Meibomian Gland Evaluation In Asymptomatic Subjects

To examine the morphologic and functional changes in meibomian glands in asymptomatic subjects.

Cross-sectional study of healthy volunteers at Ophthalmology department, Siriraj hospital, Mahidol university. Bangkok.
Thailand.

We examined 120 eyes in 60 healthy volunteers with the dry eye-related quality-of-life score questionnaire (DEQS) ≤ 14
and no ocular surface disorders. Volunteers were divided into distinct subgroups according to age (31-40, 41-50, 51-60). Slit-lamp
observation of lid margin abnormalities, corneal/conjunctival surface, fluorescein staining and fluorescein tear break-up time
(FTBUT) were performed by a single investigator. Tear functions were assessed with the Schirmer test. Evaluation of lipid tear film
thickness (LLT), blink quality and meibography to access meiboscore were performed using LipiView®. Expressibillity and meibum
quality of meibomian gland were achieved at lower lid of both eyes. Examinations were completed on the same day.

Of the 60 volunteers, 48 were female. There were 20 subjects in each age group. Meibomian gland morphology changed
(meiboscore) in upper lid and lower lid were seen abnormal (meiboscore ≥1) 71% and 51%, respectively with a significant different
among the three age groups (P<0.001, P=0.04, respectively). Lid margin abnormality such as lid margin telangiectasia, meibomian
gland plugging and lid irregularity were observed 82%, 84% and 11%, respectively and only lid irregularity was found to be
significantly different between age group (P=0.01). For tear function, median (IQR) of Schirmer I test was 10 mm (3.2-29.7) and
median (IQR) of FTBUT was 5.04 sec (3.71-7.61). Schirmer I test was significant difference between age group (P=0.01).

In asymptomatic subjects, we found incredibly number of abnormalities in both anatomical and functional aspect of
the meibomian gland. Meibomian gland morphology, Schirmer I test and lid margin irregularity were found to be significantly
changed with age. However, these volunteers were able to tolerate some degree of abnormalities and still maintain symptom-free.