Association of contact lens-related allergic conjunctivitis with changes in the morphology of meibomian glands.

PURPOSE: To observe morphological changes in the meibomian glands of patients with contact lens-related allergic conjunctivitis (CLAC) and to assess the relations between the morphological changes and eyelid and tear film parameters.

METHODS

We observed subjects in four groups: 64 eyes of 64 contact lens (CL) wearers with CLAC, 77 eyes of 77 CL wearers without CLAC, 55 eyes of 55 patients with perennial allergic conjunctivitis (perennial AC), and 47 eyes of 47 healthy volunteers. The following tests were performed: slit-lamp examination, measurement of tear film breakup time, grading of morphological changes in meibomian glands (meiboscore) as assessed by noncontact meibography, grading of meibomian gland distortion in meibography, tear production as assessed by Schirmer's I test, and grading of meibum expression.

RESULTS

The mean score for meibomian gland distortion was significantly higher in the CL wearers with CLAC than in the CL wearers without CLAC (p < 0.0001); it was also significantly higher in the non-CL wearers with perennial AC than in the non-CL wearers without perennial AC (p < 0.0001). There was no significant difference between the mean scores for meibomian gland distortion of the non-CL wearers with perennial AC and the CL wearers with CLAC (p = 0.27). The score for meibomian gland distortion was significantly positively correlated with the meibum score in the CL wearers with CLAC and with the meiboscore in the CL wearers without CLAC.

CONCLUSION

CLAC is associated with an increase in meibomian gland distortion. Allergic reaction, rather than CL wear, appears to be responsible for the increase in meibomian gland distortion in patients with CLAC.