It’s possible to evaluate meibomian gland (MG) dropout without using an infrared light system, Korean researchers recently found. The team successfully visualized MGs using a red filter on a slit lamp—and it showed substantial agreement with visualization using the standard infrared method. Although inter-observer reliability was only moderate, this alternative technique may be useful for evaluating MG dropout when an infrared meibography device isn’t available, they conclude.

The researchers evaluated MG dropout in the everted upper and lower eyelids of 125 eyes of 64 patients using infrared meibography images and color digital photographs with and without a red filter. Red-filtered images were converted to black and white and adjusted for contrast and brightness. Red-channel images were isolated from color digital photos obtained without a red filter. Two independent evaluators analyzed the meiboscore after randomization and again after a 30-day interval.

The team obtained meiboscores using red-filtered, adjusted red-filtered and red-channel images that had strong, positive correlations with those obtained using infrared images, and they noted substantial agreement between the red-filtered and infrared meibography images. The researchers add that red-filtered images had substantial intra-observer reliability and moderate inter-observer reliability, but computational adjustment of red-filtered images did not enhance their validity or reliability, and red-channel images had limitations in some cases.