Dry Eye Treatment and the Role of IPL
Updated: Oct 11
Treatment selection starts with identifying the cause of dry eyes, not choosing a device.
Dry eye disease (DED) is one of the most common eye conditions in the modern world. It is accompanied by a sensation of “sand” in the eyes, burning, tearing, light sensitivity, and reduced vision, significantly affecting quality of life.
Dry eye can result from reduced tear production, excessive evaporation or a combination of causes. Intense pulsed light, or IPL, has been studied for meibomian gland dysfunction. IPL is a non-laser light technology. Evidence for IPL should not be treated as evidence for every laser device or every form of dry eye disease.
When discussing dry eye treatment, ask about the diagnosis, indications for IPL, availability of the method and its limitations. The choice depends on the cause of symptoms and the patient's interests. A device-based procedure does not replace a comprehensive eye examination or prescribed care.
Dry eye affects different patient groups. Prevalence estimates depend on the diagnostic criteria and population studied, so a single percentage without a verifiable source is not appropriate. Age, contact lenses and prolonged screen use may be relevant to the symptoms.
People over 40 years old
Contact lens users
Office workers and those who spend long hours in front of screens
Postmenopausal women
Patients after cosmetic or ophthalmologic surgeries
DED can also accompany chronic skin conditions (e.g., rosacea with blepharitis), autoimmune diseases (e.g., Sjögren’s syndrome), and may occur as a side effect of certain medications.
Causes of dry eye disease
Dry eye can develop when the eyes produce too few tears or tears evaporate too quickly because the lipid layer is not working well. Inflammation of the eyelid margins and meibomian glands, or changes in blinking, can also contribute.
Meibomian gland dysfunction can contribute to excessive tear evaporation, but it is not synonymous with dry eye disease. An examination is needed to identify the cause of symptoms and select suitable care.
What role can IPL play?
Studies of IPL, including its use alongside other treatments, have assessed the following:
Some patients with meibomian gland dysfunction may experience improvements in tear-film stability, gland function and certain symptoms. The response varies. IPL does not guarantee relief of every symptom and is not a universal treatment for dry eye.
Discussing an individual treatment plan
Consultation and diagnosis
Diagnosing dry eye requires an eye examination. Assessment of the eyelids, skin and symptoms may form part of it, but does not replace assessment of the tear film and ocular surface:
Visual examination of eyelid margins and surrounding skin
Dermatoscopy of the surrounding skin, if a skin change needs assessment
Symptom analysis and medical history review
The findings guide an individual plan, which may include care prescribed by an ophthalmologist and device-based methods when indicated. Having a laser available does not itself establish an indication for treatment.
Questions before a procedure
Method: IPL may be considered for appropriate indications associated with meibomian gland dysfunction. It is not a laser; IPL study findings cannot automatically be applied to laser treatment.
The treatment area and eye protection depend on the specific method and device and are selected by the clinician before treatment.
Duration depends on the selected method and extent of treatment.
Sensations, pain relief and protection are discussed individually; a painless procedure cannot be guaranteed.
Session numbers and intervals depend on the diagnosis, method and response. Improvement after the first session cannot be guaranteed.
What to expect
Treatment aims to ease burning, discomfort, light sensitivity and the gritty feeling in the eyes, while improving the tear film and meibomian gland function. Symptoms and examination findings are used to assess the response. Discuss any reduction in moisturising eye drops with an ophthalmologist; this cannot be promised in advance.
In the randomized study by Toyos et al. (2022), IPL with meibomian gland expression was compared with sham IPL and the same expression procedure. Between-group differences were not found for every measure: there was no statistically significant difference in OSDI questionnaire scores or daily artificial tear use. These findings do not promise a reduced need for eye drops for every patient. Do not stop or change prescribed drops on your own; discuss further care with an ophthalmologist.
Safety questions
Before a procedure, ask about:
Before treatment around the eyes, appropriate eye protection is selected, contraindications are assessed and possible adverse effects are discussed. Protection and treatment protocols depend on the method used. The use of a medical device does not make a procedure risk-free.
During a device-based procedure around the eyes, closed eyelids do not replace appropriate eye protection. Protection is selected for the method and treatment area. Eye pain or a change in vision after a procedure requires urgent medical assessment.
Working close to the eyes requires relevant training and knowledge of the anatomy. Potential benefits and risks should be discussed before treatment; absence of complications cannot be guaranteed.
Recovery and aftercare
After the procedure:
Redness and other adverse effects are possible; their severity and duration vary.
Recovery needs and restrictions depend on the method and the skin's response.
Sun protection and aftercare are selected individually; the clinician explains how long any restrictions apply.
Follow post-procedure care instructions and continue eye drops if prescribed
What affects the result
Results depend on the cause and severity of dry eye, the degree of meibomian gland dysfunction, age, skin type and associated conditions such as rosacea or seborrhoeic dermatitis. Following the aftercare advice also matters.
Dry eye may require ongoing care. Severe untreated cases can damage the cornea, so persistent symptoms need assessment by an eye doctor.
Sources: National Eye Institute — Dry Eye; randomized study of IPL for meibomian gland dysfunction. National Eye Institute · IPL study