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As a non-invasive ocular imaging tool, in vivo confocal microscopy(IVCM)provides micro-structural information of cornea, conjunctiva and meibomian glands at the cellular level to display their microscopic structure features. IVCM supplies a unique advantage to clinical applications and research in ocular surface. Recently, application of IVCM has progressively extended to the research area on meibomian gland dysfunction(MGD)and on other diseases about meibomian gland. Thus, this paper aims to summarize the current knowledge about the role of IVCM in the assessment of meibomian glands.

This review examines currently available non-pharmaceutical treatment modalities for meibomian gland dysfunction. A detailed search of the PubMed and MEDLINE databases was performed to identify original articles in English that have evaluated such nonpharmaceutical therapies in patients with this condition. Conventional therapies such as application of a warming compress, the practice of lid hygiene, and manual expression of meibomian glands as well as more technologically advanced approaches such as intraductal probing, thermal pulsation, and intense pulsed light therapy are included in the review. These non-pharmaceutical treatment options may each have a role to play in the management of meibomian gland dysfunction, but more studies are necessary to compare treatments directly under identical experimental conditions in order to determine their relative efficacy. Additional large-scale, randomised, controlled trials are also required to provide more information such as the specific indications best suited to each treatment modality, the efficacy of such approaches in combination with pharmaceutical-based therapy, and the mechanisms of action of some of the more technologically advanced systems. [ABSTRACT FROM AUTHOR]

Little is known about the pathological roles of sebaceous glands in canine skin diseases, as most examinations have been conducted with cultured human sebaceous epithelial cell lines. To our knowledge, there is no available canine sebaceous epithelial cell line. The purpose of this study was to establish a canine sebaceous epithelial cell line and characterize it. An eyelid mass in a dog was surgically resected for treatment, and it was histologically diagnosed as sebaceous epithelioma. Collected tissue was conducted for culture, and the growing epithelial-like cells were passaged. The cells showed continuous proliferation for over 6 months. After 40 passages, the cells were named CMG-1. Lipid droplets in the cytoplasm of CMG-1 cells were confirmed by Oil Red O staining. As reported in studies with human sebaceous epithelial cell lines, lipogenesis in CMG-1 cells was promoted by linoleic acid, whereas transforming growth factor-β (TGF-β) suppressed it. Additionally, real-time PCR revealed that the expression levels of chemokines and cytokines, including CC chemokine ligand (CCL)-2, CCL-20, CXCL-10, Tumor necrosis factor-α (TNF-α), Interleukin (IL)-1α, IL-1β, and IL-8, were significantly increased in CMG-1 cells following treatment with lipopolysaccharide. In conclusion, we successfully established a new canine sebaceous epithelial cell line. Our data indicated that lipogenesis and inflammatory responses were quantitatively evaluable in this cell line. CMG-1 cells could be useful for the pathological analysis of sebaceous gland diseases in dogs. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of using meibomian gland (MG) dropout and distortion for dry eye disease (DED) diagnosis in a young population with long-term contact lens (CL) wear. Seventy-three CL-wearers and 68 non-CL-wearers (20–28 years old) participated in the study. The diagnosis of DED was based on an ocular surface disease index ≥ 13, and a noninvasive breakup time < 10 seconds or positive corneal fluorescein staining. The MG dropout and distortion in each subject were quantified with non-invasive meibography. Receiver operating characteristic (ROC) curves were created to evaluate the effectiveness of using MG dropout and distortion to determine the presence of DED in CL-wearers and non-CL-wearers. In non-CL-wearers, the MG distortion was significantly higher in DED subjects than in normal subjects (3.83 ± 1.81 versus 1.59 ± 1.04). In CL-wearers, MG distortion was not significantly different (5.12 ± 4.11 versus 5.51 ± 3.15 in normal and DED subjects respectively). The area under the ROC curve (AUC) for MG distortion was 0.783 in the non-CL-wearers, but 0.507 in CL-wearers. In non-CL-wearers, MG dropout was significantly higher in DED subjects than in normal subjects (0.22 ± 0.08 versus 0.15 ± 0.06). In CL-wearers, MG dropout was also significantly higher in DED subjects than in normal subjects (0.29 ± 0.11 versus 0.22 ± 0.08). The AUC for MG dropout used to classify DED was 0.740 in the non-CL-wearers and 0.715 in CL-wearers. MG dropout was effective in distinguishing subjects with DED from normal subjects in both CL wearers and non-CL wearers. MG distortion can only distinguish DED subjects from normal ones in non-CL wearers, but not in CL wearers. [ABSTRACT FROM AUTHOR]

