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New research · Ophthalmology
Frontiers in medicine · 2d
Cross-sectionalFrontiers in medicine · 2026

Association of a novel meibomian gland dysfunction composite score with corneal nerve parameters and ocular surface symptoms in dry eye disease.

Yao Yao, Zhaoxiang Xu, Yanhao Ma … Jian Guo
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OphthalmologyCross-sectional

Worse meibomian gland dysfunction is linked to more severe dry eye symptoms

Association of a novel meibomian gland dysfunction composite score with corneal nerve parameters and ocular surface symptoms in dry eye disease.

Yao Yao … Jian Guo
Frontiers in medicine · 2026
Purpose

To construct a composite meibomian gland dysfunction (meibomian gland dysfunction) score integrating gland dropout, expressibility, and meibum quality, and to investigate its associations with corneal nerve parameters, subjective symptoms, and ocular surface signs in patients with dry eye disease (dry eye disease).

Methods

This cross-sectional study included 137 dry eye disease patients (274 eyes).

n = 274 eyes
r = 0.769
Results
r = 0.769
worse eyelid gland health tracked with more severe self-reported dry eye symptoms
n = 274 eyes
More results

OSDI correlated strongly with corneal nerve fiber length ( r = -0.868, p < 0.01).

After controlling for nerve length, age, sex, and corneal fluorescein staining, the partial correlation between meibomian gland dysfunction composite score and OSDI dropped from 0.796 to 0.390.

More results

Patients with higher meibomian gland dysfunction grades exhibited significantly shorter nerve length, more microneuromas, worse tear break-up time, higher corneal fluorescein staining, and greater symptom scores (all p < 0.05).

Microneuroma count correlated positively with pain, asthenopia, blurred vision, and photophobia.

“
Conclusion · 1 of 2

The meibomian gland dysfunction composite score effectively reflects disease severity.

Conclusion · 2 of 2

Corneal nerve length is strongly associated with the relationship between meibomian gland dysfunction signs and subjective symptoms, providing a structural basis for understanding symptom-sign discordance in dry eye disease.

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