The treatment of dry eyes and Meibomian gland dysfunction includes eyelid heating, massage and cleaning regularly as the standard home care regime. You can use warm or hot compresses, hot flannel (face towel), eye masks and goggles. Most commonly patients like a warm compress with a face towel or flat cotton makeup removal discs, using either hot water from the tap or kettle. The water does not have any salt or other solution in it.
At Clinica London, we teach the patient how to heat their eyelids, massage them and then clean them twice daily if they have meibomian gland dysfunction and dry eyes. There are various options for the heating stage which include wet heat with a hot flannel or a wet or dry eye mask heated either with boiled water or in the microwave oven, and steam goggles such as the Blephasteam. The eye masks and goggles are available at the clinic.
Stimulating the eyes to produce tears as well as treating the Meibomian gland dysfunction all contribute to improving the patient’s eye comfort.
In a recent study (Sci Rep 2017, 5; 7: 458-48) the authors suggested the use of disposable eyelid-warming steamers that have menthol in them to stimulate a little bit of lacrimation by activating the cold sensitive pathways from the cornea. This can help dry eye patients have more comfortable eyes. You all know that when you go out in the cold, you get extra watering eyes and that is due to a reflex from the corneal surface which stimulates hypersecretion. They did a study in patients with whom some had the eyelid warming steamers with menthol, and the others did not. They looked at the effect of applying this once only for 10 minutes or repeatedly over two weeks.
They found that using menthol disposable eyelid-warming steamers increased the tear meniscus volume and tear film break up time, as well as improved the meibomian gland dysfunction both in healthy patients and in patients with dry eyes. Repeated applications did even better result in a persistent increase in tear fluid volume and improvement of tear film stability in dry eyes. Their research suggests that repeated use of a warm compress with the addition of a little bit of menthol is potentially a novel treatment for dry eye disease.
Let’s try it and let me know how you get on! Keep the eyelids closed when warming them with a pad soaked in warm water and one drop of menthol (from the health food shop). If you are using makeup removal discs to warm your eyelids, put just one drop of menthol in the centre, then turn the disc around or fold it over, and use the side with the weakest menthol to start with, to see you like it, then put some more warm water on and repeat.
Source: Sci Rep 2017, 5; 7: 458-48