Put the closed container with the EyeBag inside, into the pre-heated oven at Gas mark 1 for 15 to 20 minutes. Probing improved subjective symptoms, meibum grade, TBUT, lid margin abnormalities, and fluorescein staining compared with the control

The Blephasteam ® (Théa Laboratories, France) is a goggle system that produces moist warm air and heats the eyelids through the condensation of water vapor. The melted meibum secretion is favoured by the normal blinking of the patients during the treatment. Temperatures recorded in the outer upper eyelids were between 37.4 °C and 40.0 °C at the end of the treatment, while in the lower ones they were between 37.8 °C and 38.4 °C [ 27, 29]. Sarman ZS, Cucen B, Yuksel N, Cengiz A, Caglar Y. Effectiveness of intraductal meibomian gland probing for obstructive meibomian gland dysfunction. Cornea. 2016;35(6):721–4. Remove Blepha EyeBag® from the box and place it on a clean, dry microwaveable plate. Always make certain the dish or plate you use is completely clean as any small food residue can become very hot and these “hot spots” might cause small burns in the Blepha EyeBag® material. Prior to using this product, I was using the warm wet compresses twice a day. The problem with that is that the skin around my sensitive eyes were getting extremely dry and painful every time I applied the wet compresses (because they were so dried out from doing this for so long). I've have now been using the MGD Eyebag for two weeks now and so far so good. I don't see any symptoms of the blepharitis I had been experiencing before (swollen/puffy bottom lids, crusting around both ends of the eyes). The instruction booklet is very detailed on how to use it and how to warm it up and how long it last for. Yin Y, Liu N, Gong L, Song N. Changes in the meibomian gland after exposure to intense pulsed light in meibomian gland dysfunction (MGD) patients. Curr Eye Res. 2018;43(3):308–13.

Freedman HL, Preston KL. Heat retention in varieties of warm compresses: a comparison between warm soaks, hard-boiled eggs and the re-heater. Ophthalmic Surg. 1989;20(12):846–8. Probing improved meibum lipid levels as measured with a meibometer as well as reduced meibum viscosity EyeBag puede aliviar los síntomas del ojo seco, pero el efecto sobre la función de las glándulas de Meibomio y la estabilidad de la lágrima al utilizarse durante 4 semanas fue indetectable. Conjunctival hyperaemia: digital images of the nasal and temporal bulbar conjunctiva were captured and analysed to provide an objective measurement via edge detection and colour extraction. 16 Green-Church KB, Butovich I, Willcox M, et al. The International Workshop on Meibomian Gland Dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease. Investig Opthalmol Vis Sci. 2011;52(4):1979.

The eyeXpress™ Eye Hydration System (Holbar Medical Products, USA) is a goggle system, which provides constant but adjustable heat to the anterior surface of both eyelids. It can be applied for 15 min in the required number of sessions [ 21]. The MGDRx EyeBag® is a patented, CE marked Class 1 medical device registered with the Medicines and Healthcare products Regulatory Agency (MHRA). The MGDRx EyeBag ® (The Eyebag Company, Halifax, UK) is a reusable silk and cotton mask that can be heated in a microwave for 40 s. Peak temperatures (37.6 °C) may be reached after 2 min of its application on the external upper eyelids. After 12 min of treatment, temperatures may slightly decrease (36.8 °C) [ 16, 17]. Two studies (III) suggested that Blephasteam ® might be a safe and effective therapy for MGD because DED symptoms and MG function improved after 21 days of treatment [ 30, 31]. Ocular symptoms and clinical signs, except the conjunctival redness score, may achieve a higher improvement after Blephasteam ® than after warm compresses (III) [ 32]. However, in another study (I), signs improved equally in both therapies [ 33]. Nonetheless, Blephasteam ® may be useful for subjects who find warm compresses ineffective (III) [ 34]. Warming and Massaging Devices Zhao Y, Xie J, Li J, et al. Evaluation of monocular treatment for meibomian gland dysfunction with an automated thermodynamic system in elderly chinese patients: a contralateral eye study. J Ophthalmol. 2016;27:1–8.Some studies compared LipiFlow ® with other MGD management strategies. Almost all of the studies comparing the LipiFlow ® with traditional eyelid hygiene (I and III) found an improvement in symptoms in the LipiFlow ® group [ 37, 38, 39, 40]. Only two studies (III) found an improvement in signs, such as MG secretion and BUT [ 39, 41]. Other authors compared LipiFlow ® with other medical devices, such as Tauber et al. [ 42] (I), who compared LipiFlow ® with iLux ® and did not find differences between the two treatments. Another study (II) reported that one single LipiFlow ® session was more effective in decreasing DED symptoms compared to 3 months of oral doxycycline [ 43]. Finally, Yeo et al. [ 44] (I) showed a significant reduction in the tear evaporation rate after 4 and 12 weeks of LipiFlow ® treatment, in contrast to EyeGiene ® and Blephasteam ®. Prospective, non‐controlled (including patients who participated in the trial by Finis et al. [2014] above) MGD is the main cause of evaporative dry eye disease (DED), the most prevalent type of DED. Additionally, MGD is present in some cases of aqueous-deficiency DED [ 2]. DED is an ocular surface anomaly whose prevalence ranges from 5 to 50% worldwide, and it is associated with limitations in performing activities of daily life and even sometimes with depression [ 6, 7]. Therefore, it is important to properly manage MGD.

Rong B, Tang Y, Tu P, et al. Intense pulsed light applied directly on eyelids combined with meibomian gland expression to treat meibomian gland dysfunction. Photomed Laser Surg. 2018;36(6):326–32.This study aims to evaluate the relationship between application of the MGDRx thermal eyebag and dry eye signs and symptoms in young and older subjects and to compare the results between the two groups.