{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T09:13:03Z","timestamp":1780477983989,"version":"3.54.1"},"reference-count":99,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Ocular Surface"],"published-print":{"date-parts":[[2020,10]]},"DOI":"10.1016\/j.jtos.2020.06.008","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T04:16:52Z","timestamp":1594786612000},"page":"604-612","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":49,"title":["Meibomian gland dysfunction is the primary determinant of dry eye symptoms: Analysis of 2346 patients"],"prefix":"10.1016","volume":"18","author":[{"given":"Calesta Hui Yi","family":"Teo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon Shing","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3986-6552","authenticated-orcid":false,"given":"Louis","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtos.2020.06.008_bib1","article-title":"TFOS DEWS II definition and classification report","author":"Craig","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtos.2017.05.001","article-title":"TFOS DEWS II diagnostic methodology report","author":"Wolffsohn","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib3","article-title":"TFOS DEWS II report executive summary","author":"Craig","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib4","doi-asserted-by":"crossref","DOI":"10.1038\/eye.2010.67","article-title":"Impact of symptomatic dry eye on vision-related daily activities: the Singapore Malay eye study","author":"Tong","year":"2010","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib5","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ajo.2006.11.060","article-title":"Impact of dry eye syndrome on vision-related quality of life","volume":"143","author":"Miljanovic","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib6","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1016\/S0161-6420(03)00462-7","article-title":"Utility assessment among patients with dry eye disease","volume":"110","author":"Schiffman","year":"2003","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jtos.2020.06.008_bib7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1167\/iovs.03-0915","article-title":"The relative burden of dry eye in patients' lives: comparisons to a U.S. normative sample","volume":"46","author":"Mertzanis","year":"2005","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1080\/09286580600801044","article-title":"The annual cost of dry eye syndrome in France, Germany, Italy, Spain, Sweden and the United Kingdom among patients managed by ophthalmologists","volume":"13","author":"Clegg","year":"2006","journal-title":"Ophthalmic Epidemiol"},{"key":"10.1016\/j.jtos.2020.06.008_bib9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/09286580802521309","article-title":"United States cost-effectiveness study of two dry eye ophthalmic lubricants","volume":"16","author":"Wlodarczyk","year":"2009","journal-title":"Ophthalmic Epidemiol"},{"key":"10.1016\/j.jtos.2020.06.008_bib10","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1007\/978-1-4615-0717-8_167","article-title":"Economic and quality of life impact of dry eye symptoms in women with Sjogren's syndrome","volume":"506","author":"Sullivan","year":"2002","journal-title":"Adv Exp Med Biol"},{"key":"10.1016\/j.jtos.2020.06.008_bib11","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0b013e3181f7f363","article-title":"The economic burden of dry eye disease in the United States: a decision tree analysis","author":"Yu","year":"2011","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib12","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1097\/01.ico.0000134183.47687.75","article-title":"The economic burden of dry eye: a conceptual framework and preliminary assessment","volume":"23","author":"Reddy","year":"2004","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib13","first-page":"187","article-title":"Ocular surface disease in posttrabeculectomy\/mitomycin C patients","volume":"9","author":"Lam","year":"2015","journal-title":"Clin Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib14","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.2147\/OPTH.S134570","article-title":"Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis","volume":"11","author":"Iyer","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib15","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1038\/eye.2013.144","article-title":"Effect of chronic anti-glaucoma medications and trabeculectomy on tear osmolarity","volume":"27","author":"Lee","year":"2013","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib16","doi-asserted-by":"crossref","first-page":"7385","DOI":"10.1167\/iovs.10-6532","article-title":"Proteomic profiling of inflammatory signaling molecules in the tears of patients on chronic glaucoma medication","volume":"52","author":"Wong","year":"2011","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib17","doi-asserted-by":"crossref","DOI":"10.1177\/112067210701700311","article-title":"Ocular symptoms and signs with preserved and preservative-free glaucoma medications","author":"Jaenen","year":"2007","journal-title":"Eur J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtos.2017.04.001","article-title":"TFOS DEWS II sex, gender, and hormones report","author":"Sullivan","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib19","doi-asserted-by":"crossref","DOI":"10.1016\/j.mehy.2018.11.009","article-title":"The role of endocrine