This study aimed to establish a modified calculation formula for the grading of meibomian glands. Meibography images from 102 participants by different examiners on separate machines on two consecutive days were analyzed, quantified and compared side-by-side. Measure and calculate the ratio of the MGs area to the whole eyelid area and the ratio of the MGs to the corneal base area. Our findings demonstrate that there were significant differences in the ratio of the meibomian gland area to the whole eyelid area between two measurements, but not in the ratio of the meibomian gland area to the corneal base area. The measurement of the eyelid area showed bigger variations and poorer repeatability than the meibomian gland area and the corneal base area. As such, the ratio of the meibomian gland area to the corneal base area is a more stable indicator for the grading of meibomian glands over multiple measurement.
Keywords: Corneal base area; Grading; Meibomian gland; Quantification; White-to-white distance.
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