Scientific References on Thermotherapy and Dry Eye
📚 Scientific References on Thermotherapy and Dry Eye
IRIO ONE is based on thermotherapy protocols recognized by international ophthalmological societies.
25 peer-reviewed studies support our educational content on dry eye, Meibomian gland dysfunction, and thermotherapy.
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1️⃣ International Consensus on Dry Eye (3 studies)
TFOS DEWS II Management and Therapy Report (2017)
Summary:
The international consensus TFOS DEWS II (Tear Film & Ocular Surface Society - Dry Eye Workshop) establishes that thermotherapy between 40-45°C is one of the recommended therapeutic options for the treatment of Meibomian gland dysfunction (MGD).
This report, prepared by a panel of international experts in ophthalmology, analyzes more than 1000 scientific studies on dry eye and establishes the basis for modern treatment of this condition.
"Applying heat to the eyelids helps liquefy thickened meibomian lipids, facilitating their expression and improving the quality of the tear film."
TFOS DEWS II Definition and Classification Report (2017)
Summary:
This report officially defines dry eye as "a multifactorial disease of the ocular surface characterized by a loss of tear film homeostasis." It classifies dry eye into two main types: evaporative (caused primarily by gestational diabetes mellitus) and aqueous-deficient.
Evaporative dry eye caused by Meibomian dysfunction accounts for the majority of dry eye cases in the general population.
TFOS DEWS II Epidemiology Report (2017)
Summary:
A global epidemiological analysis establishes the prevalence of dry eye as being between 5-50% of the population, depending on the region and risk factors. It identifies age, female gender, screen use, and contact lens use as the main risk factors.
The prevalence of dry eye is increasing globally, especially in young populations due to the intensive use of digital devices.
2️⃣ Thermotherapy for Meibomian Dysfunction (4 studies)
Blackie et al. (2014) - Vectored Thermal Pulsation
Summary:
This clinical study evaluated the effect of applying controlled heat for 15 minutes in patients with Meibomian gland dysfunction. Patients were followed for 1 month to assess the duration of the benefits.
The results showed significant improvements in meibomian gland secretion quality, a reduction in dry eye symptoms, and improved glandular function. The study concluded that regular 15-minute thermotherapy sessions may contribute to the management of gestational diabetes mellitus (GDM).
Wang et al. (2015) - Confocal Microscopy of Meibomian Glands
Summary:
Study that used in vivo confocal microscopy to evaluate morphological changes in Meibomian glands after different treatments, including thermotherapy.
Thermotherapy showed observable improvements in glandular morphology, Meibomian gland density, and secretory function. Researchers confirmed that controlled application of heat can help restore the function of blocked glands.
Geerling et al. (2011) - TFOS MGD Workshop: Treatment
Summary:
International consensus on the management of Meibomian gland dysfunction establishes thermotherapy as a first-line treatment for MGD. It defines the optimal parameters of temperature (40-45°C) and duration (10-15 minutes).
Thermotherapy is most effective when applied regularly and consistently, compared to traditional compresses that lose temperature quickly.
Tomlinson et al. (2011) - TFOS MGD Workshop: Tear Film & Lipids
Summary:
Detailed analysis of the composition of the tear lipid layer and how Meibomian gland dysfunction affects its quality. Explains the mechanism by which heat liquefies thick secretions.
Meibomian secretions have a melting point around 32-35°C, but in DMG this point increases, requiring temperatures of 40-45°C to liquefy them effectively.
3️⃣ Epidemiology and Prevalence of Dry Eye (3 studies)
Lemp et al. (2012) - Distribution of Dry Eye Types
Summary:
A retrospective study analyzed 5,694 patients with dry eye to determine the distribution of types. It found that 86% of patients with dry eye had an evaporative component caused by Meibomian gland dysfunction.
Meibomian dysfunction is present in the vast majority of cases of dry eye, even when other contributing factors are present.
Nichols et al. (2011) - TFOS MGD Workshop: Executive Summary
Summary:
Executive summary of the international consensus on Meibomian Dysfunction. It states that MGD is extremely common in the general population and is the leading cause of evaporative dry eye.
The prevalence of GDM increases significantly with age, affecting more than 60% of people over 60 years old.
Bron et al. (2007) - Diagnostic Methodologies
Summary:
Comprehensive review of diagnostic methodologies for dry eye, including symptom assessment, tear break-up time (BUT), Schirmer test, and Meibomian gland assessment.
Symptoms of dry eye (dryness, burning, foreign body sensation, intermittent blurred vision) are reliable indicators of the condition and should be systematically evaluated.
4️⃣ Contact Lenses and Dry Eye (4 studies)
Nichols & Sinnott (2006) - Contact Lens Dry Eye
Summary:
A study identified that approximately 50% of contact lens wearers report symptoms of dry eye. It analyzes risk factors including contact lens type, hours of wear, and Meibomian gland condition.
