Eyelid Warming Devices: Safety, Efficacy, and Place in Therapy

Abstract

Meibomian gland dysfunction (MGD) is characterized by the obstruction and/or inflammation of the meibomian glands that result in decreased and altered meibum secretion. This results in deficiencies in the tear film lipid layer which contributes to increased evaporation and destabilization of the tear film. One of the mainstay therapies for MGD is medical devices that apply heat and/or pressure to the eyelids and promote the liquification and outflow of meibum into the tear film. Over the past two decades, there have been a surge of interest in diagnosing and managing MGD. As a result, numerous medical devices have been developed and each have their own unique approach to treating MGD. This narrative review was conducted to summarize the current state of knowledge on eyelid warming devices, specifically warm eye coverings, devices that direct heat and/or pressure to the eyelids, moisture chamber goggles, and light-based therapy. This review summarized 58 human clinical studies and found that most eyelid warming devices were efficacious in improving signs and symptoms in a wide range of MGD severities and were generally safe to use.

Keywords:

• dry eye
• meibomian gland dysfunction
• warm compresses
• thermal pulsation
• moisture chamber goggles
• intense pulsed light

Disclosure

Over the past three years, the Centre for Ocular Research & Education has received research funding from the following companies: Alcon, Allergan, Allied Innovations, Aurinia Pharma, Azura Pharma, Bausch Health Canada, Brien Holden Vision Institute, CooperVision, GL Chemtec, i-Med Pharma, Johnson & Johnson Vision, Lubris, Menicon, Nature’s way, Novartis, Ophtecs, Ote Pharma, PS Therapy, Santen, SightGlass, SightSage, Visioneering Tech. Dr Brandon Bzovey reports Research support to from listed companies: Alcon, Allergan, Allied Innovations, Aurinia Pharma, Azura Pharma, Bausch Health Canada, Brien Holden Vision Institute, CooperVision, GL Chemtec, i-Med Pharma, Johnson & Johnson Vision, Lubris, Menicon, Nature’s way, Novartis, Ophtecs, Ote Pharma, PS Therapy, Santen, SightGlass, SightSage, Visioneering Tech. Dr William Ngo reports Research support paid to institution from Alcon, Allergan, Allied Innovations, Aurinia Pharma, Azura Pharma, Bausch Health Canada, Brien Holden Vision Institute, CooperVision, GL Chemtec, i-Med Pharma, Johnson & Johnson Vision, Lubris, Menicon, Nature’s Way, Novartis, Ophtecs, Ote Pharma, PS Therapy, Santen, SightGlass, SightSage, Visioneering Tech, personal fees from Alcon, personal fees from Sun Pharma, outside the submitted work. The authors report no other conflicts of interest in this work.