Intense Pulsed Light (IPL) Therapy
The main source of tear-film trouble is the Meibomian gland. If these glands malfunction, the lipid layer may be reduced, allowing rapid evaporation of the tear complex. Furthermore, if the secretions from the Meibomian glands become trapped inside the glands, inflammation and bacteria can follow, worsening the problem. Researchers have been refining a new approach to treat this problem, using intense pulsed light, or IPL, originally developed for use in dermatology. Brief, powerful bursts of light at specific wavelengths (in this case, between 500 and 800 nm) are applied to the lower eyelid area. IPL works by closing the blood vessels that secrete the proteins responsible for the chronic inflammation and damage of the Meibomian glands.
The IPL treatment is performed in the office; takes only a few minutes and is painless. For those who have been suffering with dry eye syndrome with inadequate relief with other methods, IPL may be the appropriate therapy. Interestingly, the Intense Pulse Light machine was originally designed for skin rejuvenation but the technology has been completely reformatted so it can be used as a dry eye syndrome treatment.Matossian Eye Associates is offering the IPL treatment through their accredited Dry Eye Center of Excellence.
How We Perform the IPL Treatment
“When the patient comes in, we determine the skin type and the severity of the Meibomian gland dysfunction,” explains Dr. Matossian. “This treatment should only be used for patients whose skin is Fitzgerald type four or below, to avoid causing lightening of the skin color. We, then, give the treatment from ear to ear. If we just treat the lids, the blood vessels grow back much sooner, requiring more maintenance treatments. After placing a protective eye shield over the eyes, we treat the lower lid areas.”
Dr. Matossian states that she doesn’t directly treat the upper glands. “First of all, when you treat the side of the lid you close off blood vessels that feed into the upper glands,” she explains. “Also, once you get the lower glands working better, the lids appose each other better; as a result, the pumping mechanism that accompanies blinking is more effective in the upper glands. Third, some of the heat is transferred from the side treatment of the lower lids, so you get the warm compress effect on the upper glands indirectly.”
Dr. Matossian notes that it usually takes four treatments over the course of four months to get the secretions thin and working correctly. After the gland is normalized we do maintenance treatments every six months to a year. Younger patients need fewer treatments.
As you can see the diagnosis and treatment of Dry eyes Syndrome, Ocular surface disease, or Meibomian Gland dysfunction is complex and requires patience and persistence on the part of the eye doctor and the patient. Through careful evaluation and systematic therapeutic approach dry patients can experience significant improvement. If you have any questions about dry eye or feel you may be suffering from dry eye please call to schedule an appointment with one of our doctors.