Lindsay A. Sicks, OD, has found the perfect career fit as an Associate Professor at the Illinois College of Optometry (ICO). She describes herself as a learner at heart, a passion she tries to pass on to her optometry students and residents. “I get to learn new things all the time, and every day at ICO is uniquely interesting.”
Aside from lecturing and patient care, Dr. Sicks enjoys that her work in academia allows the opportunity to engage in research. Most recently, she worked with a team at ICO to characterize meibomian gland morphological abnormalities (both atrophy and tortuosity) and identify risk factors for the same in children. She breaks down the research process with Women In Optometry and shares insights into her team’s work, which was published in 2024.
FROM CONCEPT TO RESEARCH
It was through the College’s Summer Research Program that the project took flight. Manisha Parikh, OD, opted to spend her first-year summer “off” conducting research with a faculty member on a topic of interest to her.
Yi Pang, OD, PhD, encouraged Dr. Sicks to begin taking a closer look at meibomian glands in optometry students with one of her first research students, Priscilla Chang, OD. Dr. Pang, a pediatric optometrist, wanted Dr. Sicks involved to bring her expertise in dry eye disease and meibography to the project. The original concept with optometry students evolved into a multi-year project pivoting to examination of pediatric patients through the efforts of Chi Na Moua, OD and Xiang Jun (Jenny) Liu, OD. Together, the research team looked at how meibomian gland morphology abnormalities may be associated with dry eye.
The culmination of the project over several years found that dry eye disease is frequently underdiagnosed in pediatric patients. The team examined risk factors for gland morphology abnormalities in children. “The big task for Dr. Parikh’s summer research was to recruit patients in the pediatric department,” Dr. Sicks explains. Any child who had an eye exam and met the criteria of the study was asked for consent to participate. Then, the research team collected additional imaging and data. “The summer research program work was instrumental in obtaining the imaging needed for this study,” which included a total of 160 pediatric participants who were primarily African American and Hispanic.
ANALYZING THE DATA
The study report details that the children, ages 5 through 18 years, had a comprehensive eye exam, linear multiple regression to determine risk factors for meibomian gland abnormalities such as atrophy and tortuosity. Testing included:
- a slit-lamp examination to evaluate the meibomian glands, conjunctival papillae and tear film
- noninvasive tear film breakup time and tear meniscus height
- infrared photography assessment of meibomian gland structure
- a modified Ocular Surface Disease Index survey
- a survey on screen time, diet and outdoor activity
Dr. Sicks and Dr. Parikh reviewed and graded the imaging obtained, and Dr. Pang completed the statistical analysis. “Then the three of us put our heads together to see what we could make of the results.”
They found that more children had more severe gland tortuosity than atrophy. Yet, Dr. Sicks says she found both at more severe levels than she had anticipated. “Our percentages were higher for tortuosity compared to other studies, but there isn’t a lot of evidence on the relationship to symptoms or signs in children.” She adds that tortuosity could be a precursor to atrophy.
It’s important to note that many clinics don’t have infrared imaging or routinely use it with children. Eye care providers should perform a more thorough dry eye evaluation—including meibography—on any child who shows corneal staining or a reduced tear break-up time.
EXAM ROOM IMPACT
Risk factors for atrophy and tortuosity included unhealthy diet, limited outdoor time and high BMI. The study didn’t directly demonstrate that screen time affects outcomes, but Dr. Sicks says it is still important to be part of the conversation.
There are key takeaways from their research that can significantly impact conversations with parents. “We can ask about kids’ screen time, outdoor time and nutritional choices,” Dr. Sicks says. “It reminds parents that we are looking at the patient as a whole. As a profession, we also need to focus more on pediatric dry eye. Are we missing issues related to device use or blink rates and how they impact the meibomian glands? Can we intervene earlier?”
More studies are necessary, particularly in kids, Dr. Sicks says. Their results may conflict with those of other studies. However, it’s important to note that there’s limited research specifically conducted in this area for children. “The tests we use to assess dry eye in adults are validated in adults; we don’t have norms and cut-off scores specifically for pediatric patients. And anyone in pediatrics will tell you, kids are not just tiny adults.”
Read the full results from the study here.
Read other stories about ODs in academia here and industry/research here.
