title: Effects of Eyelid Warming Devices on Tear Film Parameters in Normal Subjects and Patients with Meibomian Gland Dysfunction.
abstract: OBJECTIVE
  To evaluate the effects of commercially available eyelid warming devices on ocular temperatures, tear film function, and meibomian glands in normal subjects and patients with meibomian gland dysfunction (MGD).
  
  
  METHODS
  Ten healthy volunteers were enrolled to evaluate the effects of a single warming and of repeated warming for 2 weeks. Ten MGD patients were enrolled for evaluation of repeated warming over 1 month. Two non-wet (Azuki no Chikara, Eye Hot R) and three wet (hot towel, Hot Eye Mask, Memoto Este) devices were compared in a masked manner. Visual analog scale (VAS) score for ocular symptoms, tear film breakup time (TFBUT), meibum grade, temperatures (eyelid skin, tarsal conjunctiva, central cornea), Schirmer test value, and meibomian gland area were measured before and after warming application.
  
  
  RESULTS
  The single application of the five warming devices improved the VAS score, TFBUT, and ocular temperatures. In the repeated warming application, Azuki no Chikara as a representative non-wet warming device induced a stable and significant improvement in TFBUT and increased the tarsal conjunctival temperature and meibomian gland area in both normal subjects and MGD patients. It also improved meibum grade in MGD patients.
  
  
  CONCLUSIONS
  Our results suggest that repeated eyelid warming with a non-wet device improves tear film function in normal individuals and may have beneficial effects on both tear film and meibomian gland function in MGD patients.
authors.affiliation: Department of Ophthalmology, Itoh Clinic, Saitama, Japan; Department of Ophthalmology, The University of Tokyo, Tokyo, Japan; Department of Ophthalmology, Keio University, Tokyo, Japan; Lid and Meibomian Gland Working Group, Japan. Electronic address: ritoh@za2.so-net.ne.jp.
authors.forename: Reiko
authors.initials: R
authors.lastname: Arita
authors.affiliation: Lid and Meibomian Gland Working Group, Japan; Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Morishige
authors.affiliation: Department of Ophthalmology, The University of Tokyo, Tokyo, Japan; Lid and Meibomian Gland Working Group, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Shirakawa
authors.affiliation: Yamaguchi University Hospital, Yamaguchi, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Inoue Eye Hospital, Tokyo, Japan; Miyata Eye Hospital, Miyazaki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Amano
mesh_terms: D000328:Adult; D000368:Aged; D001831:Body Temperature; D004867:Equipment Design; D005141:Eyelid Diseases / Q000378:metabolism / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D064368:Healthy Volunteers; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism* / Q000503:physiopathology; D008875:Middle Aged; D013499:Surface Properties; D013666:Tears / Q000737:chemistry* / Q000378:metabolism
keywords: dry eye; eyelid warming; meibography; meibomian gland; meibomian gland dysfunction; tear film