Optometrists have an abundance of tools and techniques to help diagnose and monitor dry eye, but the correlation between the signs these methods detect and the actual patient experience is poorly understood. A new study published in the March issue of Eye & Contact Lens, however, clarifies the role at least one such device, meibography, can play.

After measuring the meibography scores in both the upper and lower eyelids of 30 patients against their fluorescein break-up times (FBUT), researchers not only verified that meibography is an objective tool for the detection of meibomian gland loss, but also identified that evaluating the upper lid might be a better indicator for dropout grading.1

The study looked at 15 women and 15 men who had FBUT measurements of 9.6 (±3.1 seconds). The scores were correlated with gland loss in the upper lid, but not as strongly for the lower lid. However, meibomian gland loss was more pronounced in the lower lids. “This may indicate that smaller changes in upper eyelid are a better predictor for low FBUT than larger changes in the lower lid.”

For more than 40 years, meibography has been used to observe the morphology of meibomian glands in vivo. The technology has undergone progressive changes, including laser confocal meibography and, most recently, OCT meibography.

1. Dogan A, Kosker M, Arslan N, Gurdal C. Interexaminer reliability of meibography: upper or lower eyelid? Eye & Contact Lens. 2018;44(2):113–7.
2. Wise R, Sobel R, Allen R. Meibography: A review of techniques and technologies. Saudi J Ophthalmol. 2012 Oct; 26(4): 349–56.