Meibography of Eyes With Sequelae of Trachoma

Purpose: To study the effect of trachoma on meibomian glands using infrared meibography and to correlate the results with tear film parameters. Methods: This is a prospective cohort study in which 86 eyes of healthy volunteers and 90 eyes with trachoma were included. Clinical assessment was performed including the following: slit-lamp examination looking for signs of sequelae of trachoma, tear breakup time (TBUT), superficial punctate keratopathy (SPK), Schirmer II test (with anesthesia), and meibum score. Noncontact meibography was performed on both upper and lower eyelids separately using the meibograde system, which involved distortion of the meibomian gland, shortening, and dropout. Results: Lid margin abnormalities (telangiectasia, lid margin swelling, and hyperemia) were all significantly higher in the trachoma group. The mean SPK (1.36), meibum score (1.76), meibography dropout, distortion, shortening, and total meibography (8.19 for upper eyelids and 3.81 for lower eyelids) were all significantly higher in the trachoma group (P, 0.001) compared with the normal group were SPK (0.88), meibum score (0.16), and total meibography (1.24 for upper eyelids and 0.92 for lower eyelids). Mean TBUT (4.2 s) was significantly shorter in the trachoma group than in the normal group (10.3 s) (P, 0.001). There was no significant difference between both groups in the Schirmer II test. Conclusions: Meibography of patients with sequelae of trachoma was in agreement with the histopathologic studies. Upper eyelids were much more affected than the lower eyelids. TBUT, SPK, and meibum score were correlated with the status of meibomian glands and meibography, which were significantly different in the trachoma group.