Imaging the tarsal plate: A Mini-Review

Alberto Recchioni

doi:10.5384/sjovs.v14i2.145

Abstract

Imaging the tarsal plate and the meibomian glands (MG) grants new opportunities for ophthalmic practitioners who work in the field of the ocular surface and dry eye across the globe. The secretory role of MG plays a fundamental part in protecting the moisture in front of the eye surface by creating an active shield made of meibum (lipid) which prevents tear evaporation and causes dry eye. Evidence from the most popular Dry Eye Workshop reports (2007 and 2016) demonstrate that MG dysfunction is the first cause of evaporative dry eye which is also the most common cause of dry eye and ocular surface discomfort. Fortunately, during the last years, a plethora of new devices for MG observation, diagnosis and follow-up have been made available in the market. These devices range from invasive to minimally invasive, high to low-tech and from being expensive to low-cost. The objective of this mini-review is to condense the latest evidence in MG imaging by providing a narrative overview on the most common technologies plus some other newer aspects which might guide clinicians and researchers in the field of the ocular surface and dry eye.

Highlights

Introduction “The International Workshop on Meibomian Gland Dysfunction” established the role of meibomian glands (MG) and their dysfunction (MGD) as the most common cause of evaporative dry eye
Meibography development did not stop with IR illumination and newer approaches such as in-vivo confocal microscopy (Kobayashi et al, 2005) and optical coherence tomography have been applied for investigating the eyelids margin (Bizheva et al, 2010)
Infrared light Meibography using infrared light (700–1000mm) works by projecting infrared (IR) light onto the everted eyelid which is recorded via an IR-sensitive camera, removing the need for transillumination of the lid

Summary

Introduction

Introduction “The International Workshop on Meibomian Gland Dysfunction” established the role of meibomian glands (MG) and their dysfunction (MGD) as the most common cause of evaporative dry eye. The main aim of the researchers was to obtain a method for observing MG that could guarantee detailed images with minimal impact on patients’ comfort This was achieved by employing infra-red (IR) illumination as a light source and connecting the probe with a CCD camera sensitive to IR (Arita et al, 2008; Nichols et al, 2005; Pflugfelder et al, 1998). Meibography development did not stop with IR illumination and newer approaches such as in-vivo confocal microscopy (Kobayashi et al, 2005) and optical coherence tomography have been applied for investigating the eyelids margin (Bizheva et al, 2010) In this plethora of examination techniques, the objective of this review is to recapitulate the latest available and most commonly used technologies for MG diagnostic imaging

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Conclusion