Meibomian Gland Dysfunction Clinical Trial
Official title:
Meibography and Tear Scan Using the Oculus Keratograph 4
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.
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.
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Observational Model: Case Control, Time Perspective: Prospective
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