title: Comparison of Self-applied Heat Therapy for Meibomian Gland Dysfunction.
abstract: OBJECTIVE
  To compare the effects on ocular temperature, lipid layer grade, tear film stability, and tear meniscus height after a single application of two commercially available warm compresses in mild-to-moderate dry eye and to report participant treatment preference.
  
  
  METHODS
  Forty-one subjects with mild-to-moderate dry eye symptoms were enrolled in a randomized, paired-eye, investigator-masked trial. Heat was applied simultaneously to one eye (randomized) with a portable eye mask (EyeGiene) and to the contralateral eye with a microwave-heated flaxseed eye bag (MGDRx Eye Bag). Outer and inner eyelid temperatures, tear film lipid layer grade (LLG), and noninvasive tear film breakup time (NIBUT) were measured at baseline and immediately after 10 minutes of device application.
  
  
  RESULTS
  Outer and inner eyelid temperatures, LLG, and NIBUT did not differ before treatment between eyes assigned to eye mask and eye bag therapy. All measurements were significantly increased from baseline, after warming with both devices (all p < 0.05). Outer and inner eyelid temperature changes were significantly greater with the eye bag than with the eye mask (outer eyelid, +3.5 ± 1.0°C vs. +2.4 ± 0.8°C; inner eyelid, +3.5 ± 1.0°C vs. +2.5 ± 0.9°C; all p < 0.001), although there was no significant difference in LLG and NIBUT improvement between treatments (all p > 0.05). A majority of subjects (78%) preferred the application of heat with the eye bag over the eye mask.
  
  
  CONCLUSIONS
  Both the EyeGiene mask and the MGDRx Eye Bag are convenient eyelid warming devices that result in clinically and statistically significant increases in NIBUT and LLG in patients with mild-to-moderate dry eye symptoms. The MGDRx Eye Bag is more effective in raising ocular temperature and is the preferred treatment method among subjects.
authors.affiliation: *BOptom †PhD, MCOptom, FAAO Departments of Ophthalmology (all authors) and Optometry and Vision Science (ZJ, SML), New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
authors.forename: Michael T M
authors.initials: MT
authors.lastname: Wang
authors.forename: Zenia
authors.initials: Z
authors.lastname: Jaitley
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Lord
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Craig
mesh_terms: D000293:Adolescent; D000328:Adult; D001831:Body Temperature; D004311:Double-Blind Method; D015352:Dry Eye Syndromes / Q000503:physiopathology / Q000628:therapy*; D005141:Eyelid Diseases / Q000503:physiopathology / Q000628:therapy*; D005143:Eyelids / Q000503:physiopathology; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation / Q000379:methods*; D050356:Lipid Metabolism; D008297:Male; D008537:Meibomian Glands / Q000503:physiopathology*; D013666:Tears / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult