Warm Compresses With Massage Raise Risk for Corneal Damage

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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.

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1. 对眼睛进行热敷会增加眼睛受伤的风险吗？

2. 这项前瞻性研究表明，在健康成年人中，通过热敷和最小压力，可将大量热量传递至角膜。作者指出，角膜温度升高会增加对机械损伤的敏感性。

3. 医生可能会警告患者在热敷后进行眼睑按摩，尤其是那些角膜较薄的患者，例如圆锥角膜或近视患者。

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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在许多眼科疾病中，在温和压力下施加温热敷布可用于治疗。最近的研究结果报道，在伴有眼部或眼睑按摩的情况下，热敷可引起角膜地形不规则，视觉和/或屈光改变。此外，文献综述表明，与单独施加压力相比，施加压力的热量可引起角膜表面不对称性或规则性指数的更大变化。

这项研究量化了在对12位健康成年人（平均年龄，37岁）的闭合右眼施加最小压力的情况下，在热敷过程中角膜温度的变化。将压缩物加热至45°C并施加2分钟，然后将其取出，用红外高温计测量眼睛和角膜的温度，然后更换新加热的压缩物。在30分钟的时间内重复进行2分钟的温度测量和热敷更换循环。左眼用作未经处理的对照。

在施加热敷物和最小压力的过程中，盖和角膜的温度显着升高。平均最高上眼睑最高温度和中央角膜温度分别为42.2°C和39.4°C，分别在6分钟和8分钟时达到；两种温度均显着高于各自的平均基线温度35.4°C和35.9°C（P <.0001）。在对照眼中观察到的基线没有明显的眼睑或角膜表面温度变化，并且在测试眼和对照眼之间基线温度值没有明显差异。

这项小型研究表明，通过施加热敷和最小压力，可将大量热量传递至角膜。如果使用连续加热方法来保持敷布的热量，则有可能在较短的时间内达到较高的温度。

总结：眼睛热敷和按摩不能同时进行，否则会影响角膜。建议热敷后等待10分钟，等温度冷却后再挤压按摩。