Beyond Conjunctivitis: Long-Term Meibomian Gland And Tear Film Stability Analysis After Adenoviral Infection

To investigate the long-term effects of adenoviral keratoconjunctivitis on meibomian gland (MG) morphology and dry eye symptoms.

This cross-sectional study was conducted at a single-center tertiary care.The study clinical assessments and advanced topographic meibography measurements were performed in a controlled ophthalmology outpatient setting.

Forty eyes of 40 individuals with a history of adenoviral keratoconjunctivitis and 40 eyes of 40 healthy controls were included. Symptom severity was assessed using the Ocular Surface Disease Index (OSDI). Corneal fluorescein staining was graded according to the Oxford scale. Upper eyelid MG loss was evaluated by non-contact meibography. Non-invasive tear break-up time (NIBUT) was measured using the Sirius (CSO) Scheimpflug–Placido topography system.

The mean age was comparable between the adenoviral and control groups (30.6 ± 12.2 vs. 28.2 ± 6.5 years; p = 0.14). The mean time since adenoviral keratoconjunctivitis was 30.6 ± 26.5 months. MG loss was significantly higher in the adenoviral group compared with controls (37.6% ± 22.7% vs. 15.7% ± 8.2%; p < 0.001). OSDI scores were similar between groups (25.1 ± 4,9 vs. 20.3 ± 8,5; p = 0.69). NIBUT was significantly lower in the adenoviral group (8.14 ± 4.08 vs. 10.6 ± 3.95; p = 0.01), whereas Oxford corneal staining scores did not differ significantly (0.3 ± 0.1 vs. 0.2 ± 0.1; p = 0.341).

Adenoviral keratoconjunctivitis is associated with persistent structural changes of the meibomian glands and reduced tear film stability in the long term. Despite comparable symptom scores and corneal staining, increased MG loss and decreased NIBUT suggest subclinical ocular surface impairment. These findings highlight the importance of comprehensive MG and tear film assessment in patients with a history of adenoviral keratoconjunctivitis, even in the absence of overt symptoms.