On non-contact infrared meibography, which description best matches the appearance of meibomian glands in affected eyelids?

• A. Normal gland architecture with no dropout
• B. Dropout and shortening of the meibomian glands along the interior aspect of the eyelid
• C. Increased meibomian gland density along the eyelid
• D. Gland dropout only occurs on the exterior eyelid

Answer: (B)

Non-contact infrared meibography shows the meibomian glands as linear structures along the lid margin. In affected eyelids, the hallmark finding is loss of gland tissue — dropout — often with shortened, discontinuous segments along the interior aspect of the eyelid where the glands reside. This pattern reflects gland atrophy due to chronic obstruction and inflammation typical of meibomian gland dysfunction. A normal appearance would show intact, continuous glands; increased density is not expected, and dropout is not restricted to the exterior part of the eyelid.