Optometry and Vision Sciences Research Group, Aston University, Birmingham AL10 9AB, UK.
Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK.
Medicina (Kaunas). 2024 Sep 29;60(10):1603. doi: 10.3390/medicina60101603.
Infrared light is used to image the Meibomian glands through their thermal profile. This study aimed to investigate the effects of a combination of heating and an eyelid massage on Meibomian gland visibility and tear film parameters. Twenty-four participants (26 ± 6.9 years) were enrolled in this prospective study, which involved imaging the Meibomian glands of both the lower and upper eyelid and assessing the non-invasive breakup time (NIBUT), tear meniscus height (TMH), and blink rate (using the CA-800, Topcon) at baseline after five minutes of eyelid warming followed by a five-minute eyelid massage. The second session, which was randomised in sequence, repeated the same measurements but without the inclusion of any eyelid warming or massage as the control condition. While there was no change in lower lid Meibomian gland appearance as a result of eyelid heating, eyelid massage, or multiple lid eversion (median 2.0, range 0.0 to 4.0; = 0.782), there was a change in upper lid appearance 5 min after heating and lid massage ( = 0.025), but again, multiple lid eversion had no effect ( > 0.05). The NIBUT decreased on second lid eversion ( = 0.049), although this was not evident on the third lid eversion ( = 0.090). The effect on NIBUT was also apparent with heating ( = 0.034 immediately after) but was sustained with 5 min of eyelid massage ( = 0.031). The TMH increased with heating ( < 0.001), and this effect was sustained with 5 min of eyelid massage ( = 0.011), but there was no lid eversion effect ( > 0.05). The blink rate was unaffected by heating, eyelid massage, or multiple eversions of the eyelids (median 24 blinks/min, range 8 to 59 blinks/min; = 0.61). Conclusions: Eyelid warming can increase the visibility of the Meibomian glands, although this effect was only observed with upper lid imaging and the effect dissipated after 5 min of eyelid massage. Warming and massage also disrupt the tear film, as does multiple lid eversion, emphasising the need to use the least invasive tear film assessment techniques first.
红外光通过其热分布来对睑板腺进行成像。本研究旨在探讨加热和眼睑按摩联合应用对睑板腺可视性和泪膜参数的影响。
本前瞻性研究纳入了 24 名参与者（26±6.9 岁），对他们的上下眼睑的睑板腺进行成像，并在基线时评估非侵入性泪膜破裂时间（NIBUT）、泪膜高度（TMH）和眨眼频率（使用 CA-800，Topcon）。五分钟眼睑加热后进行五分钟眼睑按摩，然后记录结果。第二次记录在随机顺序下进行，不进行任何眼睑加热或按摩作为对照条件。
虽然眼睑加热、眼睑按摩或多次眼睑翻转（中位数 2.0，范围 0.0 至 4.0； = 0.782）均不会改变下眼睑睑板腺的外观，但加热和眼睑按摩 5 分钟后会改变上眼睑的外观（ = 0.025），但多次眼睑翻转没有影响（ > 0.05）。第二次眼睑翻转时 NIBUT 下降（ = 0.049），但第三次眼睑翻转时则不明显（ = 0.090）。加热也会影响 NIBUT（加热后立即下降 0.034），但 5 分钟的眼睑按摩也能维持这种影响（下降 0.031）。TMH 随加热而增加（ < 0.001），这种效应在 5 分钟的眼睑按摩中也能维持（增加 0.011），但眼睑翻转没有影响（ > 0.05）。加热、眼睑按摩或多次眼睑翻转均不影响眨眼频率（中位数 24 次/分钟，范围 8 至 59 次/分钟； = 0.61）。结论：眼睑加热可以增加睑板腺的可视性，但这种效果仅在上眼睑成像中观察到，且在 5 分钟的眼睑按摩后消失。加热和按摩以及多次眼睑翻转都会破坏泪膜，因此首先需要使用最不具侵入性的泪膜评估技术。
