A recent study evaluated the association between the signs and symptoms of dry eye disease (DED) and meibomian gland dysfunction (MGD) in individuals who have keratoconus (KC).¹ A prospective cross-sectional study categorized individuals who had KC according to contact lens modality. Modalities included were soft, SoftK, rigid GP (RGP), scleral, and those who did not wear contact lenses. Forty-six individuals who had KC (91 eyes, with a mean age: 45 years, range: 20–69 years) and 48 non-contact lens wearers, 20 soft, 13 RGPs, and 10 SoftK wearers were included in the study.

Multiple parameters were assessed, including visual acuity, aberrometry, noninvasive and invasive tear break-up time (NITBUT and TIBUT, respectively), tear meniscus height, Schirmer testing, meibography, meibomian gland expressibility and quality, corneal and conjunctival staining, and lid margin findings. Dry eye was defined as an Ocular Surface Disease Index (OSDI) score of 13 or greater with a TBUT or NITBUT of less than 10 seconds. MGD was defined as dry eye with greater than 25% meibomian gland loss.

Across all groups, the frequency of DED and MGD was similar. However, individuals who wore RGP lenses showed significantly worse visual acuity, higher root mean square ocular aberrations, and greater upper eyelid meibomian gland loss than non-contact lens wearers.¹

Individuals who wore soft contact lenses had significantly longer TBUT and less lid margin telangiectasia and notching. SoftK lens wearers also exhibited a higher frequency of grade 1 meibomian gland expressibility compared with the other subgroups.¹

Individuals who wore soft contact lenses had a significantly higher grade 4 corneal staining. Those who wore RGP lenses had a significantly higher prevalence of grade 5 corneal and conjunctival staining. Individual symptoms did not vary across subgroups. Although the contact lens modality did not differ in the prevalence of DED and MGD, RGP wearers demonstrated more severe ocular surface signs.

The authors highlight the importance of regular ocular surface monitoring in individuals with KC, especially those who wear RGPs.

Melissa Barnett, OD, FAAO, FSLS, practices at Baker Optometry. She also is an International Coaching Federation (ICF) associate certified coach. She has received remuneration from ABB, AbbVie, Alcon, Azura, Bausch + Lomb, BCLA, Bruder, Cloudbreak Pharma, Dompé, Epion, OCuSOFT, ScienceBased Health, STAPLE Program, Tarsus, Tenpoint Pharmaceuticals, and Théa Pharma.

 This content was supported by Contamac.