Abstract
Purpose: :
Little is known about the growth of human meibomian gland. Development of the non-invasive mobile pen-shaped infrared meibography (MeibomPen®) enabled us to observe infants’ meibomian glands without invasion. We took meibographies of different age groups to compare the morphology of the meibomian glands.
Methods: :
Subjects were healthy Japanese volunteers. After obtaining written consent, we recorded meibography in sitting position or supine position in a semi-dark room. We also measured the width of the eyelid. Reviewing the video, we counted the number of the meibomian gland in each lid and checked the presence of distortion, dropout and shortening of the gland. According to the ratio of the area of the missing gland, we scored the meiboscore from grade 0 (no loss of glands) through grade 3 (the lost area was more than two thirds of the total gland area). We regarded the number of the glands divided by width of the lid as a density of the gland. This study was approved by the institutional review board of University of Tokyo School of Medicine and adhered to the tenets of the Declaration of Helsinki.
Results: :
Pediatric group included 51 people and 102 eyes (male 21, female 30, average age 3.9 ±3.0).In the pediatric group, infants (2 month old to 1 year old) were 9 people and 18 eyes, toddler-preschoolers (1 to 6 years old) were 32 people 64 eyes, elementary school students (7 to 12 years old) were 10 people 20 eyes. Adult group included 30 people 60 eyes (male 11, female 19, average age 34.5±6.2). Numbers of the glands in upper/ lower eyelids of infants, toddler-preschoolers, elementary school students and adults were 19.3±2.0/ 18.3±1.5, 21.2±2.8/ 19.2±2.4, 24.0±3.3/ 21.0±2.7 and 26.3±2.5/ 22.7±2.7 respectively (p=0.24/0.42 between infants and preschoolers, p<0.007 between other pairs). Total meiboscores of each eye were 0, 0.1±0.4, 0.05±0.22, 0.43±0.5 respectively. Distortion was observed in 0/18 eye, 4 /64eyes, 1/20 eyes, and 6/60 eyes, shorting was seen in 0 /18 eye, 3 /64 eyes, 0 /20 eye, 4 /60 eyes and dropout was seen in 0 /18 eye, 4 /64 eyes, 1 /20 eyes, 3 /60 eyes respectively. Width of the eyelid was 22.3±1.5mm, 25.4±2.2mm, 27.5±2.1mm, 28.4±1.9mm respectively (p=0.28 between elementary school students and adults, p<0.0003 between other pairs). Density of the gland in superior/ inferior lid were 0.87±0.10/ 0.83±0.10, 0.84±0.13/ 0.76±0.12, 0.87±0.12/ 0.78±0.10, 0.93±0.12/ 0.82± 0.09 respectively (p=0.001/0.03 between toddler-preschoolers and adults, p>0.1 in other pairs).
Conclusions: :
The morphology of human meibomian gland was almost the same among all age groups. The width of the lid and the number of the gland increase in the process of growth.
Keywords: cornea: tears/tear film/dry eye • cornea: clinical science • eyelid