In vivo volumetric imaging of the human upper eyelid with ultrahigh-resolution optical coherence tomography.

The upper eyelid is a biological tissue with complex structure, essential for the maintenance of an optically clear ocular surface due to its physical (blinking) effect. The Meibomian glands (MGs) are structures that lie beneath the surface of the inner eyelid and are partially responsible for the production of the superficial oily layer of the tear film. The MGs are only superficially visible under magnification when the eyelid is everted. We present for the first time in vivo 3-D images of healthy and inflamed human MGs. Tomograms were acquired from the tarsal plate of everted human eyelids with a 1060-nm ultrahigh-resolution optical coherence tomography (UHOCT) system, with approximately 3 microm x 10 microm (axial x lateral) resolution in biological tissue at the rate of 91,911 A-scans/s. Comparison with histology shows that the UHOCT images reveal a spatial distribution of structures that appear to correspond with the MGs' acini and ducts (in healthy subjects), and accumulation of heterogeneous, highly scattering biological material and clear fluids in the visibly blocked glands. Noninvasive, volumetric high-resolution morphological imaging of the human tarsal area could have a significant impact in the clinical diagnosis of inflammatory and noninflammatory lid pathologies.