title: Treatment Practices and Outcomes of Meibomian Gland Dysfunction at a Tertiary Center in Southern India.
abstract: OBJECTIVE
  To describe the current treatment practices for meibomian gland dysfunction (MGD) at a tertiary eye center, together with the subjective outcomes and compliance behaviors of patients.
  
  
  METHODS
  This retrospective cohort study reviewed medical records for MGD severity grading, treatment prescribed, and follow-up schedule. In addition, participants were surveyed to gauge subjective outcomes and treatment adherence.
  
  
  RESULTS
  Eight hundred ten patients were diagnosed with "MGD" or "meibomitis" and had a total of 14 different treatment combinations prescribed. In 3.0% of cases, there was no treatment specified. As MGD severity increased, it became more likely that management would be applied and this was also associated with significantly longer treatment durations (P=0.02) and shorter follow-up periods (P<0.001). Posttreatment subjective outcomes and treatment adherence surveys had a response rate of 36.7% and 24.1% respectively. Overall, 53.5% reported sustained improvement, 40.7% no improvement, and 5.7% experienced temporary relief. Although no treatment regimen seemed to be more efficacious than others, patients showed greater adherence when using topical reagents compared with lid hygiene measures (P≤0.002).
  
  
  CONCLUSIONS
  Clinicians, in this large tertiary eye center, use a wide range of treatment regimens to manage MGD. This suggests the need for development of standard management protocols. Whether alone, or in combination, no MGD treatment significantly improved subjective symptoms, a result that may be influenced by compliance behaviors. Use of topical reagents (eye drops or ointment) seemed to be associated with the best compliance. Future focus on more effective MGD treatments is needed to improve practical outcomes.
authors.affiliation: Brien Holden Vision Institute (L.L., J.L.F., E.B.P.), Sydney, New South Wales, Australia; Vision Cooperative Research Centre (L.L., J.L.F., E.B.P.), Sydney, New South Wales, Australia; School of Optometry and Vision Science (L.L., Q.G., J.L.F., E.B.P.), The University of New South Wales, Sydney, New South Wales, Australia; The University of Notre Dame Australia (Q.G.), Sydney, New South Wales, Australia; and L V Prasad Eye Institute (P.K.V.), Hyderabad, India.
authors.forename: Ling
authors.initials: L
authors.lastname: Lee
authors.forename: Qian
authors.initials: Q
authors.lastname: Garrett
authors.forename: Judith L
authors.initials: JL
authors.lastname: Flanagan
authors.forename: Pravin K
authors.initials: PK
authors.lastname: Vaddavalli
authors.forename: Eric B
authors.initials: EB
authors.lastname: Papas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008537:Meibomian Glands / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009824:Ointments; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010349:Patient Compliance; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D009824:Ointments; D009883:Ophthalmic Solutions