A study to assess meibomian gland morphology using meibography in posterior blepharitis patients and normal population: A hospital-based observational study

Abstract

ABSTRACT Introduction: Noncontact infrared meibography (NIM) is a technique for quantitative assessment of meibomian gland (MG) dysfunction by providing images of the morphology of MGs. Aim: The aim of this study is to assess MG morphology using NIM (with meiboscore values) in posterior blepharitis patients and the normal population and to assess the lid margin abnormality score (LMAS), lid margin expression score, tear breakup time (TBUT), and Schirmer test values in posterior blepharitis. Methods: This was a hospital-based study on 100 consecutive patients attending the outpatient department of ophthalmology of the study institute, from June 2019 to May 2020 after getting ethical clearance. The study included 75 patients with symptoms and signs of posterior blepharitis and 25 normal patients with no evidence of posterior blepharitis. All patients were examined using slit lamp biomicroscopy for signs of posterior blepharitis and TBUT, superficial punctate keratopathy, Schirmer 1 test, and LMAS. NIM was performed for both upper and lower eyelids and was documented using the meiboscore system. Results: The meibography gland dropout was significantly higher in posterior blepharitis patients (P < 0.01) compared to normal patients. The normal patients had normal meibography in 32% and total meiboscore of Grade 1 in 56%. The LMAS was significantly higher in posterior blepharitis patients. Superficial punctate keratitis was not significantly higher in posterior blepharitis patients. The lid margin expression score was significantly higher in posterior blepharitis (P < 0.01). TBUT was significantly shorter in posterior blepharitis people (P < 0.01). The Schirmer test showed an adequate tear secretion in both groups of patients. Conclusion: NIM system can be performed easily, quickly, noninvasively and was a patient-friendly method to obtain information about the MG morphology. In our study, the majority of patients with posterior blepharitis showed significant gland dropout as viewed on NIM, compared to the normal cases studied.