disruptors in ocular surface diseases","author":"Pontelli","year":"2019","journal-title":"Med Hypotheses"},{"key":"10.1016\/j.jtos.2020.06.008_bib20","doi-asserted-by":"crossref","DOI":"10.1111\/cxo.12147","article-title":"Sex hormones and the dry eye","author":"Truong","year":"2014","journal-title":"Clin Exp Optom"},{"key":"10.1016\/j.jtos.2020.06.008_bib21","article-title":"The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee","author":"Daniel Nelson","year":"2011","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib22","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.10-6997d","article-title":"The international workshop on meibomian gland dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease","author":"Green-Church","year":"2011","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib23","article-title":"The international workshop on meibomian gland dysfunction: Introduction","author":"Nichols","year":"2011","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib24","article-title":"The international workshop on meibomian gland dysfunction: executive summary","author":"Nichols","year":"2011","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib25","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0b013e31823f0977","article-title":"Prevalence and risk factors of meibomian gland dysfunction: the Singapore Malay eye study","author":"Siak","year":"2012","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib26","doi-asserted-by":"crossref","first-page":"8013","DOI":"10.1167\/iovs.13-12802","article-title":"Corneal staining characteristics in limited zones compared with whole cornea documentation for the detection of dry eye subtypes","volume":"54","author":"Fenner","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib27","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1097\/01.ico.0000244875.92879.1a","article-title":"Prevalence of dry eye in Bangkok, Thailand","volume":"25","author":"Lekhanont","year":"2006","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib28","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1167\/tvst.8.5.30","article-title":"Spatial distribution of noninvasive break up times and clinical relevance in healthy participants and mild dry eye","volume":"8","author":"Tong","year":"2019","journal-title":"Transl Vis Sci Technol"},{"key":"10.1016\/j.jtos.2020.06.008_bib29","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1097\/01.opx.0000232814.39651.fa","article-title":"The features of dry eye disease in a Japanese elderly population","volume":"83","author":"Uchino","year":"2006","journal-title":"Optom Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib30","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1167\/iovs.04-0864","article-title":"Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study","volume":"46","author":"Lin","year":"2005","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib31","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0b013e3181814cff","article-title":"Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location","author":"Korb","year":"2008","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib32","doi-asserted-by":"crossref","DOI":"10.1038\/sj.eye.6700224","article-title":"Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer's test","author":"Isreb","year":"2003","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib33","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajo.2019.02.024","article-title":"Meibomian gland dysfunction and dry eye are similar but different based on a population-based study: the Hirado-Takushima study in Japan","author":"Arita","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib34","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0b013e31825425ef","article-title":"A newly developed noninvasive and mobile pen-shaped meibography system","author":"Arita","year":"2013","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib35","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.17-23631","article-title":"Meibography: a Japanese perspective","author":"Arita","year":"2018","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib36","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1001\/archopht.118.5.615","article-title":"Reliability and validity of the ocular surface disease index","volume":"118","author":"Schiffman","year":"2000","journal-title":"Arch Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib37","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0000000000000712","article-title":"Ocular surface disease index (OSDI) versus the standard patient evaluation of eye dryness (SPEED): a study of a nonclinical sample","author":"Asiedu","year":"2016","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib38","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1477-7525-2-44","article-title":"Comparison of the NEI-VFQ and OSDI questionnaires in patients with Sjogren's syndrome-related dry eye","volume":"2","author":"Vitale","year":"2004","journal-title":"Health Qual Life Outcome"},{"key":"10.1016\/j.jtos.2020.06.008_bib39","doi-asserted-by":"crossref","DOI":"10.1080\/09273940701486803","article-title":"Ocular surface disease index for the diagnosis of dry eye syndrome","author":"\u00d6zcura","year":"2007","journal-title":"Ocul Immunol Inflamm"},{"key":"10.1016\/j.jtos.2020.06.008_bib40","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II epidemiology