Morphological and functional characteristics of the meibomian gland in pediatric patients with epiblepharon

Background To observe morphologic and functional changes in meibomian glands in pediatric patients with and without lower eyelid epiblepharon. Methods In this prospective observation study, 55 eyes of 55 patients( 24 males, 31 females; mean age ± SD,9.82 ± 2.59 years; range 6–14 years) and 60 eyes of 60 controls ( 32 males, 28 females; mean age ± SD,10.57 ± 2.75 years; range 6–14 years) were included. The following tests were performed: eyelid margin abnormality by slit-lamp examination, measurement of noninvasive keratographic break-up time (NIKBUT), grading of absence of meibomian gland (meibography score) assessed with noncontact meibography, morphologic changes of meibomian glands (thinning, dilatation and distortion), tear production by the Schirmer 1 test, and grading of meibum quality and meibomian gland expressibility. Results The morphologic changes in meibomian glands were more common in the epiblepharon group (56.36%) than in the control group (28.33%) ( p = 0.002). The meibum quality was worse in the epiblepharon group than in the control group ( p = 0.009), and the NIKBUT was significantly shorter in the epiblepharon group than in the control group ( p = 0.012). There was no significant difference in the Schirmer 1 test, meibomian gland expressibility, eyelid margin abnormality score or total meibography score between the two groups. Morphologic changes in the meibomian glands in the upper eyelids (38.18%) were more common than those in the lower eyelids (20%) ( p = 0.036) in the epiblepharon group, and the meibography score was higher in the upper eyelids than in the lower eyelids ( p = 0.001). Conclusion There are morphological and functional changes in meibomian glands in pediatric patients with lower eyelid epiblepharon. Although the inverted eyelashes were located in the lower eyelid, morphological changes in the meibomian glands were more common in the upper eyelid.