Safety Issues: Warm Compresses, Gland Expression

[Cali]

I can’t seem to find the posts but what’s the latest on the safety concerns for:

-Warm/hot compresses. I think I read that latest studies indicate they may change the shape of the cornea?

-Meibomian Gland Expression. I think I remember reading that some doctors didn’t think they were a good idea because they’ve seen glands destroyed by gland expression (different topic than probing).

Can anyone chime in? I have to start saving the posts that interest me because I have trouble remembering later which post to look for to refer back to what I had read. Thx.

[browneyesblu]

Hi Cali,

I posted a link about warm compresses awhile ago, here it is:
http://www.ncbi.nlm.nih.gov/pubmed/23665651

As far as expression, the only thing I've seen mentioned online is that doing it yourself is bad, not because it damages the glands but because when you apply pressure to the cornea, as in massage or with a Q-tip as some drs. recommend, especially after heat, the chance of deforming it increases. That will make more sense after you read the abstract. As far as I know a good doctor can do it safely.

[Peppermint]

Wow! So what are we supposed to do if we cannot do warm compresses or expressions? Since the abstract said corneal temperatures reach their peak at 8 minutes of doing a warm compress, would it be safer to do a warm compress if it's kept under 8 minutes?

[peter56]

Hi,
in practice or at home, it is almost impossible to achieve such high temperatures at the cornea >39°!
IN this study they changed 45° WC every 2 minutes and that for 30 minutes.
So after 4 WC the corneas reached not even 39°.
On the other hand that does mean WC are only able, melting down only soft meibum secret and obstructions.
Only facial saunas do achieve higher temperatures of the inner eyelids and thus also of the cornea.

In order to achieve a long term success after probing and Lipiflow, warming-up the glands and expression is essential and necessary!
But who can afford Lipiflow every month or 2 months?
For all other patients the facial sauna and manual expression is the only way to prevent the re-closure of the glands.

The problems are the eyelid massages 2 or even 4 times a day. That will cause irritations of the eyelid skin especially that of rosacea patients.
Intensive pressure will only de-shape very warm corneas >40°, but that is very rarely.
So the average WC cannot melt down sticky meibum-secret and the massages cannot clean the glands well.

[Dog2012]

I agree with Peter 56 just regarding temperature ..and my doctor told me about the same ....However problem is what happening with glands in the time after no oil in the glands ...once you expressed and they are empty.....I remember was reading one post ..where doctor shared the same concern....by the way my doctor also not sure about a constant expression in case of M.G atrophy ..but he is ok in case of blocking.

[LaDiva]

Glad you posted Peter. I've got to do compresses and expression three times daily to keep the oil going. I no longer massage the lids, as this really tore up my eyelids. A Q-tip works much better. As I've said, if someone has a better idea, I am listening, but I'd be blind without this daily routine.

[Peppermint]

Thank you for the clarification Peter, & Dog & LaDiva for your input.

[Katewest]

I think the expression is helping a bit and I dont do heat bc of rosacea flare ups. When I saw Dr. L he advised against expression because "I was focusing on my eyes too much" but I kinda think it might be bc of all this new research? I asked him to show me how to properly do the expression bc in his book he says a lot of ppl do it wrong but he would not :/

[Almondiyz]

Hi Cali,

I posted a link about warm compresses awhile ago, here it is:
http://www.ncbi.nlm.nih.gov/pubmed/23665651

As far as expression, the only thing I've seen mentioned online is that doing it yourself is bad, not because it damages the glands but because when you apply pressure to the cornea, as in massage or with a Q-tip as some drs. recommend, especially after heat, the chance of deforming it increases. That will make more sense after you read the abstract. As far as I know a good doctor can do it safely.

WHY WHY WHY do opthalmolgist's NOT teach us about these dangers? Why do we have to come to a forum, as laymen, have to figure all this out from our own research? Then we have to read published medical journals. Are doctor's unaware...what is going on in medicine?

[karensumner]

i apply medium heat for about 8 to 10 minutes -if its too hot on your hand its too hot for your eyes..
then i use a qtip and just press up or down against the lid margins kind of like putting on eyeliner.. when i do this it doesnt press on my cornea at all..?
i think is the least invasive way to do it.

[buntbean]

Found these rounded tip stamp tongs. I wonder if they'd be good for expressions. Anyone have anything like this? You wouldn't be touching your eyes. Would this be better?
http://www.ebay.com/itm/Showgard-Sta...item4d0093bfa5

[buntbean]

OK, I bought and tried the stamp tongs (someone had to). I suppose they work alright but I think I accomplish more from pinching my lower lash line and flipping my upper lash line upwards and pushing.