Presence of Eyelid Disease in Habitual Scleral Lens Wearers

Background/Objectives: As scleral lens (SL) use continues to expand, particularly for medically necessary management of corneal irregularity and ocular surface disease, it is important to determine if wear of these lenses is associated with eyelid disease. This study evaluated habitual SL wearers for meibomian gland obstruction, meibum quality, and signs of lid margin inflammation. Methods: Eligible participants wore scleral lenses in one or both eyes for any indication and had been wearing their current lens design(s) for at least six months, with habitual wear of ≥5 h per day, six days per week. Eyelid inflammation metrics were specifically assessed. Results: Forty-nine scleral lens wearers (32 females) were enrolled. Upper lid wiper epitheliopathy (LWE) was present in 21 eyes (43%), and lower LWE was present in 15 eyes (31%). Thirty-nine eyes (80%) had expressible meibomian glands. Eyes with no expressible meibum were significantly higher in ocular surface disease (39%, 7/18) than corneal irregularity (11%, 3/27) (p = 0.03). Lid margin telangiectasia was present in wearers with ocular surface disease (61%, 11/18) and corneal irregularity (19%, 5/26) (p = 0.005). Conclusions: Eyelid disease was common among habitual scleral wearers regardless of indication for lens use. Eyes with ocular surface disease demonstrated a higher prevalence of meibomian gland obstruction and lid margin telangiectasia compared to those with corneal irregularity.