Abstract
Purpose: :
Although meibography is a useful examination revealing morphological abnormalities in patients with meibomian gland dysfunction, it is not widely performed due to its nuisance and patients’ discomfort during examination. We tried to develop a new patient–friendly method of meibography that requires no expensive apparatuses such as an infrared camera and a hand–held light source.
Methods: :
Various kinds of light–shielding filters that shield light with limited range of wavelengths were placed in front of an observing eyepiece of a slit–lamp. Lower eyelids were turned over and normal meibomian glands illuminated with a diffuse light were observed through each filter. The CCP–OY filter (Tokai Optical Co., Ltd, Aichi, Japan) that shields 350–500 nm wavelengths gave the highest contrast when observing meibomian glands illuminated with a diffuse light from a slit–lamp. Thus, meibomian glands in the lower eyelids in 20 normal eyes of 10 persons (mean age: 28.9 ± 8.6 years) and 10 eyes of 5 patients (mean age: 37.6 ± 19.6 years) with meibomian gland dysfunction were observed by means of our instant meibography using the filter that shields 350–500 nm wavelengths. The study adhered to the tenets of the Declaration of Helsinki and informed consent was obtained from all subjects before examinations.
Results: :
By using a standard slit–lamp with this filter, we could observe not only meibomian gland structure, but also eyelids and orifices of meibomian glands at the same time. Meibomian gland ducts with uniform width and length were observed in 18 normal eyes of 9 persons. Meibomian gland ducts with half length were observed in 2 eyes of one normal person. In 6 eyes of 3 patients with mild meibomian gland dysfunction, duct dilatations and a few gland dropouts were observed. In 4 eyes of 2 patients with advanced meibomian gland dysfunction, gland dropouts prevailed and meibomian glands could be observed only near the orifices.
Conclusions: :
Our novel meibography gives clear images of the meibomian glands with minimal efforts and costs. This instant meibography is a useful way to obtain information on the structure of the meibomian gland, orifices, and eyelids.
Keywords: cornea: tears/tear film/dry eye • eyelid