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Purpose.: To study screening methods and associated factors of Meibomian gland disease and dry eye subtypes in a specialized eye clinic in Singapore.

Methods.: This cross-sectional study involved 200 patients in a dry eye clinic. The outcome measures evaluated were dysfunctional tear syndrome (DTS) level, meibomian gland disease grade, Schirmer test (ST) result, fluorescein tear break-up time (TBUT), corneal fluorescein staining grade, and irritative eye symptoms.

Results.: The meibomian gland screening grade was associated with TBUT (P= 0.007), especially in the upper eyelid and correlated with reading difficulty (P= 0.007) and reversibility of symptomatic blurring with lubricants (P= 0.006). An abnormal ST result was associated with early morning discomfort (P= 0.001), and reduced TBUT was linked to discomfort in windy conditions (P< 0.001). In all patients examined, evaporative dry eye (58%) was the most common type, followed by the mixed evaporative and aqueous tear deficiency (30.5%) types. Fluorescein staining in the central and inferior cornea was most severe in the mixed type.

Conclusions.: In dry eye patients, screening for meibomian gland disease based on anteriorization of Marx's line may predict a decrease in TBUT and difficulty in performing certain visual-function–related activities. These findings facilitate better understanding of the meibomian gland's contribution to multifactorial dry eye syndrome, apart from routine conventional tests performed in clinics.