Warm Compresses

Important new book about Dry Eye and Meibomian gland dysfunction.

Warm compresses loosen the scales and debris that can be found around the eye lashes, and also help to liquefy meibum, so it can flow out of the meibomian glands and onto the surface of the eye. Warm compresses also stimulates the production of meibum.

Compresses are applied to treat chalazion, an enlarged lump in the eye lid, caused by one or more engorged meibomian glands.

Warm compresses should only be performed if the meibomian glands are not obstructed by fibrous tissue, or other material, that can block the flow of liquefied meibum. Recent evidence suggests that warm compresses applied to eye lids with obstructed meibomian glands can exacerbate the condition.

Compresses should be applied as directed by your physician — not too long and not too hot. Overuse of compresses, too hot or too long, can cause irritation. Compresses that are too hot can cause scalding or burning.

If you suffer from chronic blepharitis, evaporative dry eye, meibomian gland dysfunction (MGD), or other disease associated with meibomian glands, it is likely that you will need to perform warm compresses on a regular basis. Do not fret that this needs to be done daily. Warm compresses are not invasive or painful. Turn on some music, say a prayer, or simply take a deep breath, close your eyes, and steady your mind while you are applying the compress. In time, you may even look forward to these few moments of solitude as you take care of each precious, tiny meibomian glands.

There are many ways to perform effective warm compresses that require very little special equipment.

Wash Cloth

The most common recommendation is using a damp wash cloth that is run under hot water or heated in the microwave for a short time, so that it is warm, not hot. The wash cloth is placed over the eyes for a prescribed amount of time, one or several times a day.

Although it is a simple and inexpensive method, the water in the wash cloth contains microorganisms, including bacteria, that can cause infection. It can be difficult to control the temperature and amount of water in the wash cloth, and wash cloths cool quickly, requiring constant messy rewetting. In a pinch, however, or if only a very small area of the eye lid requires heating (if there is a single blocked meibomian gland, for example), the rolled up corner of a damp wash cloth heated in the microwave, or placed under hot running water, is easy and effective.

To reduce the risk of infection, use a clean wash cloth every time you apply warm compresses. Never apply the part that touched one eye to the other eye to avoid spreading microorganisms from one eye to the other.

Rice Baggy

Rice baggies are available online, or you can make your own using a lint free sock and some uncooked rice. The baggy is placed in the microwave until it is warm, not hot. Rice baggies are used dry, and can be kept clean, although the rice does tend to cook in the microwave. Cooked rice becomes flaky with debris that can make its way to your face and eyes. We recommend rice baggies with at least two cloth layers. The outer layer will touch your eyes. It should be lint–free, and easy to disinfect, wash, and dry. The inner layer contains the rice. If you make your own, in addition to using lint free material, be sure that the inner bag is not porous.

Thermalon Dry Eye Compress

Thermalon Dry Eye Compresses are readily available in the United States at most major drug stores and Wal-Mart.

The compress is heated in the microwave for about 20-30 seconds and applied to the eyes, where it stays warm for up to three minutes. The temperature is relatively easy to control (although sometimes the temperature can vary, even when the device is placed in the same microwave for the same amount of time) and the microwaveable beads provide just enough moist heat.

If you use a Thermalon Dry Eye compress, first place it in a lint-free cloth, like the bags that eye glasses come in, before placing it in the microwave. Follow directions for heating provided by the manufacturer. Once the compress is heated, one side may be warmer than the other. If that happens, fold the two sides against each other and hold them closed for about 20 seconds. This distributes heat more evenly. Unfold and allow the compress to cool for about 10- 15 seconds, if necessary, to avoid scalding. Then apply the compress, still in the lint-free cloth, to your eyes.

After applying the compress wash the lint-free cloth in warm soapy water, rinse thoroughly, and dry thoroughly before using again. Alternatively, you can disinfect the lint-free cloth with 91% rubbing alcohol. If you use rubbing alcohol, be sure to wash it out and allow the cloth to dry before using again. Using a thoroughly cleaned lint-free cloth each time you apply a warm compress will help prevent spreading any infection to your eyes.

You may wish to use two lint-free cloths — one that is always dry and ready to use, and one that is drying.

Blephasteam®

Warm compresses that touch the eyes transfer heat more easily than a system that relies only on steam. However, if your eyes are particularly sensitive, you may prefer steam, although too much steam can also cause irritation.

Blephasteam delivers controlled heat and moist air around the eyelids, melting the obstructing meibum, thereby helping its evacuation.

Blephasteam is currently not available in the U.S.

Tranquileyes Chronic Dry Eye Basic with Beads Kit

Tranquileyes goggles with warm water and the reusable Thermoeyes beads create 12-15 minute moist heat therapies. The heat created by the bead gel packs loosens oils in the meibomian glands. The warm water, combined with the gel packs and insulation of the thermal plastic goggle, isolates and prolongs the therapy. At the same time, it hydrates sensitive eyelid skin. The beads can also be frozen to help reduce eyelid puffiness. However, placing cold compresses on eye lids can cause meibum to harden. The goggles can also be slept in. They block light, and protect eyes from forced air heat, air conditioning, or other drafts.

Other Warm Compresses for Dry Eye

A simple online search for “Dry Eye Compresses” will result in additional resources for self-activated, microwaveable, or other eye compresses.

In-office Compresses with or without Massage

Devices that heat and massage the eyelids have been developed in the last few years. Treatment with the devicdes may be expensive and may not covered by insurance.

Anecdotal evidence suggests that the treatments are usually more effective in mild cases. In these cases, treatment is less necessary, leading to mixed reviews.

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