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American Society of Cataract and Refractive Surgery Meeting
Issue: May 25, 2012
April 20, 2012
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Imaging, measuring system improves detection of meibomian gland dysfunction

Issue: May 25, 2012

CHICAGO – A novel ocular surface imaging system provides accurate identification and assessment of meibomian gland dysfunction and dry eye disease, a speaker said here.

Perspective from Thomas John, MD

Richard S. Davidson, MD, elucidated features of the Lipiview Ocular Surface Interferometer (TearScience) during Cornea Subspecialty Day preceding the American Society of Cataract and Refractive Surgery annual meeting.

“Not all MGD is obvious,” Dr. Davidson said. “In fact, non-obvious MGD is quite common.”

Dr. Davidson cited a study in which 48% of patients had non-obvious MGD.

“Meibomian gland dysfunction may very well be the leading cause of dry eye disease around the world,” Dr. Davidson said, quoting a statement from the International Workshop on Meibomian Gland Dysfunction published in Investigative Ophthalmology and Visual Science.

The Lipiview Ocular Surface Interferometer enables precise measurement of tear film thickness and quantification of lipid levels in the tear film. It can be used in combination with the Lipiflow treatment for MGD, Dr. Davidson said.

The Lipiflow treatment involves the application of heat to the inner eyelids, liquifies meibomian gland contents and spurs the release of meibomian secretions, he said.

The Lipiview Ocular Surface Interferometer may be cost-prohibitive for some physicians, Dr. Davidson said.

  • Disclosure: Dr. Davidson has no relevant financial disclosures.


 

Perspective

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Thomas John, MD
Thomas John, MD

Chronic blepharitis is often an underdiagnosed clinical entity in general, and meibomian gland dysfunction in particular can result in secondary evaporative dry eye and a symptomatic patient. Typically a diagnosis of MGD requires the examiner to specifically look in the region of posterior eyelid margins, evaluating meibomian gland orifices, lid margin telangiectasia and the type of secretion following application of lid margin digital pressure. Objective evaluations include biochemical analysis of meibomian gland secretions utilizing assays, chromatography, spectroscopy and mass spectrometry. Other testing modalities of MGD include lipid layer interferometry, osmolarity measurement and evaporimetry, with the latter two focusing on the consequences of an altered tear lipid layer. The LipiView Ocular Surface Interferometer (TearScience) enables tear film thickness measurement and quantification of lipid levels in the tear film on the ocular surface. Introduction of such new clinical examiner-friendly tools for diagnostic evaluation of MGD will set, over time, new direction and new standards in clinical practice that will assist in earlier detection of MGD and appropriate treatment to help relieve some of the chronic symptoms associated with MGD, ultimately resulting in a happier patient.

Thomas John, MD
OSN Cornea/External Disease Board Member
Disclosures: Dr. John has no relevant financial disclosures.