Progress in the methods of image analysis of Meibomian glands

Meibography techniques allow one to visualize the silhouette of the morphological structure of the Meibomian gland through illumination of the everted eyelids. The development of non-contact infrared meibography techniques enables meibography to be used routinely during ophthalmological examination. Recently, significant research has been carried out in the field of Meibomian gland image analysis. The subjective and objective methods of the analysis provided a set of descriptive morphological features of the glands. The studies focused on finding a method of Meibomian gland analysis that is objective, quantitative, and less variable and time-consuming for specialists. Moreover, the studies have shown that the evaluation of both the morphology and function of the Meibomian glands provides important clinical information pertaining to Meibomian gland dysfunction (MGD). Meibography alone is not sufficient for the proper diagnosis of MGD but provides a lot of important information that is essential to both improve the treatment protocol and facilitate the diagnosis. This manuscript presents a review of the proposed subjective and objective methods of Meibomian glands image analysis. Moreover, the clinical application of those methods and their relationship with other examinations and symptoms of dry eye disease will be presented. The potential research areas to explore will be identified.