Comparison of Morphological and Functional Meibomian Gland Characteristics Between Daily Contact Lens Wearers and Nonwearers

PURPOSE: The aim of the study was to investigate the relationship between daily soft contact lens (CL) wear and various signs of ocular involvement. We focused on comprehensive meibomian gland (MG) evaluation, including both functional and morphological parameters of the MGs. METHODS: The ocular surface and MG characteristics were evaluated in 41 daily soft CL users and 31 age-matched non-lens wearers. We analyzed the MG function (meibum quality and meibum expressibility) and morphology (meibography) and evaluated lid margin alterations. We also correlated our findings with self-reported ocular symptoms and tear film abnormalities (tear film breakup time and Schirmer test values). RESULTS: CL use was associated with abnormal meibum quality [higher meibum quality score, odds ratio (OR) = 2.7, 95% confidence interval (CI), 1.3-5.6, P = 0.0057], more frequent bulbar (OR = 3.6, 95% CI, 1.5-8.2, P = 0.0028) and palpebral (OR = 2.4, 95% CI, 1.1-5.1, P = 0.028) conjunctival hyperemia, lid margin telangiectasia (OR = 6.0, 95% CI, 2.4-14.6, P < 0.00001), rounding (OR = 9.3, 95% CI, 1.1-81.0, P = 0.04), notching (OR = 3.9, 95% CI, 1.2-12.4, P = 0.019), hyperemia (OR = 4.3, 95% CI, 1.3-14.1, P = 0.015) of the posterior lid margin, orifice plugging (OR = 4.8, 95% CI, 1.3-17.1, P = 0.015), and retroplacement (OR = 0.8, 95% CI, 0.4-1.9, P = 0.037) after adjustment for age and sex in a logistic regression model. Lid margin abnormality and meibum quality scores strongly positively correlated with the duration of CL wear. These associations remained significant after adjustment for age and sex (P = 0.00003 and P = 0.01, respectively). CONCLUSIONS: CL wear may predispose individuals to meibomian gland dysfunction, which is not usually investigated unless significant symptoms are present. Therefore, we recommend to routinely examine CL wearers for meibomian gland dysfunction manifestations and to introduce specific prophylaxis if required.