Eyelash Extension Wear Potentiates Clinical Signs of Ocular Surface Diseases Among Young Women

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PURPOSE: The study investigated the frequency of self-reported symptoms and the association of clinical signs of ocular surface disease with eyelash extension wear among youthful women. METHODS: In this cross-sectional study, 416 female university students aged 18-29 years were classified into eyelash extension wearers (n = 208) and nonwearers (n = 208). Self-reported symptoms, care practices, and extension type were assessed using a questionnaire. Participants underwent slit-lamp examination for corneal integrity (Modified Oxford Scale), noninvasive tear break-up time (TBUT), and assessment of eyelashes, conjunctiva, and meibomian glands. RESULTS: Eyelash extension wearers reported significantly higher rates of watery eyes (38.5% vs. 21.6%; P < 0.001), natural eyelash loss (17.3% vs. 9.6%; P = 0.022), and discharge (7.7% vs. 1.0%; P = 0.002) compared with nonwearers. Clinically, wearers exhibited more eyelash abnormalities (62.2% vs. 1.9%; χ2 = 172.7, P < 0.001), reduced TBUT <10 seconds (79.8% vs. 15.4%; χ2 = 173.1, P < 0.001), greater conjunctival injection (8.7% vs. 0.5%; χ2 = 16.0, P < 0.001), and meibomian gland abnormality (8.7% vs. 3.4%; χ2 = 5.2, P = 0.023). Logistic regression revealed that extension wear was associated with approximately 22-fold higher likelihood of reduced TBUT [odds ratio (OR) = 21.74; 95% confidence interval (CI) 13.1-36.1], approximately 83-fold higher likelihood of eyelash abnormalities (OR = 83.28; 95% CI 29.8-232.9), and approximately 3-fold higher likelihood of meibomian gland abnormality (OR = 2.72; 95% CI 1.1-6.7). CONCLUSIONS: Eyelash extension wear in young women is strongly associated with increased ocular surface symptoms and clinical signs of ocular surface disease. The findings support the need for improved consumer education, stricter product regulation, and routine ocular health screening to prevent avoidable complications among extension wearers.