Appropriate meibomian gland health is critical for a healthy ocular surface. The meibomian glands produce meibum that form the outer layer of the tear film, preventing premature evaporation of the tear film’s aqueous layer. Research has shown that meibomian gland dysfunction (MGD) can cause a reduction in contact lens comfort.14,15
A single 12-minute thermal pulsation treatment has demonstrated significant improvements in meibomian secretion, tear film parameters (including MMP-9 levels), and patient symptoms measured by the Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. 16-18
Recently, researchers looked into the influence of MGD and contact lens discomfort in contact lens wearers with MGD and dry eye symptoms. Participants were randomized to a single thermal pulsation treatment and compared to a control group that received no treatment.
The treated group significantly improved both signs and symptoms associated with contact lens discomfort and increased comfortable contact lens wear time by four hours. The study followed these patients for three months, and the treatment effect was sustained for that time frame.19
Moist heat compress
A clinical study at the University of Alabama at Birmingham School of Opometry found that subjects using Bruder moist heat compress had significantly improved meibomian gland scores and experienced steeper declines in their overall eye discomfort assessment scores.
This was a four-week, single-center, three-arm, randomized, open-label clinical trial in subjects diagnosed with contact lens-induced dry eye (CLIDE) using the Contact Lens Dry Eye Questionnaire long form (CLDEQ). Fifty-one subjects were randomized to one of three treatment groups:
• Application of the compress once a day
• Application of the compress twice a day
• Warm washcloth application twice a day
A statistically significant increase in mean hours of comfortable wear time was found in subjects who used the compress compared to those using a washcloth. No statistically significant improvement in comfortable wear time was found between subjects using the compress twice daily versus once daily.20
1. Vidal-Rohr M, Wolffsohn JS, Davies LN, Cerviño A. Effect of contact lens surface properties on comfort, tear stability and ocular physiology. Cont Lens Anterior Eye. 2018 Feb;41(1):117-121.
2. Rah MJ, Merchea MM, Doktor MQ. Reducing dropout of contact lens wear with Biotrue multipurpose solution. Clin Ophthalmol. 2014 Jan 24;8:293-9.
3. Sulley A, Young G, Hunt C, McCready S, Targett MT, Craven R. Retention rates in new contact lens wearers. Eye Contact Lens. 2018 Sep;44 Suppl 1:S273-S282.
4. Dumbleton K, Woods CA, Jones LW, Fonn D. The impact of contemporary contact lenses on contact lens discontinuation. Eye Contact Lens. 2013 Jan;39(1):93-9.
5. McCulley JP, Shine WE. Eyelid disorders: the meibomian gland, blepharitis, and contact lenses. Eye Contact Lens. 2003 Jan;29(1 Suppl):S93-5.
6. Tarkowski W, Moneta-Wielgoś J, Młocicki D. Demodex sp. as a potential cause of the abandonment of soft contact lenses by their existing users. Biomed Res Int. 2015:259109.
7. Korb DR, Greiner JV, Herman JP, Hebert E, Finnemore VM, Exford JM, Glonek T, Olson MC. Lid-wiper epitheliopathy and dry-eye symptoms in contact lens wearers. CLAO J. 2002 Oct;28(4):211-6.
8. Efron N, Brennan NA, Morgan PB, Wilson T. Lid wiper epitheliopathy. Prog Retin Eye Res. 2016 Jul;53:140-174.
9. Pult H, Purslow C, Berry M, Murphy PJ. Clinical tests for successful contact lens wear: relationship and predictive potential. Optom Vis Sci. 2008 Oct;85(10):E924-9.
10. Versura P, Bernabini B, Torreggiani A, Cellini M, Caramazza R. Frequent replacement and conventional daily wear soft contact lens symptomatic patients: tear film and ocular surface changes. Int J Artif Organs. 2000 Sep;23(9):629-36.
11. Masoudi S, Stapleton FJ, Willcox MDP. Differences in tear film biochemistry of symptomatic and asymptomatic lens wearers. Optom Vis Sci. 2017 Sep;94(9):914-918.
