Evaluation of the ocular tolerance of a novel eyelid-warming device used for meibomian gland dysfunction

Abstract

Purpose: Obstructive meibomian gland dysfunction (MGD) frequently induces a chronic complaint with various symptoms related to dry eye and discomfort. Previous research indicates a pivotal role for heat therapy for melting the meibum as part of any successful management plan, but delivery of constant temperature during treatment is vital. This study evaluated the performance of a novel device designed to deliver controlled, latent, moist heat to the eyelids and surrounding area.

Methods: The signs, symptoms and ocular temperature of 25 normal subjects (M8, F17; age 29.2±5.7 years) were recorded before and after a 10min application of the Blephasteam(®) device. Ocular temperature (non-invasive ocular thermography; A40 Flir, UK), tear film stability (NIBUT), intra-ocular pressure (IOP), and ocular surface staining and hyperaemia were recorded. Results were checked for normality and compared using paired t-tests.

Results: Temperatures in both eyelids were significantly greater after device application (upper +1.7±0.9°C; lower +2.1±0.7°C, p<0.0005). Bulbar conjunctival hyperaemia significantly decreased after treatment (p<0.005), but limbal and palpebral hyperaemia remained similar (p=0.33 and p=0.11, respectively). Ocular surface staining (p=0.74) and tear film stability (p=0.12) were unchanged in this normal cohort, and there was no significant change in IOP (13.8±2.0mmHg vs 12.9±2.2mmHg; p=0.092).

Conclusions: The Blephasteam(®) device provides effective levels of warming that would be sufficient to melt meibum, and no adverse ocular responses were recorded in this cohort, indicating that this is a safe device. Interestingly, even in this normal cohort, ocular surface redness appears less after treatment.

Keywords: Eye temperature; Eyelid-warming; Infrared; Meibomian gland dysfunction; Thermal imaging; Thermography.