The topical azithromycin meibomian gland dysfunction survey: The effect of topical azithromycin on signs and symptoms of meibomian gland dysfunction

Introduction The aim of this study was to assess the long‐term effects of topical azithromycin on signs, symptoms and self‐management of meibomian gland dysfunction (MGD). Methods Forty participants were assessed for MGD and its effect on the fluorescein tear break‐up time (FTBUT). Participants were treated with topical azithromycin twice daily for 2 weeks and then once daily for a further 2 weeks. One year after treatment, 31 participants completed a survey assessing pre‐ and post‐treatment effect on symptoms, lifestyle and self‐treatment methods. Results Following treatment, there was a significant reduction in MGD grading from a median of grade 2 to grade 0 ( z = 4.40, p < 0.0001) and an increase in FTBUT from a median of 3–8 s ( z = 4.75, p < 0.0001). One year afterwards, the survey showed a significant improvement in symptoms (sensitivity to light, grittiness, burning, blurred vision, all p < 0.03) and reduction in required self‐treatments (lid wipes, tear substitutes, both p < 0.03). There was also a reduced impact on lifestyle (reading, night driving, computer use and watching television, all p < 0.0001) and in all environmental conditions (all p < 0.0001). Conclusions This study confirms the positive effect of topical azithromycin on MGD and shows it has a long‐term impact on symptoms, self‐treatment methods and lifestyle. This has implications for both chair time and healthcare costs when managing patients with MGD. Pending further clinical trials in a larger population with different demographics, topical azithromycin should be considered by all eyecare practitioners as a viable pharmacological treatment when managing MGD.