Purpose: To present the differentiating clinical findings between intratarsal keratinous cyst (IKC) and chalazion. Method: A retrospective review of medical records of all patients who presented between 2010 and 2018 at King Abdulaziz University Hospital with proven histopathological diagnosis of IKC was done. Complete ophthalmologic evaluation at presentation, surgical procedures performed, complications, histopathological findings, response to treatment and follow-up were recorded. Results: Twelve patients were found to have IKC. All patients presented with an eyelid mass with no signs of local inflammation. All lesions were fixed to the tarsus with freely mobile overlying skin, which was found to be slightly pale compared to the surrounding skin in six patients. On palpation, IKC had well-defined boarders. Isolation with clear surgical plane for cyst excision was achieved in nine patients as they were superficially involving the tarsus. When IKC involved the deep part of the tarsus, bluish/ whitish nodules were seen upon eyelid eversion. Six patients were misdiagnosed and surgically treated as a chalazion elsewhere prior to presentation to us with recurrence. Conclusion: Differentiating IKC from chalazion can be challenging. Careful clinical evaluation helps reaching the right diagnosis and providing the correct treatment, which involves complete excision of IKC to prevent recurrence. [ABSTRACT FROM AUTHOR]

Background: To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area.Methods: This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution.Results: At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74 ± 0.75, 0.48 ± 0.67, and 1.22 ± 0.60, respectively. One month after chalazion resolution, the parameters were 0.35 ± 0.49, 0.17 ± 0.49, and 0.91 ± 0.60, respectively; there was significant difference (P < 0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P > 0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93 ± 0.87, 1.07 ± 0.70, and 1.59 ± 0.76, respectively, and at 1 month after chalazion resolution, they were 0.93 ± 0.82, 0.95 ± 0.75, and 1.52 ± 0.70, respectively; there was no significant difference (P > 0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P > 0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients.Conclusions: Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term. [ABSTRACT FROM AUTHOR]

The meibomian gland dysfunction (MGD) which is responsible for the state of the lipid layer of the tear film, is of key importance in the pathogenesis of dry eye syndrome (DES) development. This article analyzes the possibility of using Intensive Pulse Light (IPL) on the Lumenis M22 device with an IPL module in patients with DES associated with MGD. It has been shown that the use of IPL in this category of patients allows achieving a more pronounced reduction of subjective and objective manifestations of DES (increased the non-invasive test break-up time(NIBUT), the lipid layer thickness (LLT) and the tear meniscus height, and also had a beneficial effect on the meibomian glands). Significant treatment efficacy has been proven in patients with MGD grades I and II, and for grade III this treatment method is the method of choice than for traditional treatment. [ABSTRACT FROM AUTHOR]

