Impact of Cold Compression with Blink Exercise on Tear Production Among Dry Eye Syndrome: A Narrative Review


Authors : Poonam Thakur; Dr. R. SreeRaja Kumar; Dr. Imran Khan

Volume/Issue : Volume 10 - 2025, Issue 12 - December


Google Scholar : https://tinyurl.com/5cwppfms

Scribd : https://tinyurl.com/4bfkx6vn

DOI : https://doi.org/10.38124/ijisrt/25dec083

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : The multifaceted ocular disorder known as dry eye syndrome (DES) that leads to eye pain, eye irritation, redness, impaired vision, and eye fatigue. It drastically lowers quality of life for millions of people globally. Age, extended use of digital screens, using contact lenses, environmental variables, and systemic disorders are important risk factors. Artificial tears, lubricating drops, and lifestyle changes are the mainstays of conventional therapy, but safe, economical, non-pharmacological alternatives are becoming more and more popular. Among these, cold compression helps reduce ocular inflammation, improve periocular blood circulation, and lessen discomfort, while blink exercises help increase tear secretion, stabilise the tear film, and minimise evaporation. However, nothing is known about how blink exercises and cold compression work together to improve tear production, tear film stability, and symptom alleviation. A narrative review was conducted using cold compression with blink exercise on tear production among dry eye syndrome. The result of reviewed studies represents that around 36 studies narratively reviewed and according to inclusion criteria the study scrutinized, and narrowed down to 12 recent studies under which 6 studies showed that participants using the gel ice pack showed a much greater increase in tear production. Furthermore studies with Cold compresses proved to be an effective and affordable alternative to artificial tears for managing dry eye symptoms with assessment tool including Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), and Schirmer’s test. Furthermore 6 studies including and showing there were significant gains from the blinking and squeezing sessions. The palpebral fissure's height increased, the rate of incomplete blinks decreased, and the tearing resilience was improved as shown by extended as demonstrated by prolonged NIBUT testing and decreased the eye-strain (VAS) and eye-dryness (SPEED) scores. When compared to the control group, each of these modifications was statistically significant. With the above mentioned studies researcher is convinced that cold compression and blinking exercise helps in reduce dry eye syndrome and improve tear production which researcher carry forward for further experimentation. Narrative review concluded that cold compression and blink exercise improves tear production and improve dry eye syndrome. Hence this can be generalised to larger population covering SDG goal 3.8, 3.9, 3D.

Keywords : Effectiveness, Cold Compression, Tear Film Dysfunction, Blink Exercise.

References :

