Meibography in clinical practice

Article

Technological advances mean meibography may be used to diagnose MGD

Meibomian gland dysfunction (MGD) is one of the most common causes of an abnormality of the tear film lipid layer and evaporative dry eye.1–5 Numerous risk factors of MGD are reported (Table 1).6 Its prevalence varies between countries from 20% to 60%, with the highest rate in Japan.6 MGD is a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal duct obstruction and/or qualitative/quantitative changes in the glandular secretion.7 This may result in alteration of the tear film, symptoms of eye irritation, clinically apparent inflammation and ocular surface disease.7

Meibography is the only clinically in vivo technique to visualize the morphology of the meibomian glands. When using this method, the structure of the meibomian glands, including the ducts and acini, can be observed.8–16 Meibography provides photographic documentation of the meibomian gland under specialized illumination techniques.17 This article is aimed to summarize recent development and investigation in meibography and its clinical relevance.

There are two principles in meibography. One is the transillumination of the everted lid11,18,19 the other is direct illumination, named the non-contact meibography.15,20–22 In the transillumination technique, the eyelid is everted over a light source.11,13,23 The most basic version uses white light, for example from a Finoff transilluminator. This is applied to the cutaneous side of the everted eyelid and allows observation from the palpebral conjunctival surface. Tapie24 was probably first describing evaluation of meibomian glands by transilluminating lids in 1977. He also captured the meibomian glands using infrared film (IR). Jester et al.16 adapted the biosmicroscopic and photographic techniques to improve upon Tapie's technique.16 Subsequently many other groups have used the transillumination IR techniques in meibomian gland observation.11,18,19,25

Newsletter

Join ophthalmologists across Europe—sign up for exclusive updates and innovations in surgical techniques and clinical care.

Recent Videos
Alfredo Sadun, MD, PhD, chief of Ophthalmology at the Doheny Eye Institute, University of California Los Angeles, shared exciting new research with the Eye Care Network during the Association for Research in Vision and Ophthalmology (ARVO) meeting on the subject of Leber hereditary optic neuropathy (LHON).
At this year's Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Utah, Nitish Mehta, MD, shared highlights from his research documenting real-world results of aflibercept 8 mg for patients with diabetic macular oedema.
ARVO 2025: Anat Loewenstein, MD, shares data from herself and her colleagues on meeting needs of patients with diabetic retinopathy
At the American Society of Cataract and Refractive Surgeons annual meeting, Sheng Lim, MD, FRCOphth discusses the benefit of endoscopic cyclophotocoagulation for patients with primary open angle glaucoma and cataracts in the CONCEPT study
A photo of Seville, Spain, with the Congress on Controversies in Ophthalmology logo superimposed on it. Image credit: ©francovolpato – stock.adobe.com; logo courtesy COPHy
Anat Loewenstein, MD, Professor and Director, Department of Ophthalmology, Tel Aviv Medical Center, discusses the Congress on Controversies in Ophthalmology (COPHy)
(Image credit: Ophthalmology Times Europe) AGS 2025: Clemens Strohmaier, PhD, on improving aqueous humour outflow following excimer laser trabeculostomy
3 experts are featured in this series.
Anat Loewenstein, MD, speaks about the 22nd Annual Angiogenesis, Exudation, and Degeneration Meeting in February 2025 and shares her global forecast for AI-driven home OCT
3 experts are featured in this series.
Related Content
© 2025 MJH Life Sciences

All rights reserved.