Does Heat Really Help Dry Eyes?

People are often advised to use a hot compress when they have dry eye disease.  Yet many instinctively feel that heat does not help and, in some cases, makes their eyes and skin feel worse.  In this article we will look at why you may have been advised to use heat, the different ways you can apply heat and when heat may not be appropriate to use regularly.

Why heat application is advised for Dry Eye Disease

In our upper and lower eyelids, we have meibomian glands that secrete an oily substance (meibum) every time we blink.  As we open our eyes that oil is spread over the surface of the eye, stopping the tears from evaporating and helping our eyes stay comfortable.  Meibum should have a consistency like olive oil; free flowing and clear.

Yet 86% of people with Dry Eye Disease have a problem called Meibomian Gland Dysfunction, otherwise known as MGD, Posterior Blepharitis or Evaporative Dry Eye Disease. For these people the glands are not working properly.  The oil might be of poor quality, or insufficient quantity to spread evenly over the ocular surface.  The consistency changes to become like butter, or even toothpaste and, as a result, the glands become congested, twisted and shortened.  You may get persistent blockages such as chalazion, and eventually the glands may stop working and start to die off (atrophy or drop out).

Meibum, rather like butter, starts to melt when it is heated.  So, if you have been asked to apply heat to your eyelids it will be to try to change the consistency of the oil in your meibomian glands so that it flows more freely over your eye every time you blink.

Ways to apply heat

The simplest and cheapest way is to use clean, hot, wet flannels.  However, this is rather messy, and it is difficult to achieve the ideal temperature required (42°C) to melt the meibum because the flannels cool down very quickly.

An Eyebag, or equivalent, is a pouch filled with seeds or beads that is heated in the microwave before it is applied to the eye area for 8-10 minutes whilst you relax. This is less messy, and the heat is more consistent than the flannels, however it does still cool down over time and you do not have control over the starting temperature.

USB powered masks are becoming more widely available and some incorporate a massage function to further encourage expression of the oils from the glands.  Ensure that you buy a reputable brand that has been tested for temperature control and do not be tempted to sit under them for longer than the recommended 8-10 minutes.

The Peep Club wand is also USB powered and provides variable heat and massage to the application area.  After some lubrication has been applied to the skin the wand is slowly run along the eyelid as close as possible to the lash line, from the inner to the outer corner, for two minutes per eyelid.  This allows you to gradually increase the heat as you become accustomed to it, and you can control if you want the massage function or not.  

Heat is not always desirable

Dry Eye Disease is an inflammatory condition, and like it or not, the application of heat increases local inflammation.  This is why large amounts of heat, for long periods of time, can exacerbate your symptoms.

Balance is key.  You need some heat to melt the congested, sticky meibum: too much heat leads to the increase of inflammation and worsening symptoms.

For many using a product like the Peep Club wand allows you to achieve that balance.  Two minutes of targeted 42°C heat and massage per eyelid gets the meibum flowing without putting heat into the whole periorbital area.  

We also advise keeping something like an Eyebag in the fridge or freezer, ready to apply if inflammation flares up.  However, in this case ensure that you keep something between the bag and your skin, and do not apply for longer than ten minutes, once per day.

Conclusion

If your eyecare professional has advised you to use heat to help relieve your Dry Eye Disease symptoms, it is important that you follow the advice given.  However, if you are experiencing problems talk to them, and discuss the best ways to achieve the desired results.  It may be that your condition would benefit from treatment such as Intense regulated Pulsed Light, or Low Level Light Therapy in addition to what you are doing at home.  You can click here for more information on these non-invasive, painless yet intensive treatments.  Alternatively, please do not hesitate to contact us if you would like a chat: you can drop us a text or WhatsApp to 07561 596128 or an email to info@sootheocularspa.co.uk