Dry Eye Treatments
Having a precise diagnosis allows us to tailor treatments to your specific needs. Our dry eye treatments include:
Lumenis Optilight™ IPL Therapy: A drug-free, drop-free solution to Dry Eye Disease / Meibomian Gland Dysfunction
Dry Eye Disease (DED) is the breakdown in the normal function of the tear film on the eye. Meibomian Gland Dysfunction (MGD) is the cause in almost 90% of cases. Most people with DED/MGD have irritated, watery eyes and it sounds odd to say they have dry eyes. If you think of the condition as a breakdown in the homeostasis of the tear film, which means there’s an imbalance in the chemistry of the tear film, and the tears can’t perform their function, you’ll understand why it’s more accurate to think of it as Tear Dysfunction Syndrome. But Dry Eye Disease is a better known term so we’ll use it in the rest of this information pack. If you suffer from DED/MGD, you know all too well that it’s a chronic and complex condition that can significantly reduce your quality of life. Traditionally, DED/MGD has been treated with a combination of eye drops to make the eyes feel better and medication to reduce inflammation. Most people with DED/MGD know how difficult i t is to maintain compliance with drug and drop regimes. IPL is an adjunct therapy that offers a low maintenance alternative to traditional DED/MGD management.
How does IPL work?
√ By sealing the flow of blood in abnormal, superficial blood vessels: IPL is natural light that is filtered to allow only a few specific wavelengths through to the area to be treated. The energy from the light is absorbed by the blood vessels that supply the eyes and reduces the inflammation in the eyelids. It’s the inflammation that causes the DED.
√ Photobiomodulation: IPL alters the metabolism of the oil-producing cells in the meibomian glands within the eyelids. This enhances cell growth and collagen synthesis in the cells of the meibomian glands and thus improves tissue repair.
√ Energising and Liquefying Meibum: Meibum is the oil produced by the meibomian glands to lubricate and protect the eye. The energy from the IPL softens the meibum, which in turn help reduce the risk of meibomian gland blockages and allows the glands to secrete more effectively.
√ Decreasing epithelial cell damage: More meibum in the tears reduces the damage DED does to the front surface (epithelium) of the cornea. Exposed and damaged cells on the corneal epithelium cause the bulk of the eye’s discomfort.
√ Reduction of demodex and bacteria: IPL kills demodex, a skin mite that lives in the follicle of eyelashes, and bacteria. An over-abundance of either bacteria or demodex leads to inflammation of the lids and the degradation of the tear film.
How is Lumenis Optilight™ IPL performed?
A layer of conductive gel, the same gel that’s used for ultra-sound scans, is applied to the skin of the area to be treated. Usually this is on the cheeks below the eyes, and over the nose. The gel helps to ensure the energy from the light is spread evenly across the skin. Eye pads or laser-grade metal eye shields are worn to protect the eyes during treatment and, while some people might experience mild discomfort from the flashes of bright light, there is no risk of damaging the eyes while wearing these shields or pads during IPL treatment. It takes 3 treatments to get the full effect/best results. Each treatment session takes about 15-20 minutes and are done 2-4 weeks apart. We’ll review your progress 3 months after the 3 rd treatment. It’s rare for someone to need another treatment at this 3 month visit, and we don’t charge for this should it be needed. Based on FDA labeling, the ongoing maintenance program is to have a single treatment every 6 months. Longer breaks between treatments might require a second treatment 2-4 weeks later, so it’s best to follow the recommended treatment schedule.
Low Level Light Therapy (LLLT)
Since 1961, doctors have used special light waves from powerful lasers to cut and heal tissues in the body. But if you use a gentler light and adjust it just right, it helps the cells in our bodies work better and heal themselves. This is one type of Photo-regeneration Therapy called Low Level Light Therapy (LLLT), or light therapy for short.
How it works:
In the same way that plants use chlorophyll to convert sunlight into energy, high intensity light emitting diodes (LEDs) utilizing specific, proven wavelengths of light can trigger a natural biostimulatory effect in human tissue. Research has shown that LED light therapy can increase circulation, accelerate tissue repair, kill acne bacteria, decrease inflammation, improve skin tone, texture and clarity, decrease under eye wrinkles as well as ease muscle and joint pain, stiffness, spasm, and pain associated with arthritis.
