Clinical Ophthalmology (Mar 2021)
Evaluation of Meibomian Gland Dysfunction Among Ophthalmic Healthcare Workers
Abstract
Alison YY Chan,1,2,* Jasmine C Chuang,1,2,* Victoria WY Wong1– 3 1Hong Kong Eye Hospital, Kowloon, Hong Kong; 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; 3HKU Health System, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong*These authors contributed equally to this workCorrespondence: Victoria WY WongHKU Health System, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong KongEmail [email protected]: To evaluate the prevalence of meibomian gland dysfunction (MGD) among ophthalmic healthcare workers.Setting: A tertiary ophthalmic center.Design: Prospective, observational study.Methods: Forty-four volunteer ophthalmologists and ophthalmic nurses were recruited. Information including demographics, contact lens wear, history of refractive surgery and symptom score based on Standardized Patient Evaluation of Eye Dryness (SPEED) II Questionnaire for Dry Eye Disease/Ocular Surface Disease were recorded. Lipid layer thickness (LLT), meibomian glands dropout and dilation grades, and proportion of partial blinking were evaluated using an ocular surface interferometer with dynamic meibomian imaging (LipiView, Johnson & Johnson). Based on the chance of MGD, meibomian gland dropout and dilation, selected subjects also underwent treatment with a thermal pulsation system (LipiFlow, Johnson & Johnson) in one or both eyes.Results: Eighty-eight eyes of 44 volunteers were evaluated during the study period. The mean LLT was 60.0nm. Twenty-seven (61.4%) subjects had a 90% or high chance of MGD and their mean lower lid meibomian gland dropout and dilation grades were 1.2 and 1.7, respectively. Twenty-eight eyes of 16 volunteers received treatment with the thermal pulsation system. Following treatment, the mean LLT improved from 50.3nm to 61.0nm (Wilcoxon’s signed rank test, p=0.001).Conclusion: Despite being more knowledgeable to MGD and more accessible to treatment, MGD is a highly prevalent condition among ophthalmic healthcare workers, with a 61.4% prevalence among the recruited subjects. This is similar to reported prevalence in Asian populations of up to 74.5%. Targeted therapy based on dynamic meibomian imaging is effective in improving both objective and subjective measures of MGD.Keywords: meibomian gland dysfunction, lipid layer thickness, dynamic meibomian imaging, thermal pulsation system
