Ultrasound biomicroscopy as a tool for conjunctiva and eyelids evaluation

Currently, ultrasound biomicroscopy (UBM) is the only diagnostic method that uses a 50‑100 MHz transducer with a depth of penetration of 4 mm. This provides greater sensitivity and resolution.

Aim. To visualize meibomian glands and to evaluate their morphological and functional status using UBM.

Methods. UBM was performed in 14 patients aged 29‑81 with obvious meibomian gland dysfunction (MGD) and healthy meibomian glands. 6 patients had no biomicroscopic signs of blepharitis while 8 patients had biomicroscopic signs of blepharitis, blepharoconjunctivitis, and MGD.

Results. UBM provides detailed information on meibomian glands and eyelid margins and their pathological conditions, i.e., eyelid margin thickening due to inflammation, meibomian gland orifice obstruction, increase in distance between meibomian glands due to their atrophy, and cartilaginous tissue destruction. UBM findings may depend on patient age as well as on disease stage and severity. When re-positioning UBM transducer, bullous conjunctiva and subconjunctival cysts can be visualized. This provides differential diagnosis between opaque cysts and tumors.

Conclusion. UBM combined with standard exams increases information value, reliability, and accuracy of the diagnostics of anterior segment disorders and facilitates the development of targeted therapeutic approaches. Further studies on diagnostic value of conjunctiva and eyelids UBM are required.

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