Similar with eyelid and MG evaluation, individuals in Level III group had a significantly higher OSDI (median in III: 20.45, II:20.45, I: 13.62, P = 0.005), lower TMH (III: 0.21 ± 0.08, II: 0.23 ± 0.13, I: 0.33 ± 0.16, P = 0.000) and ST (III: 5.55 ± 3.38, II: 8.52 ± 3.35, I: 8.57 ± 3.69, P = 0.000), shorter TBUT (III: 4.65 ± 2.49, II: 5.88 ± 3.74, I: 5.84 ± 2.40, P = 0.000), and higher CFS score (median in III: 1, II: 0, I: 0, P = 0.000), Individuals in Level III group exhibited the highest concentrations of IL-1β, IL-6, IL-8, and VEGF. This evidence concerns the gene CXCL8 and myalgic encephalomeyelitis/chronic fatigue syndrome.