Which of the following are advanced signs of EDED/MGD in dogs?

• A. Hyperemia and mucopurulent discharge
• B. Hypopyon
• C. Cataracts
• D. Retinal detachment

Answer: (A)

Advanced signs of evaporative dry eye due to meibomian gland dysfunction come from ongoing surface inflammation driven by an unstable tear film. When the lipid layer is deficient, tears evaporate more quickly, the ocular surface becomes hyperosmolar, and inflammatory cells flood the conjunctiva and cornea. The result is redness (hyperemia) and mucopurulent discharge from inflammatory exudate on the surface—classic for advanced surface disease from EDED/MGD. Intraocular signs like hypopyon point to anterior chamber inflammation (uveitis), not primarily tear-film–driven surface disease. Cataracts are lens changes, and retinal detachment is a posterior segment problem, neither of which reflect the tear-film–driven surface involvement seen with EDED/MGD. So hyperemia with mucopurulent discharge best fits the advanced surface changes of this condition.