Abstract
Menthol is thought to stimulate lacrimation via activation of cold-sensitive primary afferent neurons in the cornea. We evaluated a warm compress containing menthol as a potential treatment for dry eye by examining its effects on the tear film in healthy subjects (n = 20) and dry eye patients (n = 35). Disposable eyelid-warming steamers that either did (MH) or did not (HO) contain menthol were applied to one eye of each subject either once only for 10 min or repeatedly over 2 weeks. Single application of MH significantly increased tear meniscus volume (P = 8.6 × 10−5, P = 1.3 × 10−5) and tear film breakup time (P = 0.006, P = 0.002) as well as improved meibum condition in healthy subjects and dry eye patients, respectively. Repeated application of MH significantly increased tear meniscus volume (P = 0.004, P = 1.7 × 10−4) and tear film breakup time (P = 0.037, P = 0.010) in healthy subjects and dry eye patients, respectively. Repeated application of MH thus induced persistent increases in tear fluid volume and tear film stability in dry eye patients, suggesting that repeated use of a warm compress containing menthol is a potential novel treatment for dry eye disease.
Highlights
Subjects Healthy Dry eye Healthy Dry eye Healthy Dry eye Healthy Dry eye artificial tears, hyaluronate, diquafosol sodium chloride, or rebamipide, with the aim of increasing the volume of tear fluid or tear film stability[14]
Tear meniscus volume (TMV) was significantly increased after MH application in both healthy subjects and dry eye patients, but it was not increased after HO application in either group
We have here shown that single application of a disposable eyelid-warming device containing menthol (MH) increased TMV and prolonged tear film breakup time (BUT) in both dry eye patients and healthy subjects, whereas single application of a similar device without menthol (HO) had no such effects
Summary
Subjects Healthy Dry eye Healthy Dry eye Healthy Dry eye Healthy Dry eye artificial tears, hyaluronate, diquafosol sodium chloride, or rebamipide, with the aim of increasing the volume of tear fluid or tear film stability[14]. Previous studies have assessed the effects of various warming devices—including infrared devices[16,17], a disposable eyelid-warming device[18], warm moist air devices[19,20,21], an Orgahexa fiber eye mask[22], Blephasteam[23], MGDRx EyeBag[24,25], Azuki-no-chikara[26], and LipiFlow27—on tear function and the ocular surface. The purpose of the present study was to investigate the effects of a disposable eyelid-warming steamer containing menthol (MH) on tear film function, meibomian glands, and the ocular surface in individuals with dry eye. We first examined the effects of a single application of MH and of a similar device without menthol (HO) in healthy subjects and dry eye patients. We examined the effects of repeated warming with the two devices over a period of 2 weeks
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