Evaluation of Meibomian Gland Function and Tear Film Changes in Patients with Primary Pterygium using Dry Eye Diagnostic System

Abstract Purpose: This study aims to evaluate the impact of primary pterygium on the functions of the meibomian glands and tear film characteristics using a comprehensive dry eye diagnostic system aiming at improving therapeutic modalities of pterygium and the quality of vision. Methods: This prospective cross-sectional study was conducted at the Ophthalmology outpatient Clinic of Suez Canal University Hospitals. Twenty-two patients with unilateral primary pterygium (Group A) were compared to 22 age- and sex- matched healthy controls (Group B), All the participants underwent ocular surface evaluation including Non-Invasive Breakup Time (NIBUT), Tear Meniscus Height (TMH), meibomian gland dropout, eyelid margin abnormalities, and conjunctival hyperemia using dry eye diagnostic system. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were also assessed. Results: Abnormal TMH was noted in 68.2% of Group A patients versus 13.6% of controls (p < 0.001). Grade 2 NIBUT was recorded in 54.5% of Group A patients compared to 13.6% in Group B (p = 0.006). Significant differences were noted in meibomian gland dysfunction, eyelid margin changes, and conjunctival hyperemia between groups (p = 0.016, 0.009, and 0.001, respectively). Group A patients showed lower visual acuity compared to Group B (p = 0.004), with greater diminution at advanced disease stages (p < 0.001). There was no significant difference regarding IOP in the 2 groups. Conclusion: Primary pterygium is strongly related to significant meibomian glands dysfunction and tear film abnormalities, which significantly increased with disease progression and negatively affect visual acuity.