To warm compress or to not...that is the question.

[ema]

So, I was just reading some old threads some patients wrote to Dr. Latknay about using warm compresses. I have ocular rosacea and I do warm compresses 2x a day. Dr. Latknay said that warm compresses may be needed to open up the blocked glands, but that they should be used for a few minutes. Otherwise the warm heat can contribute to inflammation which in turn causes the meibomium glands to not function properly. So, are most people finding that warm compresses actually help or should cold compresses maybe be used to help reduce inflammation?

This may sound odd...where I currently live hasn't seen snow since 1976 and this past January it snowed 1 whole inch! So, my husband and I took advantage and spent hours gathering snow to build snowmen, this was on a Friday night. So, I was out in the cold for several hours. The next day my eyes felt better, then on Sunday it was almost as if I had normal eyes again! I am wondering if the cold temperatures really helped reduce my eye inflammation?

Any thoughts on cold helping to reduce eye inflammation?

[Guest]

I would try continuing with the warm compresses... but after expressing the glands, do a cold compress to counteract any inflamation caused by the heat... That way you get the benefits of both?

[ema]

going to give it a try...

Thanks, I will give that a try and see if that helps any.

[Pinky]

Very good question, and one that is often debated in the rosacea community.

I have found ways to use heat to open the glands without putting the heat directly on the lids, lowering the inflammatory response in the eye area.

One of the techniques I use is to fill a shot glass with water and microwave it. Then I lean my eyes near the glass so the steam opens the glands. My eyes/lids do not become red when I do this. Also, when I have a steamy hot bath, same effect.

Many occular rosacea specialists advise against warm compresses, so sometimes we just have to get a little more creative!

[sazy123]

I find they aggravate rosacea on eyelids, cause inflammtion which makes the problem worse.. personally.

If you donthave rosacea and have blocked glands causing the prob, they prob help long term. But if you only get temp relief i wouldnt bother with them as they could make it worse imo.

[ema]

Yep, I do have rosacea and I think the warm compresses have been doing more aggrivation than good. Yesterday I tried a cool compress and it felt better. Today I don't have as much burning as usual...so, maybe the heat was a bad idea.

[msienkiewicz]

Ema,

Heat definitely bothered me too. I have occular rosacea as well. My eyes love cold. Air conditioned, refrigerator, you name it. I have even stuck my head in a freezer for relief. The heat truly aggravated my eyes, increased itching and inflammation, etc.

At the moment, I try not to put anything directly on my eyes, hot or cold. I don't want to confuse the poor glands.

Melissa

[sighthound]

So I am not the only nutcase who sticks my head in the freezer?

[ringo]

I agree with all of you regarding hot compresses-- in my view they intensify inflammation even if providing temporary relief by liquefying the oil in the lid glands.

Inflammation though is the cause of these glands not functioning properly and producing such viscous clogging oil.

According to my experience and my doctor's views, and other doctors and patients, heat aggravates the inflammation, further compromises the glands and increases the viscosity of the oil. That in turn makes the patient very dependent on daily heat applications.

The treatment is quite old and was applied before the disease was understood more in depth, as it is now.Especially with rosacea sufferers, according to medical research and patients' feedback, heat is a known aggravating factor.

The topic of warm compresses is very controversial.There are many people here who also say they benefit from this treatment, at least symptomatically.
I think everyone should work out with their doctors what works best for them...

I was criticized severely by some people on the forum for expressing a sceptical attitude towards warm compresses, so I have to say-- please consult your trusted doctor about applying or not applying any treatment--- including the hot compresses. If a treatment for dry eye has a downside (most of them do), it has to be weighed against the relief and benefit the patient is experiencing together with his doctor.

My view on hot compresses is strictly my own view, and it might be inapplicable to many others' cases.

thank you for sharing your experiences,
Regards,
Dani

[ema]

How frustrating to realize that I could have been doing more harm than good for 10 months now. So, does anyone know what happened first for ocular rosacea patients...the inflammation or the blocked glands? It seems like which ever one started first that it caused the other to happen.

My eyes are no longer burning insanely every day, just some days now. So, I am thinking the inflammation may be getting better, but they are still pretty dry and definately do not look any better. I guess this all just takes a lot of time to work itself out...such a loooooong process.

I too have stuck my head in the freezer at work...of course when nobody is looking.

[ema]

Oh one more question...does anyone have a good way to loosen up the oil without applying direct heat...maybe leaning over hot steamy water?

[ringo]

if you have rosacea, I suggest (that is my opinion strictly), not to expose your face or eyes to any sort of heat; you might have become dependent on liquefying the oil in your glands this way;

but I would suggest that you consult a doctor instead, and ask him for different options that target the inflammation instead: doxycycline (takes time to work), topical antiinflammatory preparations, etc. I would advise ( my own view), not messing with your glands, or traumatizing them in any way (massaging, expressing, heating, or even freezing them;
may be going for IPL or probing by a doctor might be an option (it helps rosacea overall), but only after strict doctor's recommendation.

I hope that helps, please do not worry, it just takes TIME.

Regards,
Dani

[ema]

Thanks Dani,

I think I am going to lay off the warm compresses for now...I don't want my eyes to become dependent on heat. I am seeing Dr. Toyos in April and I am hoping he can give me a "routine" that helps more than what I have been told to do in the past.

I really appreciate your words of encouragement, it is people like you that are helping me get through this incredibly difficult journey both physically and emotionally.

I was glad to have read that you are seeing and feeling improvement.

[ringo]

Thank you so much for your reply and I guess Dr. Toyos is a good idea.

I wish you continuous improvemen, a lot of ood luck and good eye days!

regards,
Dani

[cityhunter62]

Same as you all, occular rosacea in my case, and warm compress does trigger the inflammation of my lids. However, I still does the warm compress routine, but only when I feel that my eyelids are "stuffed" and feel "heavy". So I do the warm compress hygiene three times a week, like every two or three days, just to remove all the "solid oil" which is blocked in my lids. In any case, I do it just before going to bed, because if I do it during the day or in the morning, then, systematically, one of two hours after, my eyes feel terrible and it's going worse til I go to bed.
So okay for warm compresses, but not too often and only when you feel that you need to do it in order to feel better. That's my opinion.