder; Ocular surface disease.

Fig. 1

Prevalence and severity of dry eye symptoms among patients presenting for a routine ophthalmic visit. Patients were queried regarding their experience of each symptom and asked to rate them on a 3-point scale as follows: 0 = none, 1 = present but not disturbing, 2 = disturbing, 3 = very disturbing

Fig. 2

Impact of eyelid disorders on daily life. Patients were questioned about the impact of eyelid disorders on their various aspects of daily life activities and the degree of impairment of each activity (slight, moderate or severe). N = 4859 patients with eyelid disorders