Correlation between Ocular Surface Parameters and the Severity of Blepharitis in Patients with Dry Eye

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Saif Khuzaim Al-Dossary


Purpose: This study aimed to analyze the relationship between ocular surface parameters and blepharitis severity in dry eye patients.


Methods: 140 dry eye patients with blepharitis were recruited. Tear film tests assessed stability (tear breakup time, meibomian gland function), osmolarity (osmolarity, osmolarity fluctuation, lysozyme), corneal health (staining, sensitivity, nerves) and inflammation (interleukins, MMPs). Blepharitis severity was graded using validated questionnaires. Correlations between ocular surface parameters and blepharitis scores were analyzed.


Results: Tear breakup time (r=-0.45, p<0.001) and meibomian gland function (r=-0.29, p=0.009) negatively correlated with blepharitis severity, indicating tear film instability associated with higher blepharitis grades. Tear osmolarity (r=0.38, p=0.003) and lysozyme (r=0.33, p=0.006) positively correlated, suggesting hyperosmolarity related to increased blepharitis. Corneal staining (r=0.25, p=0.018) and sensitivity (r=0.31, p=0.008) positively correlated, implying compromised corneal health with severe blepharitis. Inflammatory markers IL-6 (r=0.41, p=0.001) and MMP-9 (r=0.37, p=0.005) showed robust positive correlations.


Conclusions: Greater blepharitis severity significantly correlated with worsened tear film stability, hyperosmolarity, corneal damage and inflammation. Assessing eyelid, meibomian gland, tear film and ocular surface status concurrently is important in dry eye. Treating blepharitis may improve therapeutic outcomes. Further research could elucidate if blepharitis treatment correlates with improvement in specific dry eye parameters.


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