Blumberg MJ, et al. - In this cross-sectional study, researchers ascertained if reliance on eyelid margin vascularization as a diagnostic criterion for meibomian gland dysfunction (MGD; defined as an abnormal quantity or quality of meibum or increased pressure required to express meibum) results in underdiagnosis of MGD in people with dark skin pigmentation. They recruited consecutive cornea clinic patients in Buffalo, New York. Among 47 candidates (aged 15 to 79 years), people of all skin pigmentations were affected by meibomian gland truncation/dropout, abnormal tear production, and dry eye symptoms affected individuals of all skin pigmentations. The results show the significance of gland expression and suggest restricting dependence for MGD diagnosis on eyelid margin vascularization, particularly in those with dark eyelid skin pigmentation.