title: All Warm Compresses Are Not Equally Efficacious.
abstract: OBJECTIVE
  To investigate which warm compress (WC) methods used in a small case series are the most effective in providing heat to the inner eyelids for the supplemental treatment of meibomian gland dysfunction.
  
  
  METHODS
  Inclusion criteria included the following: 18 years or older and willingness to participate in the study, no current ocular inflammation/disease, and no ocular surgery within the last 6 months. Five patients were fully consented and enrolled. Various forms of contact and noncontact WC heating methods (dry, wet/moist, and chemically activated dry heat) were tested. A paired contralateral design was used; each subject had a heated test eye and an unheated control eye. For both test and control eyes, the temperature of the external upper, external lower, and internal lower lids was measured at baseline and every 2 minutes for 10 minutes during application. Each participant underwent each of the eight treatments under study. Microwaved compresses were heated to 47 ± 1.0°C; two compresses were self-heating and thus not under investigator control.
  
  
  RESULTS
  The mean (± SD) age of the patients was 42.2 (± 20.3) years. Out of the eight methods tested, the bundled wet/moist towel method was the only compress that elevated the temperature of all three lid surfaces (external upper, external lower, and internal lower lids) to 40°C or higher. The chemically activated EyeGiene, MGDRx EyeBag, and MediBeads compresses resulted in the lowest temperature increase at the inner palpebral surface.
  
  
  CONCLUSIONS
  The Bundle method, although the most labor intensive, increased lid temperatures above therapeutic levels, as reported in the literature, for all measured sections during the WC application. As such, this method of WC application can be recommended for supplemental at-home therapy for meibomian gland dysfunction and any condition requiring that therapeutic heat of 40°C be administered to the meibomian glands.
authors.affiliation: *OD, MPH, FAAO †OD, PHD, FAAO ‡OD, FAAO TearScience Inc, Morrisville, North Carolina (all authors); and Korb Associates, Boston, Massachusetts (all authors).
authors.forename: David K
authors.initials: DK
authors.lastname: Murakami
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Blackie
authors.forename: Donald R
authors.initials: DR
authors.lastname: Korb
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages; D001831:Body Temperature; 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*; D008537:Meibomian Glands / Q000503:physiopathology*; D008875:Middle Aged; D055815:Young Adult