Are warm compresses the right long term treatment for your dry eye/oil gland dysfunction?

May 26, 2022

Written By: Dr. Gilles, OD

Are warm compresses the right long term treatment for your dry eye/oil gland dysfunction?

Use of a warm compress is a strongly taught and prescribed first-line treatment for individuals with dry eye secondary to meibomian gland dysfunction. Unfortunately, some of us, myself included, note worsening symptoms with its use over time. Why is this? To answer this question. We need to first remind ourselves what meibomian gland dysfunction (MGD) is.

MGD occurs when oil cannot be expressed from glands in the eyelids leading to a tear film lacking necessary oil. Classically, warm compresses have been shown to melt the oil within these glands to acutely treat MGD that occurs when the oils become cold/hardened. However, we’ve found that chronically, not all individuals have solidified oils as the root or only cause of their MGD.

Another cause of MGD occurs when the eyelid tissue swells around the glands. This puts pressure on the glands, and the trapped oils are unable to move to the eyelid margin/be released onto the eye even if they are melted and clear. Inflammation and swelling can occur when the body responds to an infective organism, allergens, or environmental/genetic/hormonal stressors (aka ocular/eyelid rosacea). 

In these cases, a warm compress can unfortunately worsen our signs and symptoms chronically as it triggers dilation of the superficial blood vessels and excessive fluid to enter the eyelid. This results in more eyelid swelling; pressure build up and chronic gland dysfunction.

Many of my patients with eyelid tissue swelling have seen improvements by beginning or switching to daily cold compress use. Cold compresses can decrease swelling of the eyelid tissues, relieve pressure on the oil glands and increase oil flow. My favorite method of performing a cold compress is with the use of a cooling dry eye relief mask (eyeeco, D.E.R.M.®). Place the compress in the freezer for at least 20 minutes and wear for 10-15 min twice a day.

To find out whether a cold compress switch is right for you, schedule a dry eye evaluation or recheck with Spokane Eye Clinic today!