Dry Eye and Intense Pulsed Light: Provider’s Perspective
As we mentioned earlier in the newsletter, the Colorado Springs Eye Clinic will now offer Intense Pulsed Light Therapy (IPL) for the treatment of dry eyes. While making dry eye treatment an area of emphasis for the clinic isn’t really new, thanks to the long-standing efforts and dedication of Dr. Wetzig, it was through the inspiration of Drs. Mortland and Banich that we have decided to move forward with a therapy that addresses the cause of dry eyes more than simply treating the symptoms. We asked them to summarize their feelings regarding this advanced treatment.
“Dry eye disease sounds simple but it is actually a chronic and complex problem,” Dr. Banich said. We often think that it is simply a lack of tears and as such, using artificial tears should easily treat it. When this doesn’t happen, there is often a sense of frustration.”
“Sometimes artificial tears can take care of the symptoms,” Dr. Mortland agreed, “but many times frequent drops only temporarily take away the burning and blurriness. And it’s such a prevalent problem, especially in the high altitude and low humidity of Colorado.”
Just hearing the words “Intense Pulsed Light” sounds intimidating. Is the procedure complicated or difficult? “Not at all,” Dr. Banich emphasized. “Each treatment takes just a few minutes. Intense pulse light therapy targets eyelids and the cheek area below the eyes. The targeted light therapy ablates small eyelid margin blood vessels and decreases inflammatory markers. After 3-4 initial sessions and less frequent ongoing maintenance sessions, oil gland dysfunction of the lids improves as well as symptoms of dry eye disease.” Interestingly, the eyes are specifically avoided during the treatments.
It would make sense that if the eyes are dry, then artificial tears would make sense as the logical treatment, but obviously, this isn’t the case. Why, then, aren’t tears sufficient?
“Tears are made up of several components that include water, oil and mucous,” Dr. Mortland explained. “When any one of the components of the tears is not working properly, the vision is blurred and symptoms of dry eye are evident. The oily part of the tear film can be difficult to improve. One can use warm compresses to help the function of the oil glands, but this is time intensive, does not have long-lasting effects and has to be repeated daily. Fish oil capsules have been said to improve the oily layer, but studies haven’t conclusively proven these supplements to be beneficial.”
The variability in how dry eyes are treated is much more complex than it would seem, as the underlying cause can be so different. “Symptoms of dry eyes vary from person to person and can widely vary in a single person at different times of life.,” Dr. Banich added. “And, dry eye disease also often involves inflammation of the eyelids and abnormalities of tear composition and when combined, it can become a vicious and self-perpetuating cycle.”
“There are many medical conditions and medications that cause dry eye. As we age our body changes, our facial structure and eyelid function changes and hormone levels change. All of these things can exacerbate dry eyes, especially in women,” Dr. Mortland observed.
So if tears help, but they aren’t going to solve the problem, what distinguishes IPL from our other therapies? “Intense pulsed light gives a dual approach to the problem of dry eye caused by a deficiency of oil,” Dr. Mortland offered. “It targets the inflammatory component, which improves the expression of oils onto the eyes and it destroys the infectious component, which is a larger component of dry eye problem than most of us would like to believe.”
Dr. Banich added a personal note. “I have dry eyes and often have to remind myself that I can treat and greatly alleviate symptoms but that I likely still have a tendency toward dry eyes and will have to maintain these treatments over the long haul. I am excited to have this therapy in my dry eye toolkit and know it will help many Colorado Springs area patients to alleviate their dry eye symptoms.”
For more information regarding IPL treatment for dry eye, please contact CSEC at (719) 632-3547.