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This study evaluated relationships between meibomian gland loss (MGL) and age, sex, and dry eye.Dry eye and MGL of the lower eyelid was evaluated from 112 randomly selected subjects (66 women; mean age 62.8; SD ±15.7; and age range: 19–89 years) from Horst Riede GmbH, Weinheim, Germany. In addition, subjects were grouped into dry eye and non–dry eye by the Ocular Surface Disease Index (OSDI) score, lid-parallel conjunctival folds and non-invasive break-up time. Symptoms were evaluated by the OSDI. Meibography of the lower eyelid was performed using a Cobra camera (bon Optic, Lübeck, Germany), and images were analyzed by its digital grading tool. Data were analyzed by backward, multiple regression analyses and Pearson correlation.Analyzing all subjects, multiple regression analyses detected that age and dry eye status (dry eye diagnosis or OSDI) but not sex were significantly related to MGL. In both, non–dry eye (n=66) and dry eye subjects (n=46), dry eye status (OSDI) but not age or sex was significantly related to MGL. Ocular Surface Disease Index scores were significantly correlated with MGL, but this correlation was stronger among all subjects (Pearson correlation; r=0.536, P<0.001) and dry eye group subjects (r=0.520, P<0.001) than in non–dry eye group subjects (r=0.275, P=0.014).Dry eye group subjects showed significantly increased MGL of the lower eyelid. Age and dry eye status were related to MGL of the lower eyelid, but sex was not; dry eye status was the dominant factor.