# Knowledge and Practice of Eyelid Hygiene Among the General Population in Al-Qunfudah Governorate, Saudi Arabia: A Cross-Sectional Study

## TL;DR

This study examines eyelid hygiene practices and knowledge among people in Al-Qunfudah, Saudi Arabia, finding good habits but gaps in understanding certain eye conditions.

## Contribution

The study provides insights into eyelid hygiene behaviors and awareness of ocular surface diseases in a specific Saudi population.

## Key findings

- Most participants washed their face and eyelashes regularly, indicating good hygiene practices.
- Awareness of meibomian gland dysfunction was low despite common use of eye cosmetics.
- Higher income and eyelid cleaning habits correlated with better knowledge of dry eye disease.

## Abstract

Introduction: It is believed that ocular surface diseases (OSDs) represent a public health issue. Common disorders include blepharitis, dry eyes, and meibomian gland dysfunction (MGD). Eyelid cleanliness remains essential for preserving eyelid health and relieving ocular symptoms.

Objectives: This study aims to assess the knowledge and practice of eyelid hygiene and its associated factors among the general population in Al-Qunfudah governorate, Saudi Arabia.

Methods: A cross-sectional study was conducted on a sample of 273 adults who are above 18 years of age and live in Al-Qunfudah. The data collection tool was a validated self-administered online questionnaire, which was preceded by consent and insurance to maintain the participant's confidentiality.

Results: A total of 273 eligible participants completed the study questionnaire with a mean age of 26.9 ± 9.2 years. Exactly 196 (71.8%) were females. About 253 (92.7%) wash their face after daily activities, 208 (76.2%) wash their eyelashes, 102 (37.4%) use a cleaning solution for eyelids, and 161 (59.0%) cleaned their eyelids during the past three days. A total of 199 (72.9%) had heard about dry eye disease. Only 51 (18.7%) heard about meibomian gland dysfunction. A total of 176 (98.8%) female participants reported using eye cosmetics; 69 (39.2%) used one type. The most reported cosmetic use-associated complications included eye redness 130 (47.7%), itching 118 (43.2%), dryness 62 (22.7%), and sand sensation 42 (15.3%), while 76 (27.8%) had no effect on the eye due to the cosmetic use. Retired, those who had high incomes, and those who did not use a cleaning solution for eyelids were more aware of dry eye disease than other participants, with p-values of 0.045, 0.001, and 0.001, respectively. Those who used to wash their eyelashes knew more about meibomian gland dysfunction than those who did not (p=0.001).

Conclusion: The general population of Al-Qunfudah was well-informed about dry eye disease, the usage of eye cosmetics, and their effects on the eyes, and they had good habits of washing their faces and eyelids. On the other hand, one detrimental behavior associated with a lack of understanding of meibomian gland dysfunction is sharing cosmetic tools with other people. Lastly, patients should learn about MGD, dry eyes, and basic eyelid hygiene from ophthalmologists and primary care doctors, with a focus on low-income people. Regarding the everyday eyelid hygiene procedures that the general public is advised to follow, more research is necessary.