Hot/cold compresses

[ryanross]

I was just wondering if hot compresses were beneficial for dry eye, when redness is one of my main symptoms. My eyes get very red after performing the compress (which seems expected), and I just wanted to know if this was bad for any inflammation and redness in the eye, as heat generally promotes inflammation (even though its promotes oil flow). Should a cold compress be used following a hot compress, or does this just cancel the effect? Any advice from experienced people would be greatly appreciated.

[Rebecca Petris]

I was just wondering if hot compresses were beneficial for dry eye, when redness is one of my main symptoms. My eyes get very red after performing the compress (which seems expected), and I just wanted to know if this was bad for any inflammation and redness in the eye, as heat generally promotes inflammation (even though its promotes oil flow). Should a cold compress be used following a hot compress, or does this just cancel the effect? Any advice from experienced people would be greatly appreciated.

Depends what you mean by "dry eye" - that's a catchall term applied to almost anything. The only benefit of warm (not hot) compresses is for certain types of blepharitis/MGD where the meibomian glands need to be heated to a certain temperature regularly to liquefy oil that regularly clogs the glands. It is usually accompanied with cleansing and massage to express the glands. It may come at the tradeoff of more inflammation.

So the relationship between compresses and redness... yes, warm compresses may temporarily increase redness (which is why it's best to do them at night). The one situation where they would improve redness is only if the redness is resulting from dryness etc related to MGD/bleph. If you do not have those conditions don't bother with heat. Redness may benefit from cold compresses though.

I don't think that cold compresses 'cancel out' warm compresses, but I'd get with your doctor to get some more specifics about what's going on with your MGs and whether they are actually likely to benefit from heat. If not, it's not worth the hassle and cost.

[ryanross]

I didnt mean that redness was my main symptom, rather nighttime dryness and inability to wear contact lenses (for more than an hour or two comfortably) is probably my main concern. My problem is that every optomotrist/opthamalagist that I go to tells me I have something different. One tells me I have blepharitis and I should do compresses, another tells me that my eyes "aren't the reddest or the driest he's seen all week" (which pissed me off frankly, as he pretty much dismissed my problems) and the one I am seeing currently (Dr. Seth Meskin of eye physicians and surgeons) doesn't know what the cause is and is taking more of a medicinal approach (restasis, plugs) rather than suggesting things such as omega 3's or compresses or anything of that nature.

[Rebecca Petris]

Yeah that's frustrating.

Usually, each of them has at least one piece of the puzzle and it turns out to be up to us to put it all together in some rational manner. For example the three you mention don't sound contradictory to me. One's noticing your meibomian glands, which is good; the second said something stupid but who knows, might have actually put something intelligent or meaningful in his notes that he didn't say; and the third is addressing actual dryness (whether the dryness is the chicken or the egg - but it still probably needs addressing). You might want to take a look at my article about getting better eye care or even about finding another doctor.

[indrep]

Rebecca, I just read your "Getting better eye care" and couldn't agree more. It is interesting, as I speak with practices it dawned on me a couple months ago, that eye care providers do not deal with pathologies that cause pain. Retina pathologies, glaucoma, cataracts, ptosis of the lids, etc cause no pain at onset or as they progress. The only time an eye care provider deals with pain is post surgical(it will feel better when it heals), trauma (dido) and ocular surface disease (dry eye). I have started asking practices to survey patients that leave their practice. The first few that have done it have called back to say they are more committed than ever to learn what the dry eye sufferer is experiencing and offer solutions to help manage the issues.

[ryanross]

Are there any negative side effects to hot/cold compresses?

[ericdinn]

Cold Compresses

Cold compresses have worked wonders for my MGD. I used to use hot compresses--and I mean hot--that burned the skin around my eye. You should try cold compresses. The idea is to minimize and alleviate inflammation of the glands.

[Eyewarmers]

Cold compresses have worked wonders for my MGD. I used to use hot compresses--and I mean hot--that burned the skin around my eye. You should try cold compresses. The idea is to minimize and alleviate inflammation of the glands.

You should never do HOT compresses... Most studies suggest that a lid temperature increase of roughly 7-9 degrees F is the correct temperature. Doing this 10-20 minutes twice a day with LIGHT vertical message has been proven as an effective treatment for Meibomian Gland Dysfunction.