Purpose: To perform histopathologic analysis of tissue manifesting meibomian gland dropout on noncontact infrared meibography in a dog. Methods: A 14-year-old intact male Cairn terrier was evaluated at Triangle Animal Eye Clinic for dense corneal opacity of the right eye. A complete ocular examination was performed, including slit-lamp biomicroscopy, tonometry, and noncontact meibography. Pigmentary glaucoma with elevation of intraocular pressure was diagnosed, and meibography revealed morphological changes suggestive of gland dropout in the middle of the upper right eyelid. Results: The globe was enucleated by the transpalpebral method, and palpebral tissue was subjected to histopathologic analysis. The analysis revealed an almost complete loss of meibomian gland structure accompanied by slight enlargement and proliferation of fibroblasts as well as by infiltration of plasma cells and lymphocytes. Conclusions: Meibomian gland dropout as detected by meibography can be associated with chronic inflammation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical outcome, possible complications, and recurrence rate of distichiasis in dogs treated with partial tarsal plate excision (PTPE) technique using a transconjunctival approach. Methods: Retrospective study including 17 client-owned canine patients affected with distichiasis and presenting with associated clinical signs (ie, blepharospasm, epiphora, chronic keratoconjunctivitis, or corneal ulceration) that underwent surgical removal of the aberrant lashes using a PTPE technique between January 2018 and February 2019. Data collected included breed, age, sex, affected eyelid(s), number of distichia, and tear film breakup time (TBUT). Resected cilia-bearing tarsoconjunctival strips were submitted for histopathological analysis. Results: Thirty eyes (52 eyelids) from 17 dogs were included in the study. The median age was 688 days (range 118-4243 days). A successful outcome, defined as complete resolution of clinical signs attributable to the distichia, occurred in all eyes after a single procedure, with a mean follow-up time of 239 days (range 69-480 days). Appearance of new distichia occurred in 14/30 eyes (46.3%), and of these, three eyes needed a new PTPE procedure. Recurrence of the distichia only occurred in one eye (3.3%) which was asymptomatic. Following surgery, TBUT decreased below the normal value in 7/24 eyes (29.1%) although none developed clinical signs of qualitative tear film deficiency. Post-operative complications included trichiasis and cicatricial entropion, which developed in two eyes (6.6%), and these were successfully managed with corrective eyelid surgery. Conclusions: Partial tarsal plate excision, using a transconjunctival approach, had an excellent clinical outcome with a low incidence of complications. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of the intense pulse light (IPL) therapy for the treatment of meibomian gland dysfunction (MGD) and dry eye parameters. Methods: Patients who underwent an IPL therapy for the treatment of MGD were included in this retrospective study. Ocular Surface Disease Index (OSDI) scores, the frequency of daily lubricant use, non-invasive tear break-up time (NIBUT), meibomian glad dropout scores, corneal staining scores, and Schirmer test results were collected from patient charts that recorded at baseline and follow-up visits at 1 month, 3 months, and 12 months. For the analysis, patients were grouped based on the severity of their baseline meibomian gland dropout score as mild, moderate, and severe atrophy. Results: Forty-three patients (mild atrophy = 22, moderate atrophy = 17, and severe atrophy = 4) were included for analysis. Except for the Schirmer test, all dry eye parameters significantly improved in patients with mild and moderate atrophy following the treatment and this effect lasted until the 12-month follow-up visit (p < 0.001). No significant improvement in any parameter was observed in patients with severe atrophy at any time point (p > 0.05). In the mild and moderate atrophy groups, OSDI scores, as well as NIBUT, started improving at 1 month (p < 0.01), while corneal staining and meibomian gland dropout scores showed earliest improvements at 3 months (p < 0.01). No adverse events were observed, except for temporary redness in 4 patients. Conclusion: The IPL treatment seems an effective and safe treatment for patients with MGD. This study shows that the IPL resulting in an earlier improvement in symptoms and signs with long-lasting beneficial effect on the meibomian glands. [ABSTRACT FROM AUTHOR]

Over several months, a painless, multinodular, non-erythematous swelling of the deep tissues of his left upper eyelid developed in a 63-year-old man. An excisional biopsy with histopathologic evaluation disclosed a unique sebaceous papilloma within a cyst lined by non-keratinizing squamous epithelium that focally displayed a variably thick, superficial, eosinophilic cuticular layer. Immunohistochemical staining demonstrated that the tumor and its epithelial cystic lining had a profile consistent with Meibomian gland duct epithelium. Adipophilin highlighted cytoplasmic vacuolar lipid positivity. The encapsulation of the lesion, absence of nuclear atypia, and Ki-67 nuclear positivity restricted to the basilar cells established its intrinsically benign nature. The patient's clinical history was remarkable for pulmonary and colonic carcinomas resected, respectively, 20 years and 8 years earlier. DNA mismatch repair protein expression studies disclosed loss of nuclear immunostaining of MSH6 protein, pointing to the possibility of an underlying rare MSH6 variant of the Muir-Torre syndrome, not yet described in the ophthalmic literature. p16 nuclear positivity was also found in the tumor cells, indicating the possible role of high-risk human papillomavirus as an additional factor in the genesis of the tumor. Genetic evaluation of normal and tumoral tissues in future similar cases will detect if there is an underlying germline mutation versus a somatic mutation limited to the tumor. This will be required to fully establish a predictable linkage with this new subtype of the Muir-Torre syndrome. [ABSTRACT FROM AUTHOR]

