What is IPL? And how can it help dry eye?

Intense Pulsed Light or IPL, is a medical technology traditionally used to treat skin conditions. More recently it has been used to treat dry eye.

Plastic surgeons, cosmetic doctors and beauty therapists all use IPL to treat conditions such as: 

• hair removal 
• skin rejuvenation 
• spider veins 
• sun damage 
• acne

Ophthalmologists and Optometrists can use the same device to treat some dry eye problems. 

An IPL machine produces very intense flashes of light. This light is applied to the skin through a layer of clear water-based gel. The light then heats any brown pigment or red veins in that area of skin. The light then reduces these blemishes without breaking the skin. This works well for reducing some of the damage caused by repeated sun exposure. The flashes are fast and extremely bright, much like a camera flash.

Do you have Dry Eye Syndrome?

Dry Eye Syndrome (DES) is a common condition, affecting over 20% of the population. It affects women more than men and becomes more common with age.

Dry Eye Syndrome is sadly underdiagnosed. And it can cause several eye problems; such as grittiness, redness, eye strain, and blurred or fluctuating vision.

There are two main types of dry eye; aqueous deficiency and evaporative dry eye:

1. Aqueous deficiency occurs when the volume of tears being produced is insufficient. We need a certain volume of tears to keep the surface of the eye well lubricated.
2. Evaporative dry eye occurs when there is a sufficient volume of tears, but those tears evaporate too quickly, leaving the surface of the eye exposed. This is due to Meibomian Gland Dysfunction, a condition where the Meibomian oil glands in the eyelids do not function properly.

In most cases, people with dry eye syndrome are affected by a mix of both Aqueous Deficiency and Evaporative Dry Eye.

IPL treatment has more positive effects when used to treat evaporative dry eye, rather than aqueous deficiency.

How does the IPL treatment for dry eye work?

The intense flashes of light from the IPL machine raise the temperature in the eyelids, softening the blocked-up oil in the Meibomian glands. This allows the oils to flow more freely and to be more effective in preventing tear evaporation.  

The treatment also reduces the level of inflammatory cytokines in the eyelids. Cytokines are chemicals produced by the body that cause inflammation. The reduction in cytokines in the eyelids and surrounding Meibomian glands reduces inflammation. Inflammation causes pain, irritation, redness and reduces the ability of our eyes to produce good quality tears. Inflammation in the Meibomian glands is considered the main cause of Evaporative dry eye.  

IPL also reduces the levels of abnormal bacteria on the skin of the eyelids. Further helping decrease inflammation in and around the Meibomian glands.

How many treatments of IPL do you need?

Most research recommends four sessions of IPL. Each session consists of six to eight flashes of light, to each lower eyelid. The treatment is then repeated at three additional sessions.

• treatment two (15 days after the first treatment),
• treatment three (45 days after the first treatment)
• and then treatment four (75 days after the first treatment).

After these four treatment sessions, most people benefit from one annual treatment session.  

Is IPL treatment for dry eye safe?

IPL is safe when used appropriately. To enhance safety, your eyes are protected from the bright lights with a pair of porcelain goggles. These goggles completely block the light from reaching your eyes. To protect the skin on the cheeks and eyelids, a thick layer of clear water-based gel is applied to the area. Following treatment there may be some mild reddening of the surrounding skin – this should subside within 24-48 hours.

IPL has been safely used for almost three decades to treat skin conditions, it is only more recently that it has been used for the treatment of dry eye. A series of studies into the safety of IPL treatment for Meibomian Gland Dysfunction concluded that it was a safe and effective treatment.

Here is a video demonstrating how an IPL machine is used to treat dry eye. It shows the application of the flashes to the lower eyelids and how this works to help with Meibomian Gland Dysfunction:

What other treatments are available to treat Dry Eye Syndrome?

IPL is mainly used to treat evaporative dry eye, caused by Meibomian gland dysfunction. However, IPL is not the only treatment used for dry eye.

IPL usually needs to be used in conjunction with a few different treatments, such as:

• Artificial tear eye drops that are specifically designed to help evaporative dry eye.
• Omega-3 oral supplements.
• Low-Level Light Therapy (LLLT) is a non-invasive treatment that utilises specific wavelengths of light to stimulate healing processes in tissues. It works by penetrating the skin and tissues to a cellular level. LLLT increases ATP production in the mitochondria,  promoting blood flow, reducing inflammation, and supporting cellular regeneration. LLLT is currently available at the Wellington Eye Centre.
• Punctal plugs, are tiny silicone rods placed in the opening of the tear ducts. Punctal plugs reduce how quickly your tears drain away. This allows the existing natural tears to remain on the surface of the eye for a longer. 
• Medications such as Restasis can also be used. Restasis is an eye drop that increases tear production.

Is IPL effective in treating dry eye?

A number of studies have shown that IPL is beneficial for most patients with evaporative dry eye. 

A 2013 clinical trial in France reported on 80 patients with Meibomian Gland Dysfunction (the most common cause of evaporative dry eye); they showed a 90% satisfaction rate after a series of three treatments. 

And in 2014 Associate Professor Jennifer Craig from the University of Auckland carried out a clinical trial of IPL that found it to be very effective. After having three IPL treatments patients demonstrated a more stable tear film and 86% of the study participants reported reduced symptoms of dry eye.

The Wellington Eye Centre no longer offers IPL treatment. We may resume doing so in the future, as it is a very effective treatment option. IPL is currently available at these two other Wellington based clinics:
Thorndon Eye Clinic
Black Gates Optometrists

If you have any further questions about dry eye, or would like to see our specialists to talk through your symptoms and recommended treatments, you can email or call us on 0800 733 327 to speak to a member of our team.