Table 5.
Technique | Study Details | Lid Region | Grading Scheme | Reference |
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Meibum Characteristics | ||||
Firm digital pressure | Volume of expressed meibum | Central eight glands of lower eyelid | 0 = Normal volume. Just covers orifice 1 = increased to 2 to 3 times normal 2 = increased more than 3 times 3 = increased more than 10 times |
Mathers et al.96,97 |
Firm digital pressure | Viscosity of expressed meibum | Central eight glands of lower eyelid | 1 = normal, clear, may have a few particles 2 = opaque with normal viscosity 3 = opaque with increased viscosity 4 = severe thickening (toothpaste) |
Mathers et al.96,97 |
Firm digital pressure | Volume and viscosity of expresssed meibum Clinic-based; referred for dry eye or blepharitis n = 513 total; n = 76 normal women (used to define aqueous deficiency) |
Central eight glands of lower eyelid | Obstructive: Viscosity ≥ 3 (1, clear; 2, slightly opaque; 3, thick, opaque; 4, toothpaste Avg. lipid volume: ≤0.3 mm (diameter of expressed lipid in millimeters) Dropout: >0 (presumably examined central eight glands; includes 1/2 and whole glands) Seborrheic: Viscosity: no criteria Avg. lipid volume: >0.7 mm |
Mathers et al.96,97 Mathers and Billborough108 |
Meibum Quality and Expressibility | ||||
Firm digital pressure | Quality of meibum | Number of glands not stated | 0 = clear fluid 1 = cloudy fluid |
Bron et al.75 |
UL or LL | 2 = cloudy particulate fluid 3 = inspissated, like toothpaste |
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Firm digital pressure | Expressility of meibum from five glands | UL or LL | 0 = all glands expressible 1 = 3–4 glands expressible 2 = 1–2 glands expressible 3 = no glands expressible |
Pflugfelder et al.55 |
Standardized application of pressure | Expression applied to a set of about eight glands | Nasal, central and temporal lid | The MGYLS score is the number of Meibomian Glands out of 8, Yielding Liquid Secretion | Korb and Blackie52 Blackie and Korb81 |
Meibum Expressibility | ||||
Variable digital pressure | Gentle or forceful expression | LL | Analysis of expressed secretion | Henriquez and Korb98 |
Variable digital pressure | Expressibility of meibum | LL | 0 = clear meibum, easily expressed | Shimazaki et al.86,87 |
1 = cloudy meibum, easily expressed | ||||
2 = cloudy meibum expressed with moderate pressure | ||||
3 = meibum not expressible, even with hard pressure | ||||
Variable digital pressure using the Shimazaki schema | Measurement of lid morphology, expression and meibography | See grading box | Lid margin: Irregular Vascular engorgement Plugged orifices Displacement of MCJ, score “1” for each present |
Arita et al.109 |
Clinic based n = 53 obstructive MGD subjects n = 60 age-matched controls |
Expressed meibum (upper eyelid): 0 = clear, easily expressed 1 = cloudy, mild pressure 2 = cloudy, > moderate pressure 3 = meibum not expressed, with hard pressure |
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Meibography: upper and lower eyelids, meiboscore summed (0, no loss; 1, gland loss < 33% of total area; 2, loss = 33–67%; 3, ≥67% loss) |