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Bulgarian Review of Ophthalmology

Objective Assessment of Meibomian Gland Loss and Investigation of a Correlation with Non-Invasive Tear Break up Time using OCULUS Keratograph 5m.

A. Vassilev, I. Chernodrinska, St. Kostova, M. Slavkova, Y. Zdravkov


The tear film consists of mucus and aqueous phase produced by the Goblet cells and tear glands and overlaying oily layer which is result of the function of Meibomian glands. The tear film in Dry eye syndrome is damaged either through tear deficiency or through its excessive evaporation. It is considered that the Meibomian gland dysfunction is the main reason for Dry eye disease and can result in tear film instability, damage of the epithelial surface cells, chronic blepharitis, subjective discomfort, contact lenses intolerance and others.

Aim of the current study is the investigation of Meibomian glands in patients of different ages by determination of the percent Meibomian gland loss (MGL) for the upper and lower eyelid and the correlation analysis between MGL and non-invasive tear break up time (NIBUT).

Materials and methods: The Meibomian gland loss and NIBUT were determined by the corneal Keratograph Oculus 5m. 285 eyes were included of patients ranging from 20 to 90 years of age. The meibographic images were subsequently analyzed with Image J software. The statistical analysis regarding Pearson correlation, linear regression and ANOVA was performed with IBM SPSS v.19.0.0

Results and conclusions: A weak but statistically significant correlation was determined between Meibomian glands loss and the non-invasive tear break up time. The patients` age turns out to be the most important factor, while the gender is of no such significance. Besides a difference was estimated between the percent of lower and upper eyelid Meibomian gland loss although there is a correlation between them.


NIBUT; Meibomian gland loss; Corneal Keratography; Dry eye

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About The Authors

A. Vassilev
Department of Ophthalmology Medical University-Sofia, Aleksandrovska University Hospital, Sofia

I. Chernodrinska
Department of Ophthalmology Medical University-Sofia, Aleksandrovska University Hospital, Sofia

St. Kostova
Department of Ophthalmology Medical University-Sofia, Aleksandrovska University Hospital, Sofia

M. Slavkova
Department of pharmaceutical technology, Faculty of Pharmacy, Medical University-Sofia

Y. Zdravkov
Department of Ophthalmology Medical University-Sofia, Aleksandrovska University Hospital, Sofia