Meibomian gland structure and function in patients with Demodex blepharitis

PURPOSE: To compare structural and functional measures of meibomian gland disease (MGD) in eyes with moderate to severe Demodex blepharitis (collarette grades 2 to 4) compared with those with collarette grade 0 (0 to 2 collarettes). SETTING: Private clinical practice. DESIGN: Retrospective, single-center, noninterventional, observational study. METHODS: In this study, case records of patients aged ≥18 years with data available for collarettes and MGD signs (telangiectasia, meibum expressibility, meibum quality, and meibography) were included. Outcome measures were the comparison of the mean telangiectasia score, meibum expressibility score, meibum quality score, and meibomian gland (MG) atrophy score between eyes with moderate to severe Demodex blepharitis (collarette grades 2 to 4, or >10 collarettes) and those with collarette grade 0 (0 to 2 collarettes). Right and left eyes were analyzed separately. RESULTS: The mean telangiectasia, meibum quality, and MG atrophy scores were statistically significantly worse in the collarette grade 2 to 4 group than in those in the collarette grade 0 group for both right and left eyes (even after adjusting for age). There was a positive correlation between collarette grade and telangiectasia, meibum quality, and MG atrophy scores. CONCLUSIONS: Structural and functional measures of MGD were significantly worse in eyes with collarette grades 2 to 4 than in those with collarette grade 0. Clinicians should routinely examine their patients for Demodex infestation and signs of MGD and treat both conditions as needed, especially in the perioperative setting.