Dry Eye Questions

Our most frequently asked questions about dry eye disease.

Are there lifestyle changes that can help reduce my morning dry eye symptoms when drops and ointments fail?

Make sure you don’t sleep under a ceiling fan. A humidifier may help in the bedroom if you live in a dry climate. If you haven’t tried gel drops or ointments at bedtime, this may help. If using artificial tears, you will need to use them 3 to 5 times per day, every day.

The biggest cause of dry eye is a poor oil layer of your tears. This oil is produced by the meibomian glands near the eyelashes. As we age, they work less and less. By doing a lid scrub daily (warm washcloth wrapped around a finger or two and scrub right at the eyelid margin where eyelashes are with eyes closed – almost like you’re brushing your teeth for about 20 seconds. This stimulates blood flow to the oil glands. Warm compresses or a heated mask can also be used to increase blood flow and help melt the thick oil into thinner oil that can be expressed by the glands more easily. Our office now provides IPL treatment for dry eyes. It is a device that produces an Intense Pulse of Light to the skin that helps rejuvenate those glands, plus can make the skin around your eyes look and feel younger! Insurance does not pay, but often, after a series of these treatments, drops are no longer needed. Eat right, exercise daily, see your PCP at least yearly for blood work and a physical, and see an optometrist yearly to help manage your dry eye. There are also prescription eye drops that may be right for you. And on that same subject, some medications and/or health conditions can cause or at least contribute to dry eye syndrome.

Your practice has obtained a new tool to treat dry eyes. Tell me about Intense Pulsed Light therapy.

Intense Pulsed Light (IPL) therapy has become an increasingly popular treatment for dry eye disease, particularly when it’s linked to meibomian gland dysfunction (MGD)— which is the leading cause of evaporative dry eye. Originally developed for dermatological conditions like rosacea, IPL was first used for ocular conditions in the early 2000s. Over the past decade, it’s really gained traction in eye care, due to positive clinical studies published around 2016 and later.
The treatment works by delivering pulses of broad-spectrum light to the skin around the eyes. This light reduces inflammation, melts thickened meibum (the oil component of the tear film), and helps clear blockages in the meibomian glands. It also targets abnormal blood vessels and even Demodex mites, which can exacerbate dry eye symptoms
We have been impressed with the effectiveness after reading journal articles and attending continuing education meetings around the country. For example, a recent Mayo Clinic study found that 89% of patients experienced symptom improvement after IPL combined with meibomian gland expression, with 77% showing better gland function. These oil glands produce the very thin oily layer of the tear film and are located along the edge of the upper and lower eyelids near the eyelashes. As we age, and due to some systemic (mostly autoimmune) diseases, these oil glands begin to reduce production and quality, resulting in the watery layer of tear film evaporating, causing the symptoms of dry eye that include itchy, burny, and, oddly, watery eyes.

This sounds like a real game-changer for the treatment of dry eye. Are eye doctors embracing this new technology?

Yes, a growing number of optometrists are incorporating IPL and other advanced treatments into their practices—not just for dry eye relief, but also for aesthetic benefits. The introduction of FDA-approved systems like OptiLight by Lumenis has made IPL more accessible for managing meibomian gland dysfunction and can also reduce the fine wrinkles around the eyes.

One of the biggest hurdles in managing dry eye disease is patient compliance. Traditional treatment plans often involve a complex routine—several applications of artificial tears throughout the day, plus lid hygiene including scrubs and warm compresses daily, bedtime ointments, and sometimes expensive prescription drops like cyclosporin (Restasis) or the newer option, Miebo, which contains a perfluorohexyloctane—also known as a ‘forever chemical.’ And recent studies have found microplastics in nearly every artificial tear eye drop commercially available. They found that microplastics may cause symptoms of dry eyes, which is what we are trying to fix!

While these tools can be valuable, the reality is that most patients struggle to treat consistently due to high cost, inconvenience, and minimal improvement. And to be honest, it just makes dry eye disease more tolerable; it doesn’t fix anything. This is where IPL really shines. It addresses the underlying meibomian gland dysfunction and, for many, reduces or even eliminates the daily maintenance rituals we’ve relied on for years.

Other studies have shown that IPL can significantly improve tear breakup time, reduce inflammatory markers, and enhance meibum quality.

How often does the IPL treatment need to be done to maintain the health of the eyelids?

It’s not a one-and-done solution—patients typically need a series of four treatments spaced 2 weeks apart, and maintenance sessions may be required every six months.

The aesthetic angle, which is where IPL was first used, is a bonus that appeals to many patients, especially since IPL was originally developed for dermatology. Practices that offer both ocular and cosmetic benefits are seeing increased patient interest and satisfaction.

Optometrists are expanding beyond vision care—offering cutting-edge treatments like IPL that not only relieve dry eye symptoms, but can rejuvenate the skin around the eyes.

Clinics like ours are now offering IPL as part of a broader dry eye management strategy, often alongside treatments like meibomian gland expression, thermal pulsation (e.g., LipiFlow), and radiofrequency therapy. These modalities not only improve tear film stability and reduce inflammation, but also offer cosmetic perks—such as reducing redness, improving skin tone, and minimizing fine blood vessels around the eyes