Meibometry

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Learn more... Read the TFOS Dry Eye Workshop Report: http://www.tearfilm.org/tearfilm-repo... • Meibometry has been used to estimate the size of the lipid reservoir on the normal lid margin and its depletion in Meibomian Gland Dysfunction (MGD). • The principle of the technique is that the absorption of oil onto thin sheets of certain materials sheet increases their transparency. • In Meibometry, lipid on the lower central lid margin is blotted onto a plastic tape. • The increase in light transmission, measured by optical densitometry in the Meibometer is proportional to the amount of lipid taken up onto the tape. • For the test, loops of plastic tape are prepared with the rough absorbent side outwards. • The loop may be mounted for hand-held application or within the prism housing of an application tonometer. • The patient is seated with the head resting comfortably. • With the eyes in upgaze, the lower lid is drawn down lightly without pressure on the tarsal plate. • The standard loop of tape is applied to the central third of the everted lid margin for 3 seconds. • When the tape is handheld, a standard length is used. When the stem of the tape bends, a force of 15Gm# is applied at the point of contact on the lid. • If the patient is seated at the slit-lamp and the tape is mounted in the prism housing of a Goldmann applanation tonometer, then the pressure is 0 mmHg. • The tape is air dried for 3 minutes to allow tears to evaporate if necessary • Contact with the Meibomian reservoir of oil on the lid margin produces a line of increased transparency. • The optical density of each tape is read in the meibometer by placing the tape loop into the housing, closing the light-tight cap, and rotating the tape loop across the reading head. • A clean tape loop is used first to provide baseline data. • Then the test tape is inserted and the procedure is repeated. • The meibometer calculates the difference between the two readings and presents the result on screen in arbitrary optical density units. • In a normal subject this represents the steady state so called casual level of Meibomian lipid on lid margin. • Knowledge of the fraction of lipid taken up by the blotting procedure and calibration against a standard lipid permits a rough estimate of the amount of lipid on the lid margin to be estimated.

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