School of Optometry and Vision Science, University of New South Wales, Kensington 2052, Australia.
Cont Lens Anterior Eye. 2012 Aug;35(4):148-54. doi: 10.1016/j.clae.2012.01.001. Epub 2012 Feb 10.
To examine the role of elevated corneal temperature in the development of rubbing/massage-related corneal deformation and the possibility that warm compresses in the management of meibomian gland dysfunction or chalazion could contribute to such adverse responses.
With reference to reports of corneal deformation associated with meibomian gland dysfunction, chalazion, dacryocystoceles and post-trabeculectomy, the mechanisms for increased corneal temperature due to ocular massage, especially when combined with warm compresses are examined.
Several mechanisms for rubbing/massage to elevate corneal temperature have been described, apart from the application of warm compresses or other forms of heat.
Raised corneal temperature helps to explain corneal deformation which develops in association with rubbing or massage in conditions such as keratoconus, chalazion, post-trabeculectomy, post-laser assisted in situ keratomileusis, post-graft and dacryocystoceles. When combined with warm compresses or other methods of heat delivery to the eye, the elevation of corneal temperature appears to explain how meibomian gland dysfunction treatment involving warm compresses and massage could induce rubbing-related deformation. Patients whose management involves iatrogenic ocular massage appear to require screening for risk of corneal deformation. Risk may be increased for patients with a concurrent habit of rubbing their eyes abnormally in response to allergic itch for example. It appears to be possible to modify ocular massage techniques to reduce the risk of corneal deformation. Careful tutoring and follow-up using corneal topography appears to be required when massage is prescribed, especially when used in conjunction with heat application.
研究角膜温度升高在摩擦/按摩相关的角膜变形发展中的作用，以及在睑板腺功能障碍或霰粒肿治疗中使用热敷可能导致这种不良反应的可能性。
参考与睑板腺功能障碍、霰粒肿、泪囊炎和小梁切除术后相关的角膜变形报告，检查由于眼部按摩引起的角膜温度升高的机制，特别是当与热敷结合使用时。
除了使用热敷或其他形式的热之外，已经描述了几种摩擦/按摩来升高角膜温度的机制。
升高的角膜温度有助于解释在圆锥角膜、霰粒肿、小梁切除术后、激光辅助原位角膜磨镶术、移植后和泪囊炎等情况下与摩擦或按摩相关的角膜变形的发生。当与热敷或其他眼部热传递方法结合使用时，角膜温度的升高似乎解释了涉及热敷和按摩的睑板腺功能障碍治疗如何引起摩擦相关的变形。需要对接受医源性眼部按摩的患者进行筛查，以评估其角膜变形的风险。对于那些因过敏瘙痒等原因异常揉眼的患者，风险可能会增加。似乎可以通过修改眼部按摩技术来降低角膜变形的风险。在进行按摩治疗时，特别是在与热应用结合使用时，需要仔细的指导和使用角膜地形图进行随访。
