Dry Eye Treatment

In-Office Testing and Treatments for Dry Eye

Dry Eye Testing

Diagnosis of dry eye can be accomplished through either a comprehensive eye examination or a problem-focused medical visit. Information obtained through patient history and our dry eye questionnaire can help gauge the severity of your symptoms while a microscopic view of your eyes will be used to determine the clinical level of your condition.

Further testing will be performed at your initial dry eye evaluation and monitored at regular visits to ensure improvement of symptoms and ocular health. We begin by performing a tear film osmolarity reading with our TearLab instrument. This painless test helps to quantify the severity of your dry eye and can be used at future visits to monitor the results of your treatment.

Our doctors will evaluate your ocular health, lid structure, and blink dynamics by using a microscope. Specially dyed drops may be used to observe the quantity and quality of your tears and highlight changes made to the surface of the eye caused by poor tear flow or insufficient tears.

Based on the findings, a treatment plan will be created for you and may include the use of over-the-counter or prescription eye drops, lifestyle or contact lens changes, nutritional supplements, and at-home treatments or in-office procedures.

In-Office Dry Eye Treatments

Intense Pulsed Light Therapy (IPL)

Intense-pulsed light therapy (IPL) is a non-invasive, FDA-approved, light-based therapy that delivers targeted light energy to the eye and face region. IPL targets specific pigment and tiny inflammatory blood vessels just below the skin’s surface, effectively reducing eyelid inflammation, rosacea, and eyelash mites (demodex). These pulses promote blood flow and collagen production, alleviating dry eye symptoms while simultaneously enhancing skin appearance by improving skin tone and firmness, reducing sun damage and discoloration, and evening out skin texture.

The procedure takes about 30 minutes and involves application of ultrasound gel to the cheeks, nose and eyelids. Dr. Reghetti performs IPL by protecting the eyes with corneal shields and using a specialized handpiece to emit multiple laser pulses in the ocular region. These pulses feel like a sharp snap of a rubber band as the laser travels a wavelength of 580 nm through the epidermis of the skin, targeting the inflammatory vessels causing dry eye and activating the meibomian glands. While there may be some discomfort during the treatment, it is usually well-tolerated with minimal downtime.

Treatments are completely customized per patient and occur once every 2-4 weeks for 4 sessions then once every 6 months to a year depending upon the severity of the disease and return of symptoms. Most patients notice an improvement in their symptoms within a few weeks after treatment.

IPL is a revolutionary approach to dry eye, as it targets the root inflammatory cause of the disease. It is most effective when utilized in conjunction with radiofrequency (RF) and meibomian gland expression, as well as a tailored at-home therapy regimen that will be developed for you by Dr. Reghetti.

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Radiofrequency (RF)

Radiofrequency is our most advanced treatment option for meibomian gland dysfunction (MGD). The meibomian glands lie within the eyelid and release the lipid layer of the tear film. This oil layer (also known as meibum) helps to prevent the tears from evaporating too quickly, resulting in dry eye symptoms.

In healthy eyes, meibum should easily flow out of the meibomian glands like water and onto the surface of the eye. In meibomian gland dysfunction, the glands become clogged with thickened meibum which must be forced out like toothpaste! If this oil is not properly removed, the glands may become infected (causing styes), inflamed (causing a chalazion), or permanently damaged (causing severe and irreversible dryness).

If MGD is left untreated, the meibomian glands can begin to atrophy. Once severe atrophy has taken place, they will no longer function. This results in chronic dry eye symptoms, and obtaining relief at this stage becomes very difficult. Studies show that about 86% of dry eye sufferers have signs of MGD, and these signs can be present in patients who don’t even have symptoms of a dry eye yet! In order to keep the oil flowing freely and the meibomian glands healthy and functional, we need to melt the meibum and unclog the meibomian glands. At-home treatments such as warm compresses and lid scrubs can help, but not as efficiently as radiofrequency.

Radiofrequency (RF) is a treatment that delivers gentle heat to the eye area to stimulate and revitalize the oil glands within the eyelids, effectively targeting the underlying causes of dry eye, including inflammation and gland blockages. This process promotes blood circulation, improves gland function, melts oil blockages and stimulates collagen growth, helping to alleviate dry eye symptoms such as discomfort and blurred vision, while simultaneously enhancing skin appearance by reducing fine lines and wrinkles.

Our certified technicians apply ultrasound gel to the closed eyes and move a handheld device lightly against the closed eyelids for 10-12 minutes per eye. The RF device emits an electromagnetic frequency into the skin of the eyelids to create heat at an optimal temperature range needed to melt thickened oil (meibum) within the meibomian glands.

RF treatments are quite comfortable and feel similar to a hot stone massage. Most patients notice an improvement in their symptoms within a few weeks. Treatments will be performed once a week for one month then once every 6 months to a year depending upon the severity of the disease and return of symptoms. Dr. Reghetti recommends to continue with frequent at-home warm compresses using our dry eye relief mask (DERM) to help maintain adequate oil flow between RF maintenance treatments.

Following each radiofrequency session, meibomian gland expression and eyelid cleansing will be performed to further relieve symptoms of meibomian gland dysfunction (MGD) and improve overall eye health. During the expression, we use specialized techniques to apply gentle pressure to the eyelids, helping to release any blockages in the meibomian glands. This process promotes the flow of natural oils into the tear film, enhancing moisture retention and reducing dryness and irritation.

In most cases, RF will be utilized in conjunction with intense-pulsed light therapy (IPL) to deliver the most effective and comprehensive in-office dry eye management available. By restoring the function of these essential glands, we can help alleviate discomfort, improve vision clarity, and support long-term eye wellness!