Evaluation of the special ocular surface characteristics in Asian blepharokeratoconjunctivitis related Meibomian gland dysfunction patients

Purpose: To evaluate special ocular surface characteristics in Asian meibomian gland dysfunction(MGD) of blepharokeratoconjunctivitis(BKC) patients. Method Seventy-eight consecutive patients with MGD related BKC and 78 age- and sex-matched simple MGD subjects were enrolled. Medical history, Meibum quality, Meibomian gland expressiblity, Meibomian gland dropout and morphology changes, lid margin and ocular surface characteristics were evaluated under slit-lamp illumination. Results All clinical parameters were worse in the MGD related BKC group than in the MGD group (all P  < 0.001). Meibomian gland dropout was higher in the MGD related MGD group ( P  < 0.001), and the dropout was not associated with age. The main changes of Meibomian gland changes were that the length of gland became shorter and optical density became lower in MGD related group than in the MGD group (all P < 0.001). Conclusion MGD related BKC was a special severe MGD, mixed characters of MGD with associated ocular surface damage and MGD related evaporative dry eye. Recurrent chalazia history, severe Meibomian gland dropout, Marx line antedisplacement and worse lip wiper epitheliopathy were useful characteristics contributing to diagnose MGD related BKC.