Meibomian Gland Loss Prevalent in Healthy, Asymptomatic Children

An analysis of 35 studies found that on average, 46% of healthy children (no underlying medical conditions) demonstrated MG loss, though it’s uncertain whether these changes indicate potential progression to MGD or dry eye disease. Photo: Kambiz Silani, OD. Click image to enlarge. While most research on meibomian gland dysfunction (MGD) focuses on adults, the condition remains understudied among the pediatric population. To address this knowledge gap, a recent analysis investigated meibomian gland (MG) characteristics in healthy children, finding that even those who were asymptomatic showed significant MG loss; however, the study authors state that it’s unclear whether these changes represent normal variations or potential progression to MGD or dry eye disease. Researchers searched the Medline database for articles published between 2000 and 2024, focusing exclusively on pediatric populations aged zero to 18 years. A total of 35 studies were included in the final analysis. All children underwent infrared meibography to assess MG characteristics, and MG loss was reported using meiboscore, meiboscale and/or percentage of area loss.The study identified a weighted average prevalence of MG loss of about 46%, indicating that even in healthy populations with no underlying medical conditions, a notable proportion of children exhibit MG abnormalities. Moreover, the review documented variations in MG characteristics in the upper vs. lower eyelids; some studies indicated greater gland loss in the upper eyelid, whereas others reported the opposite.An interesting correlation emerged between body mass index (BMI) and MG characteristics; specifically, children in higher BMI percentile ranges were found to have a 3.79-fold increased likelihood of exhibiting elevated MG tortuosity. One study found that reduced vegetable intake was associated with more severe MG loss, and three others drew correlations between screen time and changes in MG characteristics. Furthermore, children with systemic conditions, like juvenile systemic lupus erythematosus and diabetes, demonstrated higher rates of gland loss.“The findings in this review reveal that MG loss and tortuosity are prevalent even in very young, healthy children,” the researchers summarized in their paper. “This review points to a need for eyecare practitioners to be more attentive to potential MG and DED symptoms in pediatric patients, as these conditions may often be overlooked in children,” they argued.Given the inconsistencies in the current literature on MG health in children, the authors emphasize the need for further studies to better understand MG morphological changes in pediatric patients, as well as the factors that may have clinical implications. Specifically, the effects of prolonged screen time and a child’s diet on MG structure and function are two areas of interest, they suggested.“Future research should aim to establish normative data for pediatric MGs and conduct longitudinal studies to determine whether early changes in MG could predict MGD or DED at a later stage,” the researchers concluded.Click here for the journal source. Ansari SM, Nguyen T, Khankan R, et al. Meibomian gland characteristics in children: a narrative review. Ophthalmic Physiol Opt. July 2, 2025. [Epub ahead of print].