report","author":"Stapleton","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib41","doi-asserted-by":"crossref","DOI":"10.1016\/S1542-0124(12)70187-8","article-title":"The association between symptoms of discomfort and signs in dry eye","author":"Johnson","year":"2009","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib42","doi-asserted-by":"crossref","DOI":"10.1111\/aos.12012","article-title":"Correlations between commonly used objective signs and symptoms for the diagnosis of dry eye disease: clinical implications","author":"Sullivan","year":"2014","journal-title":"Acta Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib43","doi-asserted-by":"crossref","DOI":"10.1016\/j.ophtha.2016.11.008","article-title":"Predictors of discordance between symptoms and signs in dry eye disease","author":"Vehof","year":"2017","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jtos.2020.06.008_bib44","doi-asserted-by":"crossref","DOI":"10.1136\/bjophthalmol-2013-303518","article-title":"Impact of dry eye on reading in a population-based sample of the elderly: the Salisbury Eye Evaluation","author":"Van Landingham","year":"2014","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib45","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/01.ico.0000133997.07144.9e","article-title":"The lack of association between signs and symptoms in patients with dry eye disease","volume":"23","author":"Nichols","year":"2004","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib46","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000016547","article-title":"Evaluation of ocular surface impairment in meibomian gland dysfunction of varying severity using a comprehensive grading scale","author":"Fu","year":"2019","journal-title":"Medicine (Baltim)"},{"key":"10.1016\/j.jtos.2020.06.008_bib47","article-title":"Functional and morphological evaluation of meibomian glands in the assessment of meibomian gland dysfunction subtype and severity","author":"Xiao","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib48","doi-asserted-by":"crossref","DOI":"10.1016\/j.ophtha.2017.05.031","article-title":"Meibomian gland disease: the role of gland dysfunction in dry eye disease","author":"Chhadva","year":"2017","journal-title":"Ophthalmology"},{"key":"10.1016\/j.jtos.2020.06.008_bib49","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.16-21374","article-title":"Clinic-based study on meibomian gland dysfunction in Japan","author":"Amano","year":"2017","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib50","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtos.2017.04.004","article-title":"Incidence and risk factors of symptomatic dry eye disease in Asian Malays from the Singapore Malay Eye Study","author":"Man","year":"2017","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib51","doi-asserted-by":"crossref","DOI":"10.1016\/S0002-9394(03)00317-9","article-title":"Diagnosing dry eye using a blue-free barrier filter","author":"Koh","year":"2003","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib52","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/09286580600878844","article-title":"Rationale and methodology for a population-based study of eye diseases in Malay people: the Singapore Malay eye study (SiMES)","volume":"14","author":"Foong","year":"2007","journal-title":"Ophthalmic Epidemiol"},{"key":"10.1016\/j.jtos.2020.06.008_bib53","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0000000000001841","article-title":"Relationship between ocular surface epithelial damage, tear abnormalities, and blink in patients with dry eye","author":"Kato","year":"2019","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib54","doi-asserted-by":"crossref","DOI":"10.1136\/bjo.2008.150847","article-title":"The prevalence of and risk factors for pterygium in an urban Malay population: the Singapore Malay Eye Study (SiMES)","author":"Cajucom-Uy","year":"2010","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib55","doi-asserted-by":"crossref","DOI":"10.1097\/OPX.0b013e3181981976","article-title":"Objective grading of the anterior eye","author":"Peterson","year":"2009","journal-title":"Optom Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib56","doi-asserted-by":"crossref","DOI":"10.1097\/00006324-199303000-00011","article-title":"CCLRU standards for success of daily and extended wear contact lenses","author":"Terry","year":"1993","journal-title":"Optom Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib57","doi-asserted-by":"crossref","DOI":"10.1016\/B978-0-7020-6660-3.00037-X","article-title":"Preliminary examination","author":"Bruce","year":"2018","journal-title":"Contact Lens Pract"},{"key":"10.1016\/j.jtos.2020.06.008_bib58","author":"Allergan"},{"key":"10.1016\/j.jtos.2020.06.008_bib59","doi-asserted-by":"crossref","DOI":"10.1001\/archophthalmol.2009.356","article-title":"Minimal clinically important difference for the ocular surface disease index","author":"Miller","year":"2010","journal-title":"Arch Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib60","article-title":"A new patient-centered approach to ocular surface discomfort","author":"Modjtahedi B","year":"2019","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib61","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2017\/1247138","article-title":"Correlation analysis of ocular symptoms and signs in patients with dry eye","volume":"2017","author":"Song","year":"2017","journal-title":"J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib62","doi-asserted-by":"crossref","DOI":"10.1001\/archopht.1995.01100100054027","article-title":"Ocular