EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1160558
SEPTEMBER 2019 | SUPPLEMENT TO EYEWORLD | 7 examination. "If you per- formed meibography on abso- lutely everyone who walks in, that would slow down the of- fice significantly, so you have to develop a scheme," Dr. Mc- Donald said. "For the average patient, if they have virtually no symptoms, but they have abnormal tear osmolarity and MMP-9 scores, I know I am going to need the meibogra- phy image to convince them to follow my treatment plan. The technicians know that they should proceed with mei- bography—before I even see the patient—if the first two tests are positive." "For anyone who is coming in for a refractive sur- gical evaluation or a cataract surgery evaluation, meibog- raphy is an essential tool," said Elizabeth Yeu, MD. Her technicians also are empow- ered to ask a few questions on any routine examination, about issues including vision fluctuation and classic dry eye symptoms (redness, irritation, foreign body sensation), which trigger a dry eye evaluation including meibography. "For anyone who is coming in for a refractive surgical evaluation or a cataract surgery evaluation, meibography is an essential tool." —Elizabeth Yeu, MD Key resource Meibography helps clinicians stage MGD and educate patients about it, but it is es- sential to provide an accurate picture of the patient's condi- tion, Dr. Gupta said. "The role of diagnostic testing is to allow us to treat diseases more effectively, to diagnose a disease, and to educate patients," said Eric Donnenfeld, MD. "Meibog- raphy gives us all of these parameters and has become a key resource. When we are looking at meibomian glands, for the most part, we are look- ing at the tip of the iceberg. When we have meibography, we have much more informa- tion on structure that trans- lates to function." n Reference 1. Arita R. Validity of noninvasive meibography systems: noncontact meibography equipped with a slit-lamp and a mobile pen-shaped meibograph. Cornea. 2013;32(suppl 1):S65–70. Figure 2. Meibography Summit responses to the question: Should meibography be performed at the point of care for cataract patients preoperatively? Yes, all cataract patients Yes, any patient suspected of having OSD Yes, any patient suspected of having MGD No, only on a case-by-case situation at this time 38% 44% 19% 0% Should meibography be performed at the point of care for cataract patients preoperatively?