Thermal massager effective for easing symptoms of dry eye

By Anne Harding

NEW YORK (Reuters Health) - A thermal massage device is as effective as artificial tears for treating dry eye, a new trial demonstrates.

Objective measures found the two treatments had similar effects, but patients gave the massager higher subjective ratings, Dr. Ji Eun Lee of Pusan National University in South Korea and colleagues found.

The prevalence of dry eye may be as high as 35% in some populations, Dr. Lee and colleagues note, and the condition is becoming more common. Recent findings have suggested that thermodynamic treatment can be helpful, but the devices have not yet been tested in a clinical trial.

In the current study, published online October 16 in the British Journal of Ophthalmology, the researchers randomly assigned 95 patients to four weeks of treatment with the Nurieye-5800 (Seodong Medical, Busan, South Korea) or artificial tears. Patients in the device group used it twice daily for 15 minutes, while patients in the artificial tears group were instructed to treat their eyes five times a day with 0.1 percent sodium hyaluronate solution. Patients with peripheral retinal degeneration that could predispose them to retinal detachment were excluded from the study.

The device delivers vibration, massage and thermotherapy, with five minutes each of two components combined: vibration and thermotherapy, vibration and massage, and massage and thermotherapy.

Both groups showed symptom improvements, with Ocular Surface Disease Index scores dropping from 60 to 27 at four weeks in the device group and from 56 to 34 in patients getting artificial tears. The improvement was significantly greater in the device group (p=0.032). Patients in the two groups also showed a similar degree of improvement in tear break-up time and fluorescein staining. Other measures were not significantly different between the two groups.

There are several mechanisms through which thermal massage could be helpful for dry eye symptoms, Dr. Lee told Reuters Health. First, he explained, vibration and massage can ease inflammation by enhancing vagus nerve activity.

"Second, ocular irritation, one of the disturbing symptoms of dry eye, can be decreased through the analgesic effects of thermotherapy. Heat also acts selectively on tissue and free nerve endings, directly or indirectly reducing pain. These aspects may explain the superior results in subjective symptoms," Dr. Lee said in an email. "Third, thermotherapy and massage using this equipment can facilitate meibomian gland secretion and protect the aqueous layer from too-rapid evaporation. Especially when the temperature surrounding the ocular surface is raised through thermotherapy, abnormal meibomian lipids can melt and form the lipid layer of the tear film."

Given that the thermal massager's mechanism of action is different from that of artificial tears, Dr. Lee added, they could be used as combination treatment, which would be especially useful in patients with meibomian gland dysfunction.

Six of the 41 patients in the device group experienced one or more adverse, compared to two of the 45 patients who got artificial tears, but there were no significant differences.

The study was funded by Seodong Medical, the maker of Nurieye-5800, and the Korean government's Korean Health Technology R&D Project.

SOURCE: http://bit.ly/1bl33Vj

Ophthalmology 2013.

(c) Copyright Thomson Reuters 2013. Click For Restrictions - http://about.reuters.com/fulllegal.asp