Meibography and Tear Scan Using the Oculus Keratograph 4
Condition: Meibomian Gland Dysfunction
MeSH terms: Meibomian Gland Dysfunction
Study type: Observational

Summary: 
      The purpose of this study is to look at both the meibomian glands and the tear film using a
      new clinical instrument marketed in Canada which was recently acquired by the Centre for
      Contact Lens Research. These will be compared between two groups of individuals, one group
      with visible meibomian gland dysfunction (MGD) and one group of individuals with normal
      meibomian gland appearance. The hypothesis is that there will be a difference between normal
      individuals and individuals with MGD with respect to the appearance of the meibomian glands
      and certain tear film attributes.
    

Detailed description: 
      Meibomian gland dysfunction (MGD) is a common clinical condition and a major cause of
      evaporative dry eye with associated discomfort, visual disturbance and contact lens
      intolerance. In MGD, meibum is often abnormal, progressively changing in color from clear to
      yellow and in consistency from liquid to thick and toothpaste-like. Evaluation of the
      meibomian glands (MG) and lipid layer is vital. In a typical clinical setting, lid and lid
      margin evaluation is often performed via slitlamp biomicroscopy; however, the structure of
      the meibomian glands is often not clearly visualized when a slit lamp is used in isolation.
      Trans-illumination of the lids is necessary to clearly view these glands.

      To date, infrared meibography has been the only method available for the assessment of
      meibomian gland structure. It is primarily regarded as a laboratory-specific procedure for
      meibomian gland drop out assessment in people suffering from MGD. Recently, the Keratograph 4
      was released by OCULUS (Wetzlar, Germany). In addition to corneal and contact lens assessment
      features, the Keratograph 4 offers a tear film (TF) scan module able to objectively assess
      tear break-up time (TBUT) with a colour coded map highlighting the regions of tear break up.
      High-resolution images of tear meniscus can also be obtained and used for subjective
      assessment of tear meniscus height (TMH) with the help of built-in software. Preliminary
      research at the Centre for Contact Lens Research has demonstrated its ability to capture
      meibography images of the upper and lower lids.

      The objectives of this study are to collect meibography, TBUT and TMH data using the
      Keratograph 4 in normal participants (no MGD) and participants with MGD and to compare these
      between the two groups and before and after the use of a meibomian gland evaluator. The
      primary outcome variables are meibography images, TBUT and TMH.

      The study hypothesis is that here will be a difference between normal participants and
      participants with MGD, with respect to meibography images (MG drop out), TBUT measurements
      (area and time of break up) and TMH measurements.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Non-contact lens wearers will be recruited using CCLR records and advertising approved by
        the UW Office of Research Ethics