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My Experience with Intense Pulsed Light and Meibomian Gland Expression

After my dry eye specialist examined my eyes and the oil being produced from my meibomian glands under a slit lamp, he determined that I had meibomian gland dysfunction and ocular rosacea. He said that I could benefit from intense pulsed light therapy (IPL) and meibomian gland expression. I decided to proceed with the treatment that day.

Potential benefits of IPL

IPL for dry eye entails basically what the name suggests: intense wavelengths of flashing light are targeted at the eyes. My doctor explained that IPL has several benefits.

First, it can help heat and liquify the oil in the meibomian glands so that it can be expressed. Second, it can help reduce inflammation by closing off abnormal blood vessels that contribute to rosacea. Third, it can stimulate cell’s mitochondria to help cells work better and produce oil. And finally, it can kill bacteria and demodex mites.

How it felt

I was a little nervous about my first treatment as I sat in the chair next to the Lumenis machine. My doctor put some numbing drops in my eyes. He then proceeded to put protective shields over my eyes and an ultrasound gel on the areas where he would administer the light treatment. Using a wand attached to the machine, he did two passes on both my upper and lower lids across the area from my right hairline to my left hairline.

People in different online forums have described the sensation as that of a rubber band being popped onto the eyes. I would say that description is somewhat accurate. It felt like a “pop” or even a shock. Sometimes it felt like a burning sensation if my doctor got really close with the wand, especially around the inside corners of my eye near my nose. In all honesty, sometimes it did hurt. And I was a little afraid to look at myself in the mirror afterward for fear of burn marks. However, to my relief, I looked normal.

The meibomian gland expression

The expression was even more uncomfortable. My doctor used a metal tool to press on my lower glands, concentrating on the corners of my eyes. He pushed with firm pressure, and it was almost unbearable at times. The top lids were a little trickier to express. He used another tool to squeeze oil from those glands. He described the consistency of the oil in my glands to that of toothpaste in my left eye and butter in my right eye. (My left eye is my worse eye). He said that the goal is for the consistency to be that of olive oil.

Afterward, he gave me some steroid drops to use to reduce inflammation over the next few days. The next day, the area under my eyes was a little swollen and slightly bruised because of the pressing from the metal tool during gland expression. The following day, that area had returned to normal. I avoided using any makeup for a couple of days after the procedure, and I avoided sunlight for about a week, as skin can be more sensitive to light after IPL.

Some progress

Initially, my doctor suggested having four IPL procedures, each two weeks apart. However, I may need more to see maximum benefit. And I would need maintenance treatments once or twice a year as well. So far, as of my writing this, I have had five IPL treatments. I have seen a small amount of progress.

Part of my issue has also been my conjunctivochalasis. I am having surgery to correct this, and hopefully, it will aid my IPL progress. With each procedure, my doctor expresses my glands, and he reports on the state of the oil coming out. At my last procedure, as of my writing this, he said that he was getting oil at an olive oil consistency from about 90 percent of my glands.

The costs

Initially, I had to pay out of pocket for each IPL procedure because the doctor’s office wasn’t sure if my insurance would cover it. Thankfully, my insurance company is covering the procedure, and I am only responsible for a co-pay. I am still hopeful that IPL will continue to improve my dry eyes, and I expect to have more procedures. Having my insurance cover it is a huge blessing and makes me more inclined to continue with the treatments.

If you have had IPL, have you seen any improvement with your dry eyes?

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ChronicDryEye.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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