surface changes and discomfort in patients with meibomian gland dysfunction","author":"Shimazaki","year":"1995","journal-title":"Arch Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib63","doi-asserted-by":"crossref","DOI":"10.1097\/OPX.0000000000001285","article-title":"Tear lactoferrin and features of ocular allergy in different severities of meibomian gland dysfunction","author":"Chao","year":"2018","journal-title":"Optom Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib64","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.09-4445","article-title":"Screening for meibomian gland disease: its relation to dry eye subtypes and symptoms in a tertiary referral clinic in Singapore","author":"Tong","year":"2010","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib65","doi-asserted-by":"crossref","DOI":"10.1136\/bjo.82.10.1203","article-title":"Allergic eye disease mechanisms","author":"McGill","year":"1998","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib66","doi-asserted-by":"crossref","DOI":"10.1111\/j.1442-9071.2007.01545.x","article-title":"Immunohistochemical findings in prosthesis-associated giant papillary conjunctivitis","author":"Bozkurt","year":"2007","journal-title":"Clin Exp Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib67","doi-asserted-by":"crossref","DOI":"10.1097\/00140068-200301001-00011","article-title":"Contact lens chemistry and giant papillary conjunctivitis","author":"Donshik","year":"2003","journal-title":"Eye Contact Lens"},{"key":"10.1016\/j.jtos.2020.06.008_bib68","doi-asserted-by":"crossref","DOI":"10.1038\/eye.1990.99","article-title":"The incidence of ophthalmic problems in the contact lens wearing population","author":"Lea","year":"1990","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib69","doi-asserted-by":"crossref","DOI":"10.2147\/OPTO.S150926","article-title":"Investigating the effect of eye cosmetics on the tear film: current insights","author":"Wang","year":"2018","journal-title":"Clin Optom"},{"key":"10.1016\/j.jtos.2020.06.008_bib70","doi-asserted-by":"crossref","DOI":"10.1016\/S1542-0124(12)70031-9","article-title":"Ocular effects of cosmetic products and procedures","author":"Coroneo","year":"2006","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib71","doi-asserted-by":"crossref","DOI":"10.1159\/000371852","article-title":"Pilot study of the influence of eyeliner cosmetics on the molecular structure of human meibum","author":"Hunter","year":"2015","journal-title":"Ophthalmic Res"},{"key":"10.1016\/j.jtos.2020.06.008_bib72","doi-asserted-by":"crossref","DOI":"10.1097\/ICL.0000000000000181","article-title":"Impact of eye cosmetics on the eye, adnexa, and ocular surface","author":"Ng","year":"2016","journal-title":"Eye Contact Lens"},{"key":"10.1016\/j.jtos.2020.06.008_bib73","doi-asserted-by":"crossref","DOI":"10.1016\/j.clae.2012.07.005","article-title":"Transport and interaction of cosmetic product material within the ocular surface: beauty and the beastly symptoms of toxic tears","author":"Malik","year":"2012","journal-title":"Contact Lens Anterior Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib74","doi-asserted-by":"crossref","DOI":"10.1111\/j.1467-2494.2004.00245_1.x","article-title":"Categorical evaluation of the ocular irritancy of cosmetic and consumer products by human ocular instillation procedures","author":"Gao","year":"2004","journal-title":"J Cosmet Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib75","doi-asserted-by":"crossref","DOI":"10.1177\/004947550403400419","article-title":"The role of eyelash dyes in allergic eye diseases","author":"Mselle","year":"2004","journal-title":"Trop Doct"},{"key":"10.1016\/j.jtos.2020.06.008_bib76","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-29568-3","article-title":"Tear eicosanoids in healthy people and ocular surface disease","author":"Ambaw","year":"2018","journal-title":"Sci Rep"},{"key":"10.1016\/j.jtos.2020.06.008_bib77","doi-asserted-by":"crossref","DOI":"10.1194\/jlr.P041780","article-title":"Lipidomic analysis of human tear fl uid reveals structure-specific lipid alterations in dry eye syndrome","author":"Lam","year":"2014","journal-title":"J Lipid Res"},{"key":"10.1016\/j.jtos.2020.06.008_bib78","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0024339","article-title":"Meibum lipid composition in Asians with dry eye disease","author":"Lam","year":"2011","journal-title":"PloS One"},{"key":"10.1016\/j.jtos.2020.06.008_bib79","doi-asserted-by":"crossref","DOI":"10.1136\/bjo.2010.185256","article-title":"Association of tear proteins with Meibomian gland disease and dry eye symptoms","author":"Tong","year":"2011","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib80","first-page":"217","article-title":"Association of dry eye signs and symptoms with tear lactoferrin concentration","volume":"62","author":"Yolton","year":"1991","journal-title":"J Am Optom Assoc"},{"key":"10.1016\/j.jtos.2020.06.008_bib81","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajo.2008.08.032","article-title":"Tear cytokine profiles in dysfunctional tear syndrome","author":"Lam","year":"2009","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib82","doi-asserted-by":"crossref","DOI":"10.1136\/bjo.64.3.217","article-title":"Identification of T and B lymphocytes in the human conjunctiva and lacrimal gland in ocular