Eyeliner Induces Tear Film Instability and Meibomian Gland Dysfunction

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Eyeliner Induces Tear Film Instability and Meibomian Gland Dysfunction

Dr. Fishman commentary: Makeup can be toxic to the meibomian glands and can result in tear film abnormality. This is further evidence that patients with dry eye disease need to consider makeup very seriously.—————————————–

Published ahead of print in Cornea, Nov 2019. Authors: Prabhasawat, Pinnita MD*; Chirapapaisan, Chareenun MD*; Chitkornkijsin, Chayachit MD*; Pinitpuwadol, Warinyupa MD*; Saiman, Manutsawin BSc*; Veeraburinon, Anupong MBA

Purpose: To compare the degree of tear film instability and severity of meibomian gland dysfunction between subjects who use eyeliner and those who do not use eyeliner.

Methods: This cross-sectional study included 42 healthy volunteer women who had no dry eye symptoms (Ocular Surface Disease Index score < 13) and aged between 18 and 40 years. The subjects were classified into 2 groups: an eyeliner-use group (EL: regularly used eyeliner ≥3 d/wk and continuously used ≥6 mo) and a noneyeliner-use group as controls. A questionnaire for ocular surface symptoms using a visual analog scale was administered. Then, a number of eye tests were performed [grading of conjunctival inflammation, fluorescein tear breakup time, ocular surface fluorescein staining, Schirmer I, evaluation of meibomian gland (MG) function, detection of eyelid margin abnormalities, and Demodex detection].

Results: Tear breakup time was significantly lower in the EL group compared with controls (3.0 ± 1.9 vs. 5.8 ± 2.1 s, P < 0.001). MG grading was significantly higher in the EL group than in controls (P = 0.004); higher grade (grades 2–3) was found in 85.7% of EL and 47.6% of controls. Meiboscore was also higher in EL than in controls (P = 0.001). Regarding the morphological changes in lid margin, only telangiectasia was detected significantly more in EL (28.6%) compared with controls (4.8%) (P = 0.041). Conjunctival inflammation was observed 4 times more in EL (66.7%) than in controls (14.3%), P = 0.001. Other outcomes included ocular surface symptoms and fluorescein staining scores, and Schirmer I and Demodex detection were not significantly different between both groups.

Conclusions: The regular use of eyeliner induces tear film instability and MG dysfunction.

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