Background: Radiation therapy (RT) is the treatment of choice in patients with low-grade ocular adenexal mucosa-associated lymphoid tissue lymphoma (OAML) and many of them experience post-RT dry eye with varying severity. The purpose of the present study was to investigate ocular effects of RT on meibomian glands and dry eye by directly visualizing structural changes. Secondly, we focused on the comparison of two groups of patients according to tumor location and radiation technique.Methods: Sixty-four eyes with OAML of conjunctiva, orbit, lacrimal gland, or lacrimal sac were grouped into conjunctival lymphoma and "orbital-type" lymphoma (i.e., orbit, lacrimal gland, and lacrimal sac). Subjects were investigated for morphological changes in meibomian glands by meiboscore grading system. Radiation technique was examined and Ocular Surface Disease Index (OSDI) questionnaire, Schirmer's test, tear film break-up time (TBUT), slit lamp examination of corneal surface and lid margin abnormality were conducted before and after RT.Results: The increase in meiboscore was statistically significant over time after RT in both groups (P < 0.001). The extent of increase in meiboscore was significantly greater in the "orbital-type" lymphoma group than in the conjunctival lymphoma group (P < 0.001). The changes in OSDI, TBUT, corneal fluorescein staining score and lid margin abnormality score after RT were significantly different across two groups (P = 0.042, 0.001, 0.035 and 0.001, respectively). Schirmer's value decreased after RT in both groups. Dry eye symptoms were most severe right after RT in both groups, but a gradual resolution was noted in most patients with conjunctival lymphoma, whereas symptoms persisted in "orbital-type" lymphoma patients. The OSDI score and corneal fluorescein staining score were positively correlated with meiboscore in "orbital-type" patients at post-RT 6 months (r = 0.43, P = 0.04; r = 0.39, P = 0.03, respectively).Conclusions: Patients with OAML had different degrees of morphological changes in meibomian glands according to tumor location and radiation technique. "Orbital-type" lymphoma patients are more likely to experience severe injury to meibomian glands, which eventually leads to persistent dry eye. Patients with "orbital-type" lymphoma should be well informed of post-RT damage on meibomian glands and persistent dry eye. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effect of the Bruder Moist Heat Compress on contact lens (CL) discomfort in subjects with contact lens-related dry eye (CLDE). This was a 4-week, single-center, three-arm, randomized, open-label clinical trial in subjects diagnosed with CLDE using the Contact Lens Dry Eye Questionnaire. Fifty-one CL wearers were randomized to one of three treatment groups: application of the Bruder Compress twice a day, Bruder Compress once a day, or warm washcloth used for ten minutes twice a day without reheating. Subject diaries were monitored for compliance and collected data on daily CL comfort upon awakening and throughout the afternoon. Clinical assessments included tear film break-up time (TBUT), lipid layer thickness (LLT), and meibomian gland evaluation. Statistical tests included a generalized linear model and one-way analysis of variance (ANOVA) to investigate treatment effect on comfortable wear time. Fifty-one subjects (98% female) completed the study. After treatment, subjects using a washcloth reported more uncomfortable contact lens wear time on average (mean = 5.1 ± 2.8 h) when compared with subjects who had used the Bruder Compress in Group 1 (mean = 2.8 ± 1.6 h) (p = 0.02). In the Bruder Compress groups, there was a significant reduction in the blockage of meibomian glands (p < 0.01). No significant difference in uncomfortable wear time was found between subjects using the Bruder Compress twice daily versus once daily (p = 0.48). Subjects using the Bruder Compress once daily had the highest rate of compliance at 90.2% (p < 0.01). No significant improvements were observed in TBUT (p = 0.76) or LLT (p = 0.78). The Bruder Moist Heat Compress resulted in a significant improvement in comfortable CL wear time in subjects with CLDE. [ABSTRACT FROM AUTHOR]

