Poor diet, high BMI risk factors for meibomian gland atrophy, tortuosity in children
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Key takeaways:
- Nearly one-third of children had severe meibomian gland atrophy, and 84% had severe meibomian gland tortuosity in at least one eyelid.
- Diet, outdoor activity and BMI were risk factors, but screen time was not.
Abnormalities in meibomian gland morphology appear common in children, with unhealthy diet, reduced outdoor activity and high BMI among reported risk factors, according to a study published in Optometry and Vision Science.
“Unfortunately, there is limited literature currently to help inform pediatric normative values for dry eye metrics,” Manisha Parikh, OD, a recent graduate of Illinois College of Optometry who practices in California, told Healio. “We are hoping ours, as well as future research, can contribute to this effort.”
Seeking to identify risk factors for meibomian gland morphology abnormalities in children, Parikh and former colleagues at the college conducted a cross-sectional study of 160 patients aged 5 to 18 years (52.5% girls; mean age, 10.9 years), most of whom were African American (51.9%) or Hispanic white (27.5%). The researchers assessed meibomian gland atrophy and tortuosity using slit-lamp examination, infrared photography and the five-point Halleran scoring system. They also administered a modified Ocular Surface Disease Index questionnaire and collected data on outdoor activity, BMI, diet and screen time.
Nearly one-third (31.3%) of participants had severe meibomian gland atrophy in at least one eyelid, and 84% had severe meibomian gland tortuosity in at least one eyelid.
The children reported a mean 9.4 hours of daily screen time, while their parents reported 8.5 hours, and they averaged 2.6 hours of daily outdoor time. The average BMI was 23.2 kg/m2, and 20% of children consumed sugary drinks and fast food more than three to five times per week.
According to researchers, risk factors for meibomian gland atrophy included high BMI (P < .001), as well as reduced outdoor activity levels (P = .02), while unhealthy diet was a risk factor for lower eyelid tortuosity (P = .01). Age, race, ethnicity, sex and screen time did not have statistically significant associations with meibomian gland atrophy or tortuosity.
“It was unexpected to find no association between meibomian gland morphology and screen time,” Parikh said. “Participant screen time was self-reported and could also vary seasonally; for example, levels may differ if children are not in school. This could have caused inaccuracies in any findings related to average screen time.”
Results also showed a median OSDI score of 9.8 (range, 0 to 71), with most participants scoring in the normal range. However, 16.9% had mild symptoms of dry eye, 8.8% had moderate symptoms, and 12.5% had severe symptoms. Girls had a median score of 11, which was significantly higher than boys’ score of 7.5 (P = .006).
“Overall, it was most surprising that we found 31% of our subjects had severe meibomian gland atrophy in at least one eyelid, and 84% of our subjects had severe meibomian gland tortuosity in at least one eyelid,” Parikh told Healio. “Based on these findings, we recommend eye care practitioners consider evaluating meibomian gland morphology routinely in children during eye exams.”
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