Tear Film Qualitative Tests
Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye and is discussed in Chapter 3. Slit-lamp examination of the eyelid margin and meibomian gland orifices is an important clinical tool in the evaluation of MGD, but interferometry and infrared meibography have enhanced the ability to assess meibomian gland structure and pathology (Fig 2-24). These tools allow clinicians to measure the height of the tear film meniscus and examine, with submicrometer accuracy, the thickness and structure of the lipid layer (Fig 2-25). They also allow real-time evaluation of the blink rate, the completeness of blink patterns, and TBUT (noninvasive) and provide objective recordings of meibomian gland dropout.
American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern Guidelines. Dry Eye Syndrome. San Francisco: American Academy of Ophthalmology; 2013. Available at www.aao.org/ppp.
Bunya VY, Langelier N, Chen S, Pistilli M, Vivino FB, Massaro-Giordano G. Tear osmolarity in Sjögren syndrome. Cornea. 2013;3(32):922–927.
The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5(2):75–92.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.