AbstractPurpose To evaluate tear break‐up time (BUT) with repeated higher order wavefront aberrations (HOA) measurements in children with Meibomian Gland Dysfunction(MGD).Methods Wavefront aberrations up to the sixth order for a 4‐mm pupil were measured in 10 normal children (Group 1) and 10 children with severe MGD (Group 2) with corneal involvement, using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The aberrometry was performed once every second for up to 20 seconds. HOA measurements were performed 3 times in a row. HOA variations were compared with the BUT by the conventional fluorescein method (CFM°.Results There was an excellent correlation between the HOA variation and the BUT recorded by the CFM in both groups. There was also an excellent reproducibility of the HOA measurements in all patients. BUT was significantly decreased (P<0.005) in all children in Group 2 compared to the normal tests subjects (Group 1).Conclusion HS aberrometry is a non ivasive method, that has been used for the last decade for the assessment of the quality of vision in patients undergoing refractive surgery and cataract or clear lensextration. Studying the HOA variation is a valuable method for evaluating both the quality visionand the BUT in children with MGD.