Purpose:
Meibomian gland dysfunction (MGD) is one of the main causes of evaporative dry eye disease (DED). Eyelid warm compresses, heated to 40-45°C, helps to liquefy the solidified meibum in MGD so that it can be expressed with a natural blink. Other than commercial heating masks, there remains unconventional home remedies that are popular with patients due to the low cost and accessibility. However, there is a paucity of studies on the heat retention of these unconventional remedies. Hence the objective of this study was to evaluate the heat retention profile of certain unconventional eyelid heating remedies for a duration of 15 minutes.

Methods:
Four unconventional eyelid heating remedies were evaluated (wooden spoon immersed in boiling water; hard-boiled egg, a bag of rice; and a hot potato). Each method was heated according to a previously established protocol and the heat retention profile was evaluated over a 15-minute period including the maximum temperature (Tmax) and the time spent in the therapeutic interval (40-45˚C). Three of these techniques (spoon, egg and potato) were performed with and without a facecloth wrapped around them, and the technique with rice was performed with 100 and 200g. The MGDRx Eyebag microwavable heating mask was used as a control.

Results:
Each unconventional method had a unique heat retention profile and reached Tmax 2 minutes after heating. The Tmax, without the facecloth, was 81.02 ± 1.79°C, 87.84 ± 4.13°C, 71.21 ± 3.83°C and 67.25 ± 2.01°C for the boiled egg, potato, bag of rice (100g) and the wooden spoon, respectively. Tmax, with the facecloth, was lower for all techniques (p<0.01) but remained >55˚C. The therapeutic interval >1 minute was reached only by the wooden spoon (4.12 min ± 1.20 min and 1.53 min ± 0.16 min, with and without the facecloth, respectively). The MGDRx Eyebag reached the therapeutic interval within 2 minutes and remained between 40-45˚C for the remainder of the 15 min (ie. 13 min total).

Conclusion:
These unconventional eyelid heating remedies, with the established protocol, have a heat retention profile beyond the therapeutic temperature for the management of MGD and has the potential to cause a burn injury of the eyelid and surrounding skin. Adding a facecloth can lower the peak temperature and increase heat retention however future studies are needed to establish precise preparation protocols to allow for comparisons. A commercial microwave eyelid heating mask, such as the MGDRx Eyebag, offers consistent heat throughout the recommended warming interval.