Are warm compresses actually even safe?

[Vivid Panda]

Other than our doctors suggesting it, has anybody seen any actual evidence in terms of medical studies/clinical studies?

My doctor told me to stop doing warm compresses but it actually dries the eye out more and creates more inflammation. Due to this advice, i stopped and started a new regiment that has actually seen a lot of positive results.

I get why warm compresses logically. The oil 'gets cold' and so we use the heat to loosen it up again but when you think about it. You can just do a gentle massage on your lower lids and that should break up the stiffness of the oil. Right? That's what ive been doing and have been seeing good results.

[MGD1701]

Glad to know you have found something helpful. Did the doctor recommend such new regimen?
Good results = you can feel oil running or...? Maybe your oil is not so thick so you dont need the heat.
If so, would it be even safer if you just do blinking exercise??

I do feel great after making warm compress/wc.
WC could be risky if too hot/wet/long etc. then possibly lead to inflammation. - not easy to master.

[DryEyeNJ]

Warm compresses do temporarily irritate my eyes, but I can definitely feel the glands secreting oils. You can always increase your omega 3 and flaxseed intake since they affect the quality of oils produced while reducing inflammation.

[Vivid Panda]

Glad to know you have found something helpful. Did the doctor recommend such new regimen?
Good results = you can feel oil running or...? Maybe your oil is not so thick so you dont need the heat.
If so, would it be even safer if you just do blinking exercise??

I do feel great after making warm compress/wc (Blephasteam).
WC could be risky if too hot/wet/long etc. then possibly lead to inflammation. - not easy to master.

Yes she did, mostly a mix of manual mgd expressions and a mineral heavy tee tree oil solution she created herself.

I have never gone into any blinking exercises actually. Would you be able to refer me to a link of good ones or a regiment you use?

I mean any amount of heat on already inflamed eyelids is only going to increase inflammation. When something is inflamed we usually put ice on it rather than heat right? I haven't looked into blephasteam but I was hoping somebody had some clinical based facts. It's one thing to feel better and another to be better. I use to do warm compresses 2x a day and now i do it once a week and i feel much better.

[MGD1701]

Hi DryEyeNJ
Thanks for the tips.
All 3 doctors who checked my glands did not give me Restasis/Cyclosporine.
It seems the trend that many American doctors consider early intervention to give such drugs is effective/important to prevent MGD progression. Have you taken any of these, if so, useful?

warm compress temporarily irritate eyes? - Good to find out why as it should not be so, I guess.
---------------------------
Hi vivid Panda
You are lucky to find a doctor who performs manual expression. I think it is very effective but have no luck to find such doctor.
Did your doctor give you Restasis/Cyclosporine/Xiidra, if so, why?

[MGD1701]

What I find strange is doctors suggest 4-15 min. warm compress. WHY such big difference??
Some even say the more/longer oil secretion feeling is better, but it is vague.
I asked my doctor, he just said, it depends, be careful and NOT more than 10 min.
But the facts and based on my research, for thick oil we need longer time and higher heat,

So I come to the conclusion that the key issue is oil secretion feeling but NO idea how long is good and its risks?
Any thoughts regarding these?

[DryEyeNJ]

Hi DryEyeNJ
Thanks for the tips. I dont have Omeg 3 issue (acutally double than normal) but my oil is still half thick.
All 3 doctors who checked my glands did not give me Restasis/Cyclosporine.
It seems the trend that many American doctors consider early intervention to give such drugs is effective/important to prevent MGD progression.
Have you taken any of these, if so, useful?

warm compress temporarily irritate eyes? - Good to find out why as it should not be so, I guess.
---------------------------
Hi vivid Panda
You are lucky to find a doctor who performs manual expression. I think it is very effective but have no luck to find such doctor.
Did your doctor give you Restasis/Cyclosporine/Xiidra, if so, why?

Blephasteam - there are some researches to support its effectivness, if you google.
I have tried several kinds/brands and find it works the best for me.

Blinking Exercise: I find Dr. Laura Periman (MD in Seattle) explains the best - in a clear/interesting fashion. Hope it helps.
https://www.youtube.com/watch?v=MzeU09n8tjQ

I have used Restasis (cyclosporine) as well as Xiidra. Both work on reducing inflammation which helps stimulate aqueous tear production. I have MGD and get about an hour of relief from Xiidra, but it's very costly at $500 a month ($120 with insurance). Most American doctor's treat dry eye in 3 visits.

