Ocular surface disease is complex issue that is commonly referred to as “Dry eye”, which is both chronic, and progressive. Many things can contribute to it including contact lens wear, advanced age, medications, health conditions and environmental factors. As a result, patients often require a custom treatment plan. IPL for treating dry eye has been a game changer, opening new options for patients who have tried drops without relief.
Being both chronic and progressive, ocular surface disease solutions that worked initially may not do the job anymore. Because of this, you want to manage both the signs and symptoms aggressively from the beginning to get ahead of the disease process. Ultimately, our goal is minimizing progression as much as possible. Initially intense pulse light, or IPL, was thought to be useful for advanced disease, but studies show it to be an important early step.
Meibomian gland dysfunction Next Step
Many patients start with artificial tear and hot compresses; if that’s not treating your symptoms intense pulse light may be a good next step. The artificial tear have their place but they only provide temporary relief of symptoms, but do nothing to treat the source of inflammation that causes symptoms. Warm compresses CAN help, but only if your in the early stages of meibomian gland dysfunction (MGD). Often at home heat treatment isn’t hot enough or targeted enough to break through the waxy built up blocking the glands. IPL addresses MGD more aggressively to provide both symptomatic relief as well as rehabilitates the ocular surface that no other treatment can accomplish.
Intense Pulse Light Repurposed for Dry Eye
This newer treatment is both, non-invasive and avoids medications. Dermatology used IPL for various skin conditions for 20+ years. Examples include the treatment of age spots, fine lines, rosacea and hair removal. Dermatologists noted that patients with such skin conditions, especially rosacea, reported improvement in their dry eye symptoms following treatment of nearby skin.
IPL treatment done in our office consists of 4 treatments over about 2-4 months. We insert shields on the eyes so we can treat both the lower lid AND the upper lid. Dr. Foster performs your initial treatments herself to ensure the ideal treatment is achieved. The light is bright but painless and you can leave the office with no down time; treatments take about 15-20 minutes. (More on what to expect here.)
How often do I need IPL repeated?
After the initial series of IPL treatments is completed, most people need occasional maintenance treatments annually or less frequent. The frequency of these maintenance treatments will depend on the severity of inflammation around your eyes. Dr. Foster may also recommend a combination of IPL with other treatments such as thermal expression, lid debridement or medications to provide the most effective management of one’s dry eye. IPL does a great job rehabilitating the ocular surface, but without maintenance treatments, your eye will gradually revert back to the way it was, or worse, progress further.
Review of how IPL treats the ocular surface
IPL treats dry eye through multiple pathways:
- Heats the oil glands that line the lids, liquefying the hardened oils within.
- Liquid oil expressed: open glands are functional glands
- IPL energy absorbed by the blood vessels around the eyes, called telangiectasia, get knocking down, reducing how much inflammation leaks into the surrounding tissue
- Reduced bacterial load and Demodex mite on and around the eyelids, another source of ocular inflammation.
- There may also be some stimulation of the nerves around the eye, which can reduce symptoms of dry eye.
Want to know more about how intense pulse light works, see our original article.
Don’t suffer in silence! If you still have symptoms after trying things like artificial tears and hot compresses, schedule a visit our dry eye specialist Dr. Foster. She specializes in the treatment and management of dry eye and will customize a plan to address your needs.
Call or text us at 816-524-8900.
Posted June 2022 by Laura Nennig, OD; she specializes in contact lens fittings, with advanced training with scleral lenses including those used for dry eye treatment and has a passion for ocular wellness . She works closely with our resident dry eye specialist, Alyssa (Sherwood) Foster, OD.
