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4 (2.3) vs 4.3 (2.3), p=0.03) and fewer ghost glands (mean 0.33 (0.88) vs 0.89 (1.8), p=0.006) in the upper lid. In the DREAM study, most MG morphologic features were not associated with the severity of DED symptoms or signs. Tortuous glands and a higher composite score for MG features were associated with longer tear break-up times and longer Schirmer test length in the upper eyelid only. Patients with Sjogren syndrome had fewer distorted and ghost glands. In the DREAM study, most MG morphologic features were not associated with the seve
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