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Review
. 2011 Mar 30;52(4):2006-49.
doi: 10.1167/iovs.10-6997f. Print 2011 Mar.

The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee

Alan Tomlinson  1 , Anthony J Bron, Donald R Korb, Shiro Amano, Jerry R Paugh, E Ian Pearce, Richard Yee, Norihiko Yokoi, Reiko Arita, Murat Dogru
Affiliations
Review

The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee

Alan Tomlinson et al. Invest Ophthalmol Vis Sci. .
No abstract available

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Figures

Figure 1.
Figure 1.
Normal lid margin, showing meibomian orifices (arrows) and clear, expressed oil (courtesy of A. Bron).
Figure 2.
Figure 2.
Standardized meibomian gland expression performed at the slit lamp using a diagnostic expression instrument (Korb and Blackie52). See text for further details (courtesy of D. Korb). Reprinted with permission from Korb DR, Blackie CA. Meibomian gland diagnostic expressibility: correlation with dry eye symptoms and gland location. Cornea. 2008;27(10):1142–1147.
Figure 3.
Figure 3.
Spreading of a normal tear film lipid layer image by interferometry (courtesy of N. Yokoi).
Figure 4.
Figure 4.
Normal meibomian glands of a 38-year-old woman, viewed by infrared meibography shows scattered gland absence or irregularity (courtesy of R. Arita).
Figure 5.
Figure 5.
Photographic montage of the lower lid viewed by transillumination meibography. There is extensive meibomian gland dropout in a patient with meibomian gland dysfunction (courtesy of N. Yokoi).
Figure 6.
Figure 6.
Meibomian gland dysfunction. Cloudy expressed meibum (arrows) (courtesy of A. Bron).
Figure 7.
Figure 7.
Meibomian gland dysfunction: expression of opaque meibum (courtesy of D. Korb).
Figure 8.
Figure 8.
Meibomian gland dysfunction: strings of toothpaste-like opaque meibum expressed in response to forceful bimanual gland expression (courtesy of D. Korb).
Figure 9.
Figure 9.
Cicatricial meibomian gland dysfunction. Lid margin hyperemia with orifice opacity with plugging (arrows); (courtesy of A. Bron).
Figure 10.
Figure 10.
Advanced non-cicatricial meibomian gland dysfunction: dense orifice opacification with periductal fibrosis (courtesy of A. Bron).
Figure 11.
Figure 11.
Cicatricial meibomian gland dysfunction: All meibomian orifices open onto the marginal conjunctiva, with some exposure of terminal ducts (arrows) (courtesy of A. Bron).
Figure 12.
Figure 12.
Cicatricial meibomian gland dysfunction: All meibomian orifices open onto the hyperemic marginal conjunctiva, with some exposure of terminal ducts (arrows) (courtesy of A. Bron).
Figure 13.
Figure 13.
Advanced cicatricial meibomian gland dysfunction: orifice retroplacement and opacity (courtesy of G. Foulks).
Figure 14.
Figure 14.
Dimpling or notching of the posterior lid margin due to tissue absorption in the region of the orifices (courtesy of J. Shimazaki).
Figure 15.
Figure 15.
Advanced meibomian gland dysfunction: epithelial ridging extending between opacified meibomian gland orifices (courtesy of A. Bron).
Figure 16.
Figure 16.
In vivo confocal microscopy of meibomian glands, showing the dilatation of acinar units in a patient with obstructive meibomian gland dysfunction (right) compared to that in a healthy control (left) (courtesy of M. Dogru).
Figure 17.
Figure 17.
Evaporimetry (courtesy of A. Tomlinson).
Figure 18.
Figure 18.
This figure was published in Ophthalmology, Vol 117, Ibrahim OM, Matsumoto Y, Dogru M et al., The efficacy, sensitivity, and specificity of in vivo laser confocal microscopy in the diagnosis of meibomian gland dysfunction. Page 670, ©Elsevier (2010). Reprinted with permission.
See this image and copyright information in PMC

References

    1. Foulks G, Bron AJ. A clinical description of meibomian gland dysfunction. Ocul Surf. 2003;1:107–126 - PubMed
    1. Kozak I, Bron AJ, Kucharova K, et al. Morphologic and volumetric studies of the meibomian glands in elderly human eyelids. Cornea. 2007;26:610–614 - PubMed
    1. Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared meibography to document age-related changes of the Meibomian glands in a normal population. Ophthalmology. 2008;115:911–915 - PubMed
    1. Nicolaides N, Kaitaranta JK, Rawdah TN, Macy JI, Boswell FM, 3rd, Smith RE. Meibomian gland studies: comparison of steer and human lipids. Invest Ophthalmol Vis Sci. 1981;20:522–536 - PubMed
    1. Chew CKS, Hykin PG, Jansweijer C, Dikstein S, Tiffany JM, Bron AJ. The casual level of meibomian lipids in humans. Curr Eye Res. 1993;12:255–259 - PubMed

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