Pre-existing Meibomian dysfunction is a major risk factor for developing contact lens intolerance.
Dumbleton et al. (2011) - Lens Replacement Compliance
Summary:
Analysis of the relationship between contact lens replacement frequency and dry eye symptoms. It found that 12-51% of users discontinue contact lenses due to dryness and discomfort.
Daily disposable contact lenses cause fewer dry eye problems than monthly or annual contact lenses.
Stapleton et al. (2006) - Silicone Hydrogel Lenses
Summary:
Review of silicone hydrogel contact lenses and their impact on the ocular surface. Analyzes how oxygen permeability (Dk/t) affects the development of dry eye.
Contact lenses with a higher Dk/t (>100) cause less corneal hypoxia and less dryness, but do not eliminate the risk of dry eye.
Efron et al. (2002) - Oxygen Permeability
Summary:
A technical study on the properties of modern contact lenses establishes that lenses with a Dk/t <30 have a higher risk of complications, including dry eye.
5️⃣ Eye Strain and Screens (5 studies)
Sheppard & Wolffsohn (2018) - Digital Eye Strain
Summary:
A systematic review on digital eye strain establishes that 70-90% of workers who use screens experience symptoms. It identifies dry eye as a major component of computer vision syndrome.
Eye strain is directly related to reduced blinking and the development of dry eye during screen use.
Rosenfield (2011) - Computer Vision Syndrome
Summary:
Comprehensive review of computer vision syndrome that defines its ocular causes (dry eye, refractive problems, accommodation problems) and potential treatments.
Computer vision syndrome is a multifactorial condition, but dry eye due to reduced blinking is the most common component.
Blehm et al. (2005) - Computer Vision Syndrome Survey
Summary:
An epidemiological survey found that up to 90% of computer users develop symptoms of eye strain at some point. Identify the main symptoms and risk factors.
Tsubota & Nakamori (1993) - Blink Rate and VDT
Summary:
Pioneering study that showed that screen use reduces blink rate from 15-20 blinks/minute to only 5-7 blinks/minute.
Reduced blinking during screen use is the main mechanism by which screens cause dry eye.
Portello et al. (2013) - Incomplete Blinks
Summary:
A study found that during screen use, not only is the frequency of blinking reduced, but many blinks are also incomplete (they do not completely close the eye), worsening lubrication.
6️⃣ Chalazion and DMG (2 studies)
Gilchrist et al. (2009) - Chalazion Clinical Review
Summary:
Clinical review of chalazion that establishes its definition, causes, symptoms, and treatments. Identifies Meibomian gland obstruction as the main cause.
A chalazion is a manifestation of Meibomian gland dysfunction, and treatment of the underlying gestational diabetes mellitus (GDM) is essential to prevent recurrences.
Lindsley et al. (2017) - Chalazion Interventions
Summary:
A Cochrane review on interventions for chalazion found that applying heat is the most effective conservative treatment.
Regular thermotherapy may help prevent recurrent chalazia by improving the function of the Meibomian glands.
7️⃣ Blurred Vision and Tear Film (3 studies)
Tutt et al. (2000) - Tear Break-Up and Vision
Summary:
A study demonstrated that tear film rupture causes optical aberrations resulting in intermittent blurred vision. It measured the visual impact of tear break-up using aberrometry.
The tear film acts as the eye's first refractive surface. When it breaks down, it causes immediate visual distortions.
Koh et al. (2002) - Higher-Order Aberrations
Summary:
A study that used wavefront sensors to measure how tear break-up increases higher-order optical aberrations, affecting visual quality.
Tear break-up causes an immediate and significant increase in aberrations, explaining why vision temporarily improves when blinking.
Goto et al. (2003) - Evaporation Dynamics in MGD
Summary:
A study measuring tear evaporation rate in people with and without Meibomian gland dysfunction found that in MGD, evaporation is 3-4 times faster.
Accelerated evaporation in DMG explains why the tear film breaks down so quickly, causing frequent blurred vision.
8️⃣ Complementary Treatments (1 study)
Bhargava et al. (2015) - Omega-3 for CVS
Summary:
A clinical study that evaluated the effect of omega-3 supplements in patients with dry eye related to computer vision syndrome found significant improvements in dry eye symptoms and signs.
Omega-3 supplements (1000-2000 mg EPA+DHA/day) can improve the quality of meibomian secretions and reduce dry eye symptoms in 2-3 months.
🏛️ Recommendations from Ophthalmological Societies
The following international organizations recognize thermotherapy as a therapeutic option for Meibomian gland dysfunction:
American Academy of Ophthalmology (AAO)
The AAO mentions in its clinical guidelines that applying heat to the eyelids can help improve the function of the Meibomian glands.
Tear Film & Ocular Surface Society (TFOS)
TFOS established in its DEWS II consensus (2017) that thermotherapy between 40-45°C is one of the recommended options for DMG.
