Impact of Dyslipidemia on Tear Film and Meibomian Gland Dysfunction: A Cross-Sectional Study of the Interplay Between Serum Lipid Profile and Ocular Surface Health

Purpose: To determine the relationship between dyslipidemia and dry eye disease (DED), as well as its influence on tear film and meibomian glands.

Methods: This cross-sectional study included 40 patients with a mean age of 35.2 ± 13.9 years without any history of dyslipidemia. DED and serum lipid profile were evaluated after 8 hours of fasting. Patients were classified according to serum lipid levels with the following cut-off values: total cholesterol (TC) (200 mg/dl), high-density lipoprotein (HDL) (40 mg/dl), low-density lipoprotein (LDL) (130 mg/dl), and triglycerides (TG) (150 mg/dl). The relationship between serum lipid levels and DED was analyzed with the following variables: dry eye questionnaire-5 (DEQ-5), first (F-NIBUT) and average (A-NIBUT) noninvasive breakup time, tear meniscus height (TMH), lipid layer grade (LLG), conjunctival bulbar redness (CBR), and upper (U-LAMG) and lower (L-LAMG) loss area of meibomian glands.

Results: Regarding tear film, patients with elevated TC and LDL levels reported significantly higher DEQ-5 scores and TMH ( < 0.05), while those with lower HDL levels showed significantly higher LLG ( < 0.05). Regarding MGD, patients with elevated TC, LDL, and TG, as well as lower HDL levels showed significantly higher L-LAMG ( < 0.05). HDL was correlated with LLG ( < 0.05), while TC was correlated with TMH ( < 0.05) and L-LAMG ( < 0.05), respectively.

Conclusions: Disorders in TC, HDL, LDL, and TG levels were associated with DED, having an impact on the tear film and meibomian glands, specifically in DEQ-5 scores, LLG, and L-LAMG.