![]() ![]() ![]() Due to the disruption to the tear film and lipid layer that results from a contact lens on the surface of the eye, it was hypothesized that applying a warm compress to the eyelids to improve functioning of the meibomian glands would result in increased meibum secretion and improve comfortable contact lens wear time. demonstrated that a warm compress applied to the eyelids increased tear lipid layer thickness by increasing meibum secretion from the glands. With good patient compliance, warm compresses have been shown to be an adequate supplemental therapy for MGD as the heat softens meibum in glands allowing for secretion from the gland orifice. ![]() Warm compresses are a commonly prescribed treatment method for applying localized heat to the meibomian glands to improve secretion, , ]. Consequently, treatment of MGD may support functioning of the meibomian glands and lead to improvement in patient contact lens comfort. Another study by Ong and Larke that enrolled both contact lens wearers and controls found MGD in 30% of the contact lens wearers compared to only 20% of controls. Korb and Henriquez found evidence of MGD in 36.6% of symptomatic contact lens wearers. Ĭontact lens wearers often report dry eye symptoms and show signs of MGD including gland atrophy, thinned lipid layer, and increased tear film instability. MGD is considered by many to be the leading cause of dry eye disease throughout the world, and is a chronic and progressive condition that can contribute to a poor quality lipid layer and contact lens discomfort. ![]() This is further exacerbated if the patient has an already unstable lipid layer due to the presence of meibomian gland dysfunction (MGD). As a result of this disruption from the contact lens, the tear film tends to have an increased rate of evaporation which is accompanied by poor wetting on the surface of the contact lens and inadequate lubrication on the surface of the eye. Indeed, when a contact lens is placed on the eye, the tear film is split into pre- and post-lens tear films. The International Workshop on Contact Lens Discomfort published in 2013 concluded from a thorough review of the literature that discomfort and dryness are the primary reasons for contact lens intolerance. Though newer and healthier contact lens materials have been developed, discomfort remains the top reason for contact lens discontinuation and dropout rates are estimated to be as high as 15.9% in the United States. The Bruder Moist Heat Compress resulted in a significant improvement in comfortable CL wear time in subjects with CLDE.Īn estimated 40.9 million people in the United States aged 18 or older wear contact lenses. No significant improvements were observed in TBUT (p = 0.76) or LLT (p = 0.78). Subjects using the Bruder Compress once daily had the highest rate of compliance at 90.2% (p < 0.01). No significant difference in uncomfortable wear time was found between subjects using the Bruder Compress twice daily versus once daily (p = 0.48). In the Bruder Compress groups, there was a significant reduction in the blockage of meibomian glands (p < 0.01). After treatment, subjects using a washcloth reported more uncomfortable contact lens wear time on average (mean = 5.1 ± 2.8 h) when compared with subjects who had used the Bruder Compress in Group 1 (mean = 2.8 ± 1.6 h) (p = 0.02). Statistical tests included a generalized linear model and one-way analysis of variance (ANOVA) to investigate treatment effect on comfortable wear time.įifty-one subjects (98% female) completed the study. Clinical assessments included tear film break-up time (TBUT), lipid layer thickness (LLT), and meibomian gland evaluation. Subject diaries were monitored for compliance and collected data on daily CL comfort upon awakening and throughout the afternoon. Fifty-one CL wearers were randomized to one of three treatment groups: application of the Bruder Compress twice a day, Bruder Compress once a day, or warm washcloth used for ten minutes twice a day without reheating. This was a 4-week, single-center, three-arm, randomized, open-label clinical trial in subjects diagnosed with CLDE using the Contact Lens Dry Eye Questionnaire. The purpose of this study was to investigate the effect of the Bruder Moist Heat Compress on contact lens (CL) discomfort in subjects with contact lens-related dry eye (CLDE). ![]()
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