Chromatin organization is essential for maintaining cell-fate trajectories and developmental programs. Here, we find that disruption of H3K36 methylation dramatically impairs normal epithelial differentiation and development, which promotes increased cellular plasticity and enrichment of alternative cell fates. Specifically, we observe a striking increase in the aberrant generation of excessive epithelial glandular tissues, including hypertrophic salivary, sebaceous, and meibomian glands, as well as enhanced squamous tumorigenesis. These phenotypic and gene expression manifestations are associated with loss of H3K36me2 and rewiring of repressive H3K27me3, changes we also observe in human patients with glandular hyperplasia. Collectively, these results have identified a critical role for H3K36 methylation in both in vivo epithelial cell-fate decisions and the prevention of squamous carcinogenesis and suggest that H3K36 methylation modulation may offer new avenues for the treatment of numerous common disorders driven by altered glandular function, which collectively affect large segments of the human population. [Display omitted] • Disruption of H3K36 methylation via H3K36M expression drives epithelial plasticity • This triggers epithelial glandulogenesis while also increasing cancer susceptibility • H3K36M rewires the global and genome-wide H3K36me2 and H3K27me3 epigenetic landscape • These chromatin changes suppress differentiation genes while activating glandular genes Ko et al. show that disrupting the epigenome via the expression of a mutant histone (H3K36M) promotes chromatin alterations that drive a striking increase in epithelial gland formation (salivary, sebaceous, and meibomian) while also predisposing cells to increased squamous cell carcinoma, revealing a role for epigenetics in epithelial gland formation. [ABSTRACT FROM AUTHOR]

AIM: To evaluate changes in tear film stability and meibomian gland function and the clinic efficacy of three different artificial tears in patients with preoperative dry eye after phacoemulsification. METHODS: All 90 cataract patients(90 eyes)with preoperative dry eye who underwent phacoemulsification randomly divided into three groups(Group A treated with protein-free calf blood extract ophthalmic gel; Group B treated with sodium hyaluronate eye drops; Group C treated with Vitamin A palmitate eye gel). Ocular Surface Disease Index(OSDI), Schimer's I test(SⅠt), tear film break time(BUT), corneal fluorescein staining(FL)and meibography were performed for all patients preoperatively and 7, 30 and 90d postoperatively. RESULTS: No statistical differences existed among the three preoperative groups(P>0.05). Except meibomian gland score, there was no statistical significance among preoperatively and 7, 30, 90d postoperatively of the three groups(P>0.05). At 7d postoperatively, SⅠt and BUT of every group were lower than those before treatment, FL scores and OSDI scores were higher than those preoperative(PP>0.05). At 30d postoperatively, SIt, BUT, OSDI scores in group A and C were better than in group B, which displayed statistical differences(PPPP>0.05). CONCLUSION: Tear film stability and meibomian gland function were affected by phacoemulsification. Topical application of deproteinised calf blood extract eye gel, sodium hyaluronate eye drops and Vitamin A palmitate eye gel all hase a clearly beneficial effect on subjective symptoms. Deproteinised calf blood extract eye gel and Vitamin A Palmitate Eye Gel had more powerful effect on BUT than sodium hyaluronate, however deproteinised calf blood extract eye gel is more effective in superficial punctuate keratopathy.

Shima Fukuoka,1–3 Reiko Arita,2–4 Rika Shirakawa,2,3 Naoyuki Morishige2,5 1Department of Ophthalmology, Omiya Hamada Eye Clinic, 2Lid and Meibomian Gland Working Group (LIME), Saitama-shi, Saitama, 3Department of Ophthalmology, University of Tokyo School of Medicine, Bunkyo-ku, Tokyo, 4Department of Ophthalmology, Itoh Clinic, Saitama-shi, Saitama, 5Department of Ophthalmology, Oshima Eye Hospital, Fukuoka-shi, Fukuoka, Japan Purpose: To examine the changes in meibomian gland morphology and ocular higher-order aberrations (HOAs) in eyes with chalazion and its excision. Methods: Seven male patients with previous history of chalazion excision and seven control male subjects were enrolled. Changes in meibomian gland morphology (meiboscores, gland dropout, and shortening) were evaluated by using meibography equipped in a wavefront analyzer KR-1W and in a slit-lamp device BG-4M. Ocular HOAs were measured sequentially with KR-1W. The tear film breakup time (BUT) was measured. Results: Both KR-1W and BG-4M visualized meibomian gland as clear similar images. The tear film BUT (mean ± SD, 5.6±3.0 vs 9.4±2.3 seconds, P=0.025), the total meiboscore (median [interquartile range], 2 (2-3) vs 0 (0-1), P=0.007) as well as the meibomian gland dropout rate (86% vs 14%, P=0.008) and shortening rate (100% vs 29%, P=0.031) differed significantly between the patient and control groups. The first total ocular HOAs (0.142±0.063 vs 0.130±0.015, P=0.80) were similar in both groups, whereas the stability index of the total HOAs over time (0.0041±0.0048 vs -0.0012±0.0020, P=0.030) differed significantly between the patient and control groups. Conclusions: Chalazion and its excision were associated with dropout and shortening rate of meibomian glands. The morphological changes of meibomian glands in chalazion may be associated to instability of the tear film, which was suggested by the tear film BUT and the stability of ocular HOAs. Keywords: meibomian gland, meibography, wavefront analyzer, higher-order aberrations, chalazion excision

