**Background:** Dry eye disease (DED) is a common multifactorial ocular surface condition that significantly impairs quality of life. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye. While global prevalence estimates range from 5% to 50%, data from Central and South America—home to approximately 616 million people—are sparse. This systematic review and meta-analysis aimed to estimate the prevalence and incidence of dry eye and MGD in these regions and identify associated factors.
**Methods:** The review followed a registered protocol (PROSPERO CRD42021256934) and PRISMA/MOOSE guidelines. Searches were conducted in Ovid MEDLINE and Embase on August 16, 2021, for studies published between January 1, 2010, and August 16, 2021. Eligible studies included population-based, clinic-based, or database studies reporting prevalence or incidence of dry eye or MGD in Central or South America. Case reports, case series, case-control studies, and interventional studies were excluded. Two investigators independently screened records, extracted data, and assessed risk of bias using a tool for descriptive epidemiological studies. Meta-analyses used generalized linear mixed-effects models with a logit link. Heterogeneity was assessed using I² and τ².
**Key Results:** Fourteen studies (11,594 participants) were included. No studies reported incidence. Population prevalence of dry eye was 13% (95% CI, 12%-14%) in Brazil (one study) and 41% (95% CI, 39%-44%) in Mexico (one study). Meta-analyses showed dry eye prevalence of 70% (95% CI, 56%-80%; I²=82%; 3 studies) among indoor workers, 71% (95% CI, 65%-77%; I²=92%; 3 studies) among students, and 83% (95% CI, 77%-88%; I²=88%; 2 studies) in general ophthalmology clinics. MGD prevalence was 23% (95% CI, 16%-31%) among indoor workers (1 study) and 68% (95% CI, 62%-72%) in general ophthalmology clinics (1 study). Associated factors included older age (OR range 1.04–2.02), female sex (OR range 1.49–3.82), contact lens use (OR range 1.12–4.67), and smoking (OR range 1.24–1.44). For MGD, risk factors included older age (OR 1.07 per year, 95% CI 1.05–1.09), male sex (OR 1.7, 95% CI 1.04–2.6), arthritis (OR 7.7, 95% CI 1.001–59), and antihypertensive use (OR 2.7, 95% CI 1.3–5.7).
**Clinical Implications:** Dry eye is highly prevalent in Central and South America, particularly among younger populations (students) and those with prolonged computer use. The wide variation in estimates underscores the need for standardized diagnostic criteria. Low-cost interventions such as ergonomic modifications and awareness campaigns in schools and workplaces may help reduce disease burden. However, results should be interpreted cautiously due to high risk of bias in many included studies and limited generalizability.