Impact of smoking exposure on meibomian gland morphology and tear film stability: a cross-sectional study

Increased smoking exposure is strongly associated with deleterious structural and functional alterations of meibomian glands. Increased smoking exposure is associated with more severe meibomian gland morphological damage, worsened eyelid margin signs, reduced meibum quality and quantity, and accelerated deterioration of tear film stability. The underlying mechanisms may involve oxidative stress and chronic inflammation induced by tobacco smoke. For the management of smoking-related meibomian gland dysfunction (MGD), smoking cessation should be advised along with targeted anti-inflammatory or antioxidant treatments.