Background: Recent studies have demonstrated that pterygium has a close relationship with dry eye disease. This study is to determine abnormalities in meibomian gland and tear function in patients with pterygium and to assess the relationship between the variables. Materials and Methods: Forty eyes from forty patients with primary nasal pterygium and forty eyes from forty volunteers without ocular pathologies were enrolled in this study. Ocular surface disease index scores, meibomian gland expression scores, lid margin abnormality scores, meiboscore, tear film breakup time (BUT), Schirmer test (SIT) value, and the lower tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) using Fourier domain optical coherence were performed. Analysis of variance was applied for intergroup comparisons. A statistical significance level of P < 0.05 was considered. Results: Ocular symptom scores, BUT scores, lid margin abnormality, meibomian gland expression, and meiboscore were significantly higher in pterygium patients than in controls (P < 0.01 for all scores). However, the SIT scores, the lower TMH, TMD, and TMA values did not revealed a significant difference between two groups (all P > 0.05). Multivariate regression analysis demonstrated that meiboscore significantly correlated with ocular symptom scores, BUT, lid margin abnormality scores, and meibomian gland expression scores. Conclusions: Meibomian gland function may be altered in pterygium patients, which is associated with uncomfortable ocular symptoms. Being aware of meibomian gland changes seems essential to understand the complex relationship among pterygium, tear film functions, and ocular surface changes.

Introduction This study proposes the utility of an infrared auto refractometer for meibography and compares miebographs obtained by an auto refractometer to meibographs obtained by a designated meibography machine. Methods A prospective observational comparative study of meibographs of patients with clinical signs of meibomian gland dysfunction (MGD) using a designated meibography machine and an infrared auto refractometer. Five masked, experienced interpreters graded the images of the two machines. The Kappa test was used to calculate Intra-rater and inter-rater agreements between the meibography machine and automated refractor grading of meibomian gland dysfunction. Results High-quality photos of all 30 eyes delineating the meibomian glands (MG) were successfully obtained with both the meibography machine and the autorefractor. Both methods had a good intra-rater agreement (κ= 0.667 to 0.784, average 0.738). Poor to fair interrater agreement was noticed in the grading of autorefractor images (k= -0.030 to 0.343, average 0.092) and poor to moderate agreements between investigators for meibography machine images (K= -0.016 to 0.420, average 0.173). Conclusion A commercially available auto refractometer could capture high-quality non-contact IR digital meibographs., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alsaab et al.)

Objective: To investigate meibomian gland (MG) morphology by noncontact infrared meibography in Shih Tzu dogs with or without keratoconjunctivitis sicca (KCS). Procedures: Fourteen eyes of 12 Shih Tzu dogs (mean age of 10.7 years, range of 7‐13 years) presented to Yakumo Animal Hospital or Triangle Animal Eye Clinic from 2011 to 2017 with clinical signs and a Schirmer tear test (STT) result consistent with KCS (<10 mm/min) were examined. Twenty‐eight eyes of 16 Shih Tzu dogs (mean age of 12.4 years, range of 8 to 15 years) with a STT > 15 mm/min served as healthy controls. Both groups of dogs underwent routine slitlamp biomicroscopy followed by noncontact infrared meibography of the upper eyelid with both desktop‐type and mobile‐type systems. Results: Meibography revealed morphological abnormalities of MGs in 13 eyes of 11 dogs with KCS. The abnormalities included gland shortening in 64% and gland dropout in 64% of the 14 eyes in the KCS group. Morphological changes were also observed in MGs of 16 eyes of 10 dogs in the control group. These changes included shortening in 46% and dropout in 17.8% of the 28 eyes in the control group. Dropout was significantly more common in eyes with KCS than in control eyes (P < 0.01). Conclusions: The frequency of MG abnormalities is increased in Shih Tzus with KCS compared with control animals. A reduced quality of the tear film associated with increased evaporation and reduced retention of tear fluid likely exacerbates the effects of a reduced tear volume in animals with aqueous deficiency. [ABSTRACT FROM AUTHOR]