Dry Eye: Pulsed Light Therapy

With the arrival of winter, not only do temperatures drop significantly, but daily habits change: people spend more time indoors, reducing exposure to sunlight, while excessive use of home heating creates dry environments with low humidity. This often results in headaches, throat dryness, and dry eyes. Such conditions predispose individuals to evaporative dry eye, a form of ocular discomfort characterized by burning, redness, a foreign body sensation, and blurred vision, which often clears after blinking. One of the most promising treatments currently available for evaporative dry eye is Intense Pulsed Light (IPL) therapy, a non-laser light-based approach offering immediate benefits.

What is evaporative dry eye?

Dry eye is a common condition affecting both younger and older populations. It has become even more prevalent due to increased screen time and the widespread adoption of remote work. There are two main types of dry eye:

Aqueous-deficient (due to insufficient tear production)
Evaporative dry eye, the most common form, characterized by excessively rapid tear evaporation between blinks.

In evaporative dry eye, the lack of a stable tear film leads to ocular burning, chronic inflammation, and a persistent gritty or sandy sensation in the eyes.

In many cases, the cause is a deficiency in the lipid (oil) component of the tear film. Lipids play a crucial role in preventing tear evaporation and are secreted by the Meibomian glands, which often become blocked or underactive in people with this condition.

Diagnosis and Treatment

The gold standard for diagnosing evaporative dry eye is the Break-Up Time (B.U.T.) test, which measures how quickly tears evaporate after blinking. A normal B.U.T. is greater than 10 seconds per eye and is largely influenced by lipid concentration in the tears.

First-line therapy usually includes lubricating eye drops, which hydrate the ocular surface and reduce friction between the eye and the eyelid. In some cases, anti-inflammatory or corticosteroid drops may be prescribed.

However, eye drops must be applied several times a day, sometimes over long periods, and can be costly, leading many patients to abandon treatment. This has prompted the adoption of longer-lasting, device-based therapies—such as IPL—to manage chronic evaporative dry eye effectively.

What is Pulsed Light Therapy?

Intense Pulsed Light (IPL) is currently the most effective non-invasive therapy for evaporative dry eye. Initially developed for dermatological applications, IPL has since been FDA-approved for ocular use due to its high safety and efficacy.

The IPL device includes a handheld applicator connected to a central unit. It emits non-laser light pulses directed toward the upper and lower eyelids.

The treatment is quick, painless, and non-invasive. The patient’s eyes are protected with rigid goggles, and any moles or scars on the eyelids are covered. Then, the eye doctor activates the treatment, delivering pulses that heat and liquefy the oils trapped in the Meibomian glands, restoring tear film stability.

For best results, patients are advised to complete at least four IPL sessions, spaced at regular intervals, with optional follow-up sessions after six months or more.

Risks and Benefits

IPL therapy offers rapid relief by unblocking the Meibomian glands and restoring lipid content to the tear film. This provides long-lasting comfort and greatly reduces symptoms.

The treatment is FDA-approved, CE-marked, and does not carry age limitations. There are virtually no significant risks when performed correctly. However, patients undergoing treatment for epilepsy or those taking photosensitizing medications should avoid IPL therapy.

Benefits include:

Immediate and lasting relief from burning and redness
Significant improvement in tear film stability
Non-invasive and well-tolerated sessions

Useful Tips

Dry eye is a multifactorial condition. Here are some preventive measures:

Moderate indoor heating to avoid overly dry environments
Maintain a healthy, balanced diet, particularly foods rich in vitamin A and omega-3 fatty acids, such as:
- Leafy green vegetables
- Oily fish
- Eggs
- Milk
- Orange-colored fruits and vegetables

These nutrients help protect the ocular surface epithelium and support the function of internal eye structures, including the retina.