12. Masoudi S, Zhao Z, Stapleton F, Willcox M. Contact lens-induced discomfort and inflammatory mediator changes in tears. Eye Contact Lens. 2017 Jan;43(1):40-45.
13. Downie LE, Gad A, Wong CY, Gray JHV, Zeng W, Jackson DC, Vingrys AJ. Modulating contact lens discomfort with anti-inflammatory approaches: a randomized controlled trial. Invest Ophthalmol Vis Sci. 2018 Jul 2;59(8):3755-3766.
14. Arita R, Fukuoka S, Morishige N. Meibomian gland dysfunction and contact lens discomfort. Eye Contact Lens. 2017 Jan;43(1):17-22.
15. Machalińska A, Zakrzewska A, Adamek B, Safranow K, Wiszniewska B, Parafiniuk M, Machaliński B. Comparison of morphological and functional meibomian gland characteristics between daily contact lens wearers and nonwearers. Cornea. 2015 Sep;34(9):1098-104.
16. Greiner JV. Long-Term (3 Year) Effects of a single thermal pulsation system treatment on meibomian gland function and dry eye symptoms. Eye Contact Lens. 2016 Mar;42(2):99-107.
17. Zhao Y, Veerappan A, Yeo S, Rooney DM, Acharya RU, Tan JH, Tong L; Collaborative Research Initiative for Meibomian gland dysfunction (CORIM). Clinical trial of thermal pulsation (LipiFlow) in meibomian gland dysfunction with preteatment meibography. Eye Contact Lens. 2016 Nov;42(6):339-346.
18. Kim MJ, Stinnett SS, Gupta PK. Effect of thermal pulsation treatment on tear film parameters in dry eye disease patients. Clin Ophthalmol. 2017 May 9;11:883-886.
19. Blackie CA, Coleman CA, Nichols KK, Jones L, Chen PQ, Melton R, Kading DL, O'Dell LE, Srinivasan S. A single vectored thermal pulsation treatment for meibomian gland dysfunction increases mean comfortable contact lens wearing time by approximately 4 hours per day. Clin Ophthalmol. 2018 Jan 17;12:169-183.
20. Bruder Healthcare. Bruder Announces Eyeleve Contact Lens Compress. Available at: https://www.prnewswire.com/news-releases/bruder-announces-eyeleve-contac.... Accessed 6/12/19.
21. Rynerson JM, Perry HD. DEBS – a unified theory for dry eye and blepharitis. Clin Ophthalmol. 2016 Dec 9;10:2455-2467.
22. Mulder D, Kyser K, Rosenberg B, Connor D, Choat C, Narayanan S. Clinical effectiveness of lid debridement with blephex treatment. Invest Ophthalmol Vis Sci. 2015;56(7):4440.
23. Connor CG, Narayanan S, Miller W. Reduction in inflammatory marker matrix metalloproteinase-9 following lid debridement with BlephEx. Invest Ophthalmol Vis Sci. 2017 June;58(9):448.
24. Siddireddy JS, Tan-Showyin J, Vijay AK, Willcox M. A Comfortable Eye Needs Fats. Thesis competition at the University of South Wales, Sydney, 2015.
25. Giovagnoli D, Graham SJ. Inferior punctal occlusion with removable silicone punctal plugs in the treatment of dry-eye related contact lens discomfort. J Am Optom Assoc. 1992 Jul;63(7):481-5.
26. Geldis JR, Nichols JJ. The impact of punctal occlusion on soft contact lens wearing comfort and the tear film. Eye Contact Lens. 2008 Sep;34(5):261-5.
27. Hom MM. Use of cyclosporine 0.05% ophthalmic emulsion for contact lens-intolerant patients. Eye Contact Lens. 2006 Mar;32(2):109-11.
28. Willen CM, McGwin G, Liu B, Owsley C, Rosenstiel C. Efficacy of cyclosporine 0.05% ophthalmic emulsion in contact lens wearers with dry eyes. Eye Contact Lens. 2008 Jan;34(1):43-5.