Warm Compresses With Massage Raise Risk for Corneal Damage

TAKE-HOME MESSAGE

1. Does applying a warm compress to eyes increase the risk of eye damage?

2. This prospective study demonstrated that significant heat is transferred to the cornea with the application of a warm compress and minimal pressure in healthy adults. The authors indicated that a rise in corneal temperature can increase susceptibility to mechanical trauma.

3. Physicians may caution patients about lid massage following warm compress application, especially those patients who have thinner corneas such as those with keratoconus or myopia.

回家留言

1. 對眼睛進(jìn)行熱敷會增加眼睛受傷的風(fēng)險嗎？

2. 這項前瞻性研究表明，在健康成年人中，通過熱敷和最小壓力，可將大量熱量傳遞至角膜。作者指出，角膜溫度升高會增加對機(jī)械損傷的敏感性。

3. 醫(yī)生可能會警告患者在熱敷后進(jìn)行眼瞼按摩，尤其是那些角膜較薄的患者，例如圓錐角膜或近視患者。

Summary

Warm compresses applied with gentle pressure are used therapeutically in many ophthalmic conditions. Results of recent studies have reported that topographic corneal irregularity and visual and/or refractive change may be induced with the application of warm compresses with accompanying ocular or lid massage. In addition, a literature review has suggested that, compared with the application of pressure alone, heat applied with pressure can induce greater changes in corneal surface asymmetry or regularity indices.

This study quantified the change in corneal temperature during warm compress application with minimal pressure to the closed right eyes of 12 healthy adults (mean age, 37 years). Compresses were heated to 45°C and applied for 2 minutes, after which time they were removed for temperature measurements of the eye and cornea with an infrared pyrometer, followed by replacement with a newly heated compress. The 2-minute cycles with temperature measurement and warm compress replacement were repeated over a 30-minute period. The left eye served as an untreated control.

Lid and corneal temperatures were significantly elevated during the application of warm compresses and minimal pressure. The mean maximum outer upper lid and central corneal temperatures were 42.2°C and 39.4°C, respectively, and were reached at 6 and 8 minutes; both temperatures were significantly higher than respective mean baseline temperatures of 35.4°C and 35.9°C (P < .0001). There were no significant lid or corneal surface temperature changes from baseline observed in control eyes, and baseline temperature values did not differ significantly between test eyes and control eyes.

This small study showed that there is significant heat transfer to the cornea with the application of warm compresses and minimal pressure. Should continuous heating methods be used to maintain the heat of the compress, there is potential for higher temperatures to be reached over a shorter time period.

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在許多眼科疾病中，在溫和壓力下施加溫?zé)岱蟛伎捎糜谥委?。最近的研究結(jié)果報道，在伴有眼部或眼瞼按摩的情況下，熱敷可引起角膜地形不規(guī)則，視覺和/或屈光改變。此外，文獻(xiàn)綜述表明，與單獨(dú)施加壓力相比，施加壓力的熱量可引起角膜表面不對稱性或規(guī)則性指數(shù)的更大變化。

這項研究量化了在對12位健康成年人（平均年齡，37歲）的閉合右眼施加最小壓力的情況下，在熱敷過程中角膜溫度的變化。將壓縮物加熱至45°C并施加2分鐘，然后將其取出，用紅外高溫計測量眼睛和角膜的溫度，然后更換新加熱的壓縮物。在30分鐘的時間內(nèi)重復(fù)進(jìn)行2分鐘的溫度測量和熱敷更換循環(huán)。左眼用作未經(jīng)處理的對照。

在施加熱敷物和最小壓力的過程中，蓋和角膜的溫度顯著升高。平均最高上眼瞼最高溫度和中央角膜溫度分別為42.2°C和39.4°C，分別在6分鐘和8分鐘時達(dá)到；兩種溫度均顯著高于各自的平均基線溫度35.4°C和35.9°C（P <.0001）。在對照眼中觀察到的基線沒有明顯的眼瞼或角膜表面溫度變化，并且在測試眼和對照眼之間基線溫度值沒有明顯差異。

這項小型研究表明，通過施加熱敷和最小壓力，可將大量熱量傳遞至角膜。如果使用連續(xù)加熱方法來保持敷布的熱量，則有可能在較短的時間內(nèi)達(dá)到較高的溫度。

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總結(jié)：眼睛熱敷和按摩不能同時進(jìn)行，否則會影響角膜。建議熱敷后等待10分鐘，等溫度冷卻后再擠壓按摩。