Heat and Inflammed eyelids...

[Rory]

It seems to be common practice here and in the dry eye world.... that MGD is treated with warm compresses, rice baggies etc. I have very inflamed eyelids periodically.

I have recently been advised by my optomerist not to use heat to help unblock my meibomiam glands as heat will exacerbate my inflammation.....and he said if I was to use any compress that it should be cold.... He didnt however recommend using any compress.

Instead he recommended merely using a supranette (sterile eyelid wipe).... wrapped around the index finger and rub the eyelids fairly hard from nose to ear back and forwards about 15 times per lid. This he said is the most effective way of unblocking the glands.

Has anyone else ever done this.... if so what were their results?

Also have people really ever noticed great results from the warm compress, cotton bud method? It seems to make sense that heat would soften any blockages.... but is it reality? And does it not exacerbate inflammation?

[NYer]

I was concerned about the same thing because I have rosacea and inflammation doesn't respond well to heat.
I posted a question to Dr. Latkany about this. He said to do hot compresses once a day for no more than 4 minutes. The thing is that the heat (by the way, you don't have to make the compress THAT hot) is what softens up and supposedly opens the glands. It's sort of like when you have a pimple. If you hold a hot washcloth on it for a while, the pimple becomes soft and it opens and then you get get all the junk out of it without squeezing too hard. This is the same thing. A cold compress wouldn't accomplish anything as far as opening the glands, but it is soothing to the inflamation. So when you're trying to open the glands, use the warm compress. Any other time, for soothing purposes, use cold.
And by the way, you said "rub the eyelids fairly hard". Take it easy on your eyelids...that's really thin skin. You want to press with some pressure but you don't want to rub hard (as if you're trying to remove a stain). That would really irritate your lids.

[Rebecca Petris]

There are no hard and fast rules. A big variable is the production and consistency of the oil. The reason warm compresses are popular is that when body heat is insufficient to liquefy the oil, extra heat loosens it up so that it can either run out on its own or be expressed manually. If the oil is really hardened in the glands, it may be difficult or impossible to 'push' out, at least safely.

Another issue is that what we require during an 'acute' phase is different than what we require for maintenance. Personally I'm in a state where a good warm compress does everything I need.

[Rory]

I was concerned about the same thing because I have rosacea and inflammation doesn't respond well to heat.
I posted a question to Dr. Latkany about this. He said to do hot compresses once a day for no more than 4 minutes. The thing is that the heat (by the way, you don't have to make the compress THAT hot) is what softens up and supposedly opens the glands. It's sort of like when you have a pimple. If you hold a hot washcloth on it for a while, the pimple becomes soft and it opens and then you get get all the junk out of it without squeezing too hard. This is the same thing. A cold compress wouldn't accomplish anything as far as opening the glands, but it is soothing to the inflamation. So when you're trying to open the glands, use the warm compress. Any other time, for soothing purposes, use cold.
And by the way, you said "rub the eyelids fairly hard". Take it easy on your eyelids...that's really thin skin. You want to press with some pressure but you don't want to rub hard (as if you're trying to remove a stain). That would really irritate your lids.

Yes you are certainly right about not too hard! However there has to be a degree of pressure otherwise there would be no effect at all. I am certainly very cautious with my eyes and would never go over the top.

Thanks for the advice.. i think i will definitely apply a warm compress for a few minutes prior to my "aggresively gentle" rubbing.

[TRiBaL]

Ya same here. My eyelids sometimes cant take the heat because of the inflammation. I wonder if thats really good at all to put warm compresses on your eyelids in first place.