Spanish Society of Ophthalmology (SEO)
The SEO recognizes thermotherapy as part of the therapeutic arsenal for the management of evaporative dry eye caused by DMG.
🔬 How does IRIO ONE apply these protocols?
IRIO ONE is designed to apply constant heat at 42°C for 15 minutes , following the parameters mentioned in the ophthalmological literature:
- Temperature: 42°C (within the 40-45°C range recommended by TFOS DEWS II)
- Duration: 15 minutes (standard protocol according to Blackie et al. 2014)
- Consistency: Uniform heat without temperature loss (vs. traditional compresses that lose heat in 2-3 minutes)
In addition, IRIO ONE combines thermotherapy with gentle micro-vibrations to promote the expression of meibomian oils.
⚖️ Legal Notice
IRIO ONE is an eye wellness product inspired by these scientific protocols.
IRIO ONE is not a medical device and is not intended to diagnose, treat, cure or prevent any disease.
If you experience symptoms of dry eye, consult an ophthalmologist for proper diagnosis and treatment.
The scientific references presented on this page are for informational and educational purposes. They support our blog content but do not constitute a guarantee of specific results with the use of IRIO ONE.
📚 Complete Bibliographic References
- Jones L, Downie LE, Korb D, et al. TFOS DEWS II Management and Therapy Report. Hidden Surf . 2017;15(3):575-628.
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Hidden Surf . 2017;15(3):276-283.
- Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II Epidemiology Report. Hidden Surf . 2017;15(3):334-365.
- Blackie CA, Coleman CA, Holland EJ. Vectored thermal pulsation for MGD. Clin Ophthalmol . 2014;8:589-593.
- Wang MTM, Jaitley Z, Lord SM, Craig JP. Confocal microscopy of meibomian glands. Br J Ophthalmol . 2015;99(12):1680-1685.
- Geerling G, Tauber J, Baudouin C, et al. TFOS MGD Workshop: Treatment. Invest Ophthalmol Vis Sci . 2011;52(4):2050-2064.
- Tomlinson A, Bron AJ, Korb DR, et al. TFOS MGD Workshop: Tear film lipids. Invest Ophthalmol Vis Sci . 2011;52(4):1979-1993.
- Lemp MA, Crews LA, Bron AJ, et al. Distribution of dry eye types. Cornea . 2012;31(5):472-478.
- Nichols KK, Foulks GN, Bron AJ, et al. TFOS MGD Workshop: Executive summary. Invest Ophthalmol Vis Sci . 2011;52(4):1917-1929.
- Bron AJ, Abelson MB, Ousler G. Diagnostic methodologies for dry eye. Hidden Surf . 2007;5(2):108-152.
- Nichols JJ, Sinnott LT. Contact lens dry eye factors. Invest Ophthalmol Vis Sci . 2006;47(4):1319-1328.
- Dumbleton K, Woods C, Jones L, Fonn D. Lens replacement compliance. Cont Lens Anterior Eye . 2011;34(3):114-119.
- Stapleton F, Stretton S, Papas E, et al. Silicone hydrogel lenses. Hidden Surf . 2006;4(1):24-43.
- Efron N, Morgan PB, Katsara SS. Oxygen permeability of lenses. CLAO J. 2002;28(4):177-182.
- Sheppard AL, Wolffsohn JS. Digital eye strain. BMJ Open Ophthalmol . 2018;3(1):e000146.
- Rosenfield M. Computer vision syndrome review. Ophthalmic Physiol Opt . 2011;31(5):502-515.
- Blehm C, Vishnu S, Khattak A, et al. CVS review. Surv Ophthalmol . 2005;50(3):253-262.
- Tsubota K, Nakamori K. Dry eyes and VDT. N Engl J Med . 1993;328(8):584.
- Portello JK, Rosenfield M, Chu CA. Blink rate and CVS. Optom Vis Sci . 2013;90(5):482-487.
- Gilchrist H, Lee G. Chalazion clinical review. Clin Exp Optom . 2009;92(5):390-394.
- Lindsley K, Nichols JJ, Dickersin K. Chalazion interventions. Cochrane Database Syst Rev. 2017;1:CD007742.
- Tutt R, Bradley A, Begley C, Thibos LN. Tear break-up and vision. Invest Ophthalmol Vis Sci . 2000;41(13):4117-4123.
- Koh S, Maeda N, Hori Y, et al. Tear break-up aberrations. Am J Ophthalmol . 2002;134(1):115-117.
- Goto E, Endo K, Suzuki A, et al. Tear evaporation in MGD. Invest Ophthalmol Vis Sci . 2003;44(2):533-539.
- Bhargava R, Kumar P, Kumar M, et al. Omega-3 for CVS dry eye. Cont Lens Anterior Eye . 2015;38(3):206-210.
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