My Experience with Intense Pulsed Light (IPL) Therapy 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 therapy
IPL therapy entails basically what the name suggests: intense wavelengths of flashing light are targeted at the eyes. My doctor explained that IPL can be an effective treatment for dry eye and 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 eye 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.
Was IPL an effective treatment?
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 this as a treatment for dry eye.
If you have had IPL, was it an effective treatment for your dry eyes?
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