Immediate Effects Of A Single-Session Eyelid Massage Device On Symptoms And Tear Film Stability In Patients With Blepharitis–Associated Dry Eye Disease And Blepharitis: A Proof-Of-Concept Study

Dry eye disease and blepharitis are common ocular surface disorders that significantly impair patients’ quality of life. Meibomian gland dysfunction, particularly in aging populations, disrupts tear film stability and contributes to persistent ocular discomfort. Eyelid hygiene, warm compresses, and mechanical massage can improve gland secretion, yet conventional treatments are often insufficient. Eyelid massage devices have recently emerged, but evidence on single-session effects remains limited. This study aims to evaluate the immediate impact of a single eyelid massage on symptoms and tear film stability, while suggesting its potential future role in supporting ocular surface health and optimizing ocular parameters before surgery.

This study was conducted at the Ophthalmology Outpatient Clinic, Atatürk University Faculty of Medicine, Erzurum, Turkey, including patients aged 18–60 years diagnosed with meibomian gland dysfunction and blepharitis presenting with dry eye symptoms. The treatment group received a single session of eyelid massage in addition to conventional therapy, while the control group was followed with conventional therapy alone under standard outpatient conditions.

This prospective, randomized interventional study included 40 participants aged 18–60 years with blepharitis -associated dry eye disease, 20 in the treatment group and 20 in the control group.All completed the OSDI questionnaire and underwent ophthalmologic examination including MGD score, lid margin score, Oxford staining, tear break-up time (TBUT,pre- and post), Schirmer test, and VAS comfort assessment.The control group received conventional therapy alone, while the treatment group received a single 5-minute eyelid massage session using the NURIEYE device (high temperature–15 massage mode) plus conventional therapy.Data were analyzed using SPSS;p<0.05 was considered significant.The study was approved by the local ethics committee.

The study sample included both sexes, with a mean age of 42.53 ±15.63 years; both groups were homogenous in age and sex. Age correlated positively with lid margin score (r = 0.319, p = 0.045) and MGD score (r = 0.446, p = 0.004), but not with Schirmer test, OCSS, TBUT (pre/post), OSDI pre, or VAS post (p> 0.05).Post-treatment TBUT negatively correlated with lid margin score (r = -0.501, p = 0.024).Pre-treatment TBUT showed a weak-to-moderate negative correlation with MGD score (r =-0.478, p = 0.002).No correlations were found between TBUT and OSDI or VAS comfort.Mean VAS comfort was 7.95 ± 1.54 in the massage group versus 6.00 ± 1.62 in controls (p <0.001). Pre- and post-massage TBUT increased from 4.10 ± 1.77 s to 7.60 ± 2.96 s (p <0.001).

Age was not directly associated with tear production, ocular surface staining, tear stability, or subjective symptoms, but its association with lid margin and meibomian gland health highlights the need to consider age in evaluations.Participants in the massage group had significantly higher VAS scores than controls, showing that a single session of eyelid massage effectively improved perceived comfort.Tear stability was also significantly enhanced in blepharitis-associated dry eye, suggesting short-term therapeutic benefit.Future larger studies are warranted to confirm these findings and further explore its potential to optimize ocular surface parameters, including intraocular lens measurements, prior to cataract and refractive surgery.