Impact of Lid Margin Diseases on Tear Film Stability and Ocular Surface Parameters: A Prospective Controlled Study with Healthy Subjects

Abstract

Background: Lid margin diseases, including anterior and posterior blepharitis and meibomian gland dysfunction, are major contributors to
tear film instability and evaporative dry eye disease. Alterations in the lipid layer of the tear film disrupt ocular surface homeostasis, leading to
discomfort, visual disturbance, and epithelial damage.
Aim: To prospectively evaluate the impact of lid margin diseases on tear film stability and ocular surface parameters and to compare findings
with healthy controls attending at Anmmch Gaya, Bihar.
Methodology: This prospective controlled study included 200 participants over a 10-month period, comprising 100 patients with clinically
diagnosed lid margin disease and 100 age- and sex-matched healthy controls. All participants underwent a comprehensive ophthalmic examination,
tear film break-up time (TBUT), Schirmer’s test, ocular surface staining assessment, and ocular surface disease index (OSDI) scoring. Meibomian
gland morphology and expressibility were also evaluated.
Results: Patients with lid margin disease demonstrated significantly reduced TBUT and Schirmer values compared to controls (p <0.001).
Ocular surface staining and meibomian gland dropout were markedly higher among cases. A strong correlation was observed between disease
severity and worsening tear film parameters, along with increased symptom scores.
Conclusion: Lid margin diseases significantly compromise tear film stability and ocular surface health. Early diagnosis and targeted management
are essential to reduce disease burden and improve patient outcomes in tertiary care settings.