title: Epidemiology of Meibomian Gland Dysfunction in an Elderly Population.
abstract: OBJECTIVE
  To study the epidemiology of meibomian gland (MG) dysfunction in an elderly, predominantly male population.
  
  
  METHODS
  Prospective study of 233 subjects seen in the Miami Veterans Affairs eye clinic. Patients underwent a complete ocular surface examination, including dry eye questionnaires and tear assessments (osmolarity, tear breakup time, corneal staining, Schirmer test). The main outcome measures were correlations between MG parameters and demographics, dry eye symptoms, and tear parameters. The studied MG parameters were eyelid vascularity and meibum quality; a score ≥2 for either parameter was considered abnormal.
  
  
  RESULTS
  Mean age of the 233 subjects was 63 years (SD = 11); 91% were male and 59% had at least 1 abnormal MG parameter (abnormal quality 55%; vascularity 17%). Demographically, patients with abnormal MG parameters were significantly older than their counterparts without these findings. Whites were more likely to have abnormal eyelid vascularity compared with blacks [n = 36 (31%) vs. n = 1 (1%), P < 0.0005] but no differences were noted between races with respect to meibum quality. Abnormal meibum quality, but not abnormal vascularity, was significantly associated with more severe dry eye symptoms. Similarly, abnormal meibum quality, but not eyelid vascularity, was significantly associated with worse dry eye signs, including decreased tear breakup time and increased corneal staining (P < 0.05 for all).
  
  
  CONCLUSIONS
  MG dysfunction is a frequent finding in an elderly, predominantly male population with racial differences noted in the frequency of abnormal eyelid vascularity but not in MG quality. Abnormal meibum quality was significantly associated with more severe dry eye symptoms and signs.
authors.affiliation: *Ophthalmology Department, Miami Veterans Administration Medical Center, Miami, FL; and †Bascom Palmer Eye Institute, University of Miami, Miami, FL.
authors.forename: Yousef A
authors.initials: YA
authors.lastname: Alghamdi
authors.forename: Carolina
authors.initials: C
authors.lastname: Mercado
authors.forename: Allison L
authors.initials: AL
authors.lastname: McClellan
authors.forename: Hatim
authors.initials: H
authors.lastname: Batawi
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015352:Dry Eye Syndromes / Q000453:epidemiology; D005141:Eyelid Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans