Dry eye disease is a chronic, progressive condition. It has multiple causes such as contact lens wear, advanced age, medications, medical conditions and environmental conditions to name a few. As a result, patients often require treatment that is tailored to their specific signs and symptoms.
Being a chronic and progressive disease, what once worked for a patient may not do the job in the future. This is also a reason that you want to manage both the signs and symptoms aggressively from the beginning to stay ahead of the disease process, minimizing progression as much as possible.
One treatment that is beneficial to many with dry eye that goes beyond the use of artificial tears and medications is IPL, Intense Pulse Light. IPL is used in a variety of situations in skin care such as the treatment of fine lines and wrinkles and hair removal. It was observed that patients with dry eye that underwent IPL for such skin care conditions reported an improvement in their dry eye symptoms.
Dr. Roland Toyos of Memphis, TN spearheaded investigation into IPL as a treatment for dry eye. Summit Eye Center followed this research closely and was one of the first practices in Kansas City to offer IPL as a treatment to its dry eye patients.
IPL treats dry eye with a multifaceted approach. First, IPL heats the oil glands that line the lids, liquefying the hardened oils within. The doctor will then express these glands at the conclusion of the treatment to help restore normal oil flow into the tear film. This oil is an important component of our natural tear film. Also, IPL energy is absorbed by the blood vessels around the eyes. This shrinks abnormal blood vessels and minimizes the inflammatory cells that trigger dry eye. There is also a reduction in the microbial flora and Demodex mite loads at the eyelids, which improves dry eye. In addition, there may be some stimulation of the nerves that line the treatment area, which aids in the treatment of dry eye.
The IPL treatment is done in the office and consists of 4 treatments over a 4-month period. First, the doctor will place shields over the eyes to protect them from the light pulses. A thin layer of cooling gel is applied to the skin. A small device then applies the pulses of light to the treatment area around the eyelids. Finally, the doctor will express the oil glands that line the lids.
After the initial series of IPL treatments, most people will then have occasional maintenance treatments. The frequency of these maintenance treatments will depend on the severity of each individual’s dry eye. Your doctor may also recommend a combination of IPL treatments with other treatments such as punctal plugs or medications to provide the most effective management of one’s dry eye.
Initial treatment for dry eye often begins with artificial tear use in conjunction with warm compresses and lid massage. The artificial tear use provides temporary relief of symptoms, but does not address the cause of dry eye. Warm compresses address one cause of dry eye, Meibomian Gland Dysfunction (MGD), but are often not intense enough to break through with lasting relief. IPL addresses MGD more aggressively to provide both symptomatic relief as well as slowing the progression of one’s dry eye.