diseases","author":"Belfort","year":"1980","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib83","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.15-17433","article-title":"Corneal epithelial immune dendritic cell alterations in subtypes of dry eye disease: a pilot in vivo confocal microscopic study","author":"Kheirkhah","year":"2015","journal-title":"Investig Ophthalmol Vis Sci"},{"issue":"9","key":"10.1016\/j.jtos.2020.06.008_bib84","first-page":"2773","article-title":"Impact of bioaerosols and particulate matter on dry eye symptoms and signs","volume":"60","author":"Huang","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"13","key":"10.1016\/j.jtos.2020.06.008_bib85","first-page":"2751","article-title":"Prevalence of allergic conjunctivitis, ocular surface disease subtypes, and mixed disease","volume":"55","author":"Opitz","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib86","doi-asserted-by":"crossref","DOI":"10.1016\/j.optom.2016.06.002","article-title":"The potential role of neuropathic mechanisms in dry eye syndromes","author":"Mcmonnies","year":"2017","journal-title":"J Optom"},{"key":"10.1016\/j.jtos.2020.06.008_bib87","doi-asserted-by":"crossref","DOI":"10.1016\/j.exer.2017.06.011","article-title":"Ocular surface inflammation impairs structure and function of meibomian gland","author":"Mizoguchi","year":"2017","journal-title":"Exp Eye Res"},{"key":"10.1016\/j.jtos.2020.06.008_bib88","first-page":"107","article-title":"If it itches, it's allergy...right?","volume":"147","author":"Kabat","year":"2011","journal-title":"Rev Optom"},{"key":"10.1016\/j.jtos.2020.06.008_bib89","doi-asserted-by":"crossref","DOI":"10.1016\/S1542-0124(12)70545-1","article-title":"Kinetic analysis of tear lipid layer interference images before and after the treatment of dry eye with allergic conjunctivitis","author":"Saiki","year":"2005","journal-title":"Ocul Surf"},{"key":"10.1016\/j.jtos.2020.06.008_bib90","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.19-26810","article-title":"Relationship between sleep and symptoms of tear dysfunction in Singapore Malays and Indians","author":"Lim","year":"2019","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"10.1016\/j.jtos.2020.06.008_bib91","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0000000000000464","article-title":"Depression, stress, quality of life, and dry eye disease in Korean women: a population-based study","author":"Na","year":"2015","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib92","doi-asserted-by":"crossref","DOI":"10.1038\/eye.2016.186","article-title":"Depression and anxiety in dry eye disease: a systematic review and meta-analysis","author":"Wan","year":"2016","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib93","doi-asserted-by":"crossref","DOI":"10.1038\/eye.2014.263","article-title":"Neuropathic ocular pain: an important yet underevaluated feature of dry eye","author":"Galor","year":"2015","journal-title":"Eye"},{"key":"10.1016\/j.jtos.2020.06.008_bib94","doi-asserted-by":"crossref","DOI":"10.1111\/j.1755-3768.1991.tb01999.x","article-title":"Tear break\u2010up time is related to blink frequency","author":"Yap","year":"1991","journal-title":"Acta Ophthalmol"},{"key":"10.1016\/j.jtos.2020.06.008_bib95","doi-asserted-by":"crossref","DOI":"10.1016\/S0892-8967(00)00033-X","article-title":"Relation between tear breakup time and spontaneous blink rate","author":"Al-Abdulmunem","year":"1999","journal-title":"Int Contact Lens Clin"},{"key":"10.1016\/j.jtos.2020.06.008_bib96","doi-asserted-by":"crossref","DOI":"10.4103\/jovr.jovr_12_18","article-title":"Effect of intense pulsed light therapy on tear proteins and lipids in meibomian gland dysfunction","author":"Ahmed","year":"2019","journal-title":"J Ophthalmic Vis Res"},{"key":"10.1016\/j.jtos.2020.06.008_bib97","doi-asserted-by":"crossref","DOI":"10.1080\/02713683.2017.1406525","article-title":"Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction (MGD) patients","author":"Yin","year":"2018","journal-title":"Curr Eye Res"},{"key":"10.1016\/j.jtos.2020.06.008_bib98","article-title":"Multicenter study of intense pulsed light therapy for patients with refractory meibomian gland dysfunction","author":"Arita","year":"2018","journal-title":"Cornea"},{"key":"10.1016\/j.jtos.2020.06.008_bib99","article-title":"Long-term effects of intense pulsed light combined with meibomian gland expression in the treatment of meibomian gland dysfunction","author":"Rong","year":"2018","journal-title":"Photomed Laser Surg"}],"container-title":["The Ocular Surface"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542012420301051?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542012420301051?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T04:38:17Z","timestamp":1761539897000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542012420301051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":99,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["S1542012420301051"],"URL":"https:\/\/doi.org\/10.1016\/j.jtos.2020.06.008","relation":{},"ISSN":["1542-0124"],"issn-type":[{"value":"1542-0124","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Meibomian gland dysfunction is the primary determinant of dry eye symptoms: Analysis of 2346 patients","name":"articletitle","label":"Article Title"},{"value":"The Ocular Surface","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtos.2020.06.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}