I remember the late Mrs Diggle, a patient I looked after around the turn of the millennium,” says Professor Teifi James. “She said to me, as her ophthalmic surgeon: ‘What you’re telling me to do is rubbish. You’re saying use a warm compress – a flannel – but it doesn’t work!’” She was not alone in her view – she spoke for many. It was clear that something more convenient, safe and effective was required.

Over the next year or two, Teifi set to work on developing a more sophisticated and user-friendly version of the hot flannel compress, resulting in the launch of the EyeBag in 2005. 

Necessity is the mother of invention, a truth not lost on Teifi. “I wanted to provide a more sophisticated 21st-century reusable hot compress, one that would overcome all the drawbacks and flaws of the hot wet flannel. Patient convenience was paramount. Providing a convenient, safe, effective and less messy alternative was always going to improve compliance.”

Teifi points out that the simple act of applying a warm compress can be incredibly effective at relieving not only blocked meibomian glands but also pressure on professional time.  

In a specialism replete with high-technology devices, medications and procedures, hot compresses are relatively simple in their mechanism of action. 

Now retired, Teifi explains that many people with dry eye symptoms have clogged-up meibomian glands, or meibomian gland dysfunction (MGD). Meibomian glands sit within the eyelids, their openings on the edges of the lid margins, and they naturally produce oils that prevent the tear film from drying out. “For various reasons, often due to diet and lifestyle, the meibomian glands block up, and the stuff in them becomes more viscous, like grease rather than oil.”

The warmth applied to the eyelids needs to raise the eyelid temperature from its usual 34-35°C to 40°C or more for around five minutes, which softens the grease, allowing it to be expressed and unblocking the gland orifices. “It needs to be wiped away while still warm and soft,” Teifi explains, adding that “a standard DIY hot wet flannel compress does not deliver this sustained raised temperature whereas commercial warm compresses do”.