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Modified fundus camera: portable screening tool for meibomian gland dysfunction in cataract patients

Poster Details

First Author: K.Sainani INDIA

Co Author(s):    K. Vunnava   R. Shetty   S. Prabhu   K. Rajamani   L. Fathima        

Abstract Details

Purpose:

We present a study of Meibomian glands in cataract patients, and compute two quantitative parameters to determine Meibomian gland dysfunction (MGD). Our aim is to check if significant number of patients undergoing cataract have MGD. This would play a role in dry eye symptoms and patient satisfaction after cataract surgery.

Setting:

Narayana Nethralaya Super Speciality Eye Hospital, Bangalore, India

Methods:

60 eyes of 30 patients, who were more than 50 years of age, and presenting to cataract surgery clinic, underwent meibography. Images of the upper lid were captured using Bosch Infrared Hand-held Imager (prototype), which is a modified fundus camera. These images were first enhanced using adaptive histogram equalization for better viewing of the glands. We have developed an automatic algorithm to segment the glands, which performs noise reduction (using Butterworth filter), morphological operations and Gabor filtering. The parameters analyzed using the algorithm were: Gland loss from gland area, and number of tortuous glands.

Results:

Among 60 eyes,we observed:(i) 4 of them had gland loss above 20% (on average, 27�Â�±13 %),(ii) 22 had glands loss between 10% and 20%(on average, 13�Â�±3 %),and (iii) 38 had gland loss less than 10%(on average, 7�Â�±3 %). Over 60 eyes, the average number of glands that were tortuous was 10 (with standard deviation of 3),out of the mean 16 number of total glands.These results show that there is significant meibomian gland loss and that the majority of the glands in these eyes are tortuous.From the literature, we know that both these parameters are good indicators of MGD.

Conclusions:

Signs of MGD in the glands are prevalent among a sizeable number of patients in cataract age groups. A major cause of patient discomfort after cataract surgery is the symptom of dryness, which will be increased in those with pre-existing gland loss and abnormal glands. There is no other objective way of analysis of Meibomian glands other than infra-red imaging. Hence we conclude that imaging Meibomian glands before cataract surgery would be an advantage.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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