It is believed that smoking leads to meibomian gland drop out, glands that atrophy and no longer produce meibum or that disappear altogether, leading to evaporative dry eye and meibomian gland dysfunction (MGD). Over time with smoking, drop out begins at the outer edges of the eyes and moves to the center. Stopping smoking does not bring back dead meibomian glands, but there is believed that the drop out can be halted if smoking is stopped.
Meibomian gland disorder and smoking
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Prevalence of dry eye in the normal population in Jeddah, Saudi Arabia
Bukhari A, Ajlan R, Alsaggaf H.
Orbit (Amsterdam, Netherlands)
2009;28(6):392-7. doi: 10.3109/01676830903074095.
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