  1. A D Kim 1, A Muntz. Therapeutic benefits of blinking exercises in dry eye disease. Cont Lens Anterior Eye. 2021 Jun;44(3):101329.  doi: 10.1016/j.clae.2020.04.014. Epub 2020 May 12. Available at:  https://pubmed.ncbi.nlm.nih.gov/32409236/
  2. Amal Hashem Mohamed, Soher Ahmed Awad. Effect of Blinking Exercises on Eye Dryness and Quality of Life for Elderly People. Assiut Scientific Nursing Journal.  Volume & Issue: Volume 12, Issue 45 - Serial Number 1, July 2024, Pages 1-200  Available at :https://asnj.journals.ekb.eg/article_373149.html
  3. Andrew Kao; Robert Latkany. Use of Artificial Tears vs Cold Compresses for the Treatment of Dry Eye. Investigative Ophthalmology & Visual Science June 2013, Vol.54, 6052. doi: https://iovs.arvojournals.org/article.aspx?articleid=2151062
  4. Dikchhya Sharma 1, Sabina Shrestha. Dry Eyes among Visual Display Terminal Users Visiting the Outpatient Department of Ophthalmology of a Tertiary Care Centre.  Nepal Med Assoc 2023 Oct 31;61(266):803–806. doi: 10.31729/jnma.8307 https://pmc.ncbi.nlm.nih.gov/articles/PMC10579771
  5. Fatma Khalil Abd Elhamed, 2Laila Awadin Ali Hassan. Effects of Blinking Exercise Application on Anxiety and Eye Dryness among Elderly Patients. Egyptian Journal of Health Care, June 2024 EJHC Vol. 15 No. 2 Available at: https://ejhc.journals.ekb.eg/article_378174_b89b349e0fb62aea0e4c9c4c062a179f.pdf
  6. James S Wolffsohn 1, Sònia Travé-Huarte . Optimisation of blinking exercises for dry eye disease. Cont Lens Anterior Eye . 2025 Oct;48(5):102453. doi: 10.1016/j.clae.2025.102453. Epub 2025 Jun 3. doi: 10.1016/j.clae.2025.102453. Epub 2025 Jun 3. Available at  https://pubmed.ncbi.nlm.nih.gov/40467388/
  7. Paramdeep Bilkhu a, James Wolffsohn . Investigating the subjective cooling effect of eyelid cleansing gel on eyelid and ocular surface temperature. Contact Lens and Anterior Eye. Volume 42, Issue 4, August 2019, Pages 411-414 https://www.sciencedirect.com/science/article/abs/pii/S136704841830897X
  8.  R.Balamurgan, Phulen Sarma. A simple method (Schirmer iv) to stimulate reflex tear volume secretion by application of of gel ice pack on the closed eyelid in dry eye patients. IHOPE Journal Of Opthalmology.3(2);45-51 doi: 10.252559/IHOPEJO_11_2024
  9. Reiko Arita , Shima Fukuoka. Effects of blinking exercises on palpebral fissure height and tear film parameters. Ocul Surf. 2025 Apr:36:237-243. doi: 10.1016/j.jtos.2025.02.003. Epub 2025 Feb 5.  Available at https://pubmed.ncbi.nlm.nih.gov/39920919/
  10. Siman Arnold Xavier, Praisy Elina Thomas. The effect of I-blink exercises on dry eye among young adults. Global Journal For Research Analysis. DOI:  10.36106/gjra/9207898 Available at: https://www.researchgate.net/publication/394579207_THE_EFFECT_OF_I-BLINK_EXERCISES_ON_DRY_EYE_AMONG_YOUNG_ADULTS
  11. Smrithi Mani 1, Haoxing D Jin conducted study on Randomized Controlled Study of Cooled vs Room-Temperature Artificial Tears for Reducing Ocular Surface Irritation After Intravitreal Injection. Journal of  Vitreoretinal Disease. 2023 May 18;7(4):310–315. doi: 10.1177/24741264231175555 https://pmc.ncbi.nlm.nih.gov/articles/PMC10621712/
  12. Tadisina Sanjay Reddy , Prathima Linga. Study on association of dry eye disease (DED) with visual display terminal (VDT) use among medical college students. Indian Journal of Clinical and Experimental Ophthalmology. 2024;10(3):568–572 https://ijceo.org/archive/volume/10/issue/3/article/21657/pdf

The multifaceted ocular disorder known as dry eye syndrome (DES) that leads to eye pain, eye irritation, redness, impaired vision, and eye fatigue. It drastically lowers quality of life for millions of people globally. Age, extended use of digital screens, using contact lenses, environmental variables, and systemic disorders are important risk factors. Artificial tears, lubricating drops, and lifestyle changes are the mainstays of conventional therapy, but safe, economical, non-pharmacological alternatives are becoming more and more popular. Among these, cold compression helps reduce ocular inflammation, improve periocular blood circulation, and lessen discomfort, while blink exercises help increase tear secretion, stabilise the tear film, and minimise evaporation. However, nothing is known about how blink exercises and cold compression work together to improve tear production, tear film stability, and symptom alleviation. A narrative review was conducted using cold compression with blink exercise on tear production among dry eye syndrome. The result of reviewed studies represents that around 36 studies narratively reviewed and according to inclusion criteria the study scrutinized, and narrowed down to 12 recent studies under which 6 studies showed that participants using the gel ice pack showed a much greater increase in tear production. Furthermore studies with Cold compresses proved to be an effective and affordable alternative to artificial tears for managing dry eye symptoms with assessment tool including Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), and Schirmer’s test. Furthermore 6 studies including and showing there were significant gains from the blinking and squeezing sessions. The palpebral fissure's height increased, the rate of incomplete blinks decreased, and the tearing resilience was improved as shown by extended as demonstrated by prolonged NIBUT testing and decreased the eye-strain (VAS) and eye-dryness (SPEED) scores. When compared to the control group, each of these modifications was statistically significant. With the above mentioned studies researcher is convinced that cold compression and blinking exercise helps in reduce dry eye syndrome and improve tear production which researcher carry forward for further experimentation. Narrative review concluded that cold compression and blink exercise improves tear production and improve dry eye syndrome. Hence this can be generalised to larger population covering SDG goal 3.8, 3.9, 3D.

Keywords : Effectiveness, Cold Compression, Tear Film Dysfunction, Blink Exercise.

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