Visit 1) Recommend hot compresses and supplements
Visit 2) Try a mild steroid (Lotemax/Alrex) and use punctal plugs
Visit 3) Prescribe Restasis or Xiidra

In reality, these cookie cutter plans do not work for most people, unless you're symptoms are mild to moderate. For severe dry eyes, they would send you to a corneal specialist for serum drops or someone who could fit you with scleral lenses. I have not tried the latter two mostly because I don't want to get burned with more bills.

[Frustrated34]

I have been told that my glands are inflamed but not secreting very much oil at all! I have done hot compress for 9 months starting at 3-4 times a day and now down to 2! What I don’t understand is a few times a month or so I will have tons of oil come out and I experience the blur after the compress but other times nothing comes out ! Has anyone experienced this and if u stop compresses did the inflammation improve or get worse? I just don’t want to make my eyes worse!!

Thanks for the help !

[MGD1701]

Hi Frustrated

If you feel great after compress & oil is flowing, then it is right.
If not, you need to find out why (maybe too hot, too long??) and better stop.

If inflammed,
1) most drs do not recommend warm compress but cold or the combination.
The most recent study, by Dr Caroline Blackie, MGD expert (and her team) shows the temperature should be 45C
for an effective result. But if your oil is not so thick, about 42C with longer time, should do the work too and is safer.

2) good to get it under control as soon as possible, good diet, omega 3, effective lid cleanser
(I prefe to add tea tree oil product to kill demodex)

Good luck!

[Hokucat]

This article on warm compress plus massage can cause corneal warping has been posted in this forum before, but wanted to post it again for the newer members:

https://www.reviewofoptometry.com/ar...rong-way-43097

[Frustrated34]

Thanks for the replies! I don’t have any oil flowing most times! Only sometimes if I take a break usually for a couple days! My left eyelid is constantly inflamed and I have perm red veins that really get more red as the day goes on !

I have been told that my oil glands are inflamed and not much is coming out and they aren’t plugged or atrophied ! My worry is that if I don’t get this inflammation under control that it will cause more problems!!

i am on restasis, use lid cleaner and take omegas ! I am also pretty healthy and run regularly ! I don’t understand why this is happening! I never had a problem until I had a baby! It’s seriously ruining my life ! I have high myopia and just want to wear contacts again !

i am now going to try cold compresses as I wonder if I am doing them too hot? I’m not sure!

I appreciate the feedback!!

[MGD1701]

Hi,
contact lens are likely make your inflammed eyes worsen.

[Frustrated34]

I haven’t worn them in 11 months !

[MGD1701]

Hi Frustrated

Found my old post, maybe it fit here better. Hope it helps.

Doctors recommend from 5-20 min.
All doctors just told me 10 min. but after experiments/studies (took 3 months),
what work for me are:

13-15 min, 43-*45C
in the morning moist heat (to remove debris etc) &
before bed dry heat (only because it is easier)

The tricks: constant heat, 45C and enough time.
If you feel oil is flowing and feel great afterwards then it is correct.

*45C
The study by Dr Caroline Blackie (partner of Dr D. Korb, inventor of LipiFlow) suggests that
warm compresses are more effective when the temperature reaches 45°C (113°F) and are frequently reheated,
so called, Bundle method
https://www.youtube.com/watch?v=fpwA76xepa4

I found this one is also useful, also mention 1) 45C, 2) reheat
https://www.youtube.com/watch?v=SyzGc4HqI68&t=295s
When to do warm compress (& different brands) by Dr Dave Kading

---------------
Dr Korb finds Blephasateam good too - more my posting July 22 2018 including his 2016 vidoes I have found

http://forum.dryeyezone.com/forum/dr...ueeze-lids-etc

[MGD1701]

Hi Frustrated

Just curious,
Did your dr did MMP-9 test to check the level of inflammation? if so, which level? & the source? bacteria or demodex?

If no much oil come out, maybe you have scar tissue or too clogged or secretion is too thick? good to find out.
to get oil running is super important for comfort and get inflammation under control.