Tear <sup>1</sup>H Nuclear Magnetic Resonance-Based Metabolomics Application to the Molecular Diagnosis of Aqueous Tear Deficiency and Meibomian Gland Dysfunction

<b><i>Purpose:</i></b> Meibomian gland dysfunction (MGD) is a major cause of signs and symptoms related to dry eyes (DE) and eyelid inflammation. We investigated the composition of human tears by metabolomic approaches in patients with aqueous tear deficiency and MGD. <b><i>Methods:</i></b> Participants in this prospective, case-control pilot study were split into patients with aqueous tear deficiency and MGD (DE-MGD [<i>n</i> = 15]) and healthy controls (CG; <i>n</i> = 20). Personal interviews, ocular surface disease index (OSDI), and ophthalmic examinations were performed. Reflex tears collected by capillarity were pr…