Research indicates that cells absorb particles of light (photons) and transform their energy into adenosine triphosphate (ATP), the form of energy that cells utilize. The resulting elevation of ATP is then used to power metabolic processes; synthesize DNA, RNA, proteins, enzymes, and other products needed to repair or regenerate cell components; foster mitosis or cell proliferation; and restore homeostasis. Simply put, the LED light source provides compromised cells with added energy so the cells performance is enhanced.
Since 1987, skin doctors have used light therapy to help heal and make skin healthier. In 1999, eye doctors started using this technology to treat a kind of eye problem called glaucoma with a method called Selective Laser Trabeculoplasty (SLT). This method doesn’t hurt the eye; it just helps it work better to drain fluid.
There’s a trick to making sure the light therapy works right, especially when helping with a condition called Meibomian Gland Dysfunction, which affects the eyelids. You have to set the light just right—how strong it is, how long it shines, and more.
Modern LED light therapy tools allow for adjustment all these parameters to obtain the ideal settings for treating the eyelids. The best part? LED light therapy works on all skin types without causing any color changes in the skin.
Light therapy helps improve meibomian gland function allowing them to clean out their own gunk just like the body does when it heals a small bump or a red spot. The glands also start working better and make more of their natural oils without needing more treatments.
Not only is LED light therapy a good choice for treating dry eyes, but it also offers a gentle way of dealing with eyelid issues, like chalazions, which are like little lumps that can form on the eyelids. This is really important for kids, because it’s a lot safer than having to go through surgery, which can be scary and risky.
We use the Celluma LLLT system - a world leader in this technology. Celluma is FDA cleared for multiple skin and lid conditions and uses patented technology that allows the light sources to get closer to the skin, maximizing light therapy effectiveness more than any other LED device.
In 2019, research published in the journal Clinical Ophthalmology demonstrated that the integration of Intense Pulsed Light (IPL) and Low Level Light Therapy (LLLT) in a unified treatment protocol significantly enhanced tear breakup time and Meibomian Gland Dysfunction (MGD) grading scores, along with a marked improvement in patient-reported symptoms, observed one to three months post-treatment.
The expense associated with acquiring both systems has been a barrier for many ophthalmic practices to implement this combined approach.
Dr. Collazo distinguished himself as the first ophthalmologist in Puerto Rico to merge these two sophisticated technologies into a singular treatment regimen. Furthermore, he innovatively included simultaneous Blephex blepharoexfoliation without increasing the cost, offering this comprehensive treatment package for the same fee that other clinics charge for just one of these services.
* There is no cure for DED, only best management to give you the best quality of life. Clinical studies show that IPL combined with LLLT significantly reduces the signs and symptoms of DED, as well as the need for drugs and ocular lubricants (eye drops).
What to do next? If you’d like to be assessed for DED and learn if you’re suitable for IPL call us at (787) 728-3700 to ask for an dry eye evaluation.
Other treatments available for DED
Autologous Serum Eye Drops (ASED)
Customized eye drops using your blood to provide a nourishing solution for the ocular surface.
Blephex
A precise and efficient in-office deep eyelid cleaning treatment to address eyelid inflammation and promote a healthy lid margin.
Doxycycline and Azithromycin Drops
Oral medications to manage underlying causes of dry eye.
Intense Pulsed Light (IPL)
We use the Lumenis Optilight IPL system. The only system clinically proven and FDA approved for MGD treatment.
Celluma LED Light Therapy
Celluma uses light energy to improve cellular health by accelerating the repair and replenishment of compromised tissue cells. A 2019 study published in the Journal of the American Academy of Ophthalmology showed that Combining IPL and LLLT therapies in a single treatment produced significant improvements in tear breakup time and MGD grading scores, with an associated improvement in the patient's subjective dry eye symptoms, one to three months after treatment.
Lid-Warming Electronic Eye Masks
Enhancing the function of meibomian glands through precisely controlled warming. Studies show that the eyelid temperature must remain between 104 and 107 degrees Fahrenheit for 15 minutes for this type of at-home therapy to be effective. These specially designed electronic masks accomplish that while providing mild pressure and vibration to ensure maximum effect in clearing the meibomian glands.
Thermal Eyelid Pulsation Therapy
An in-office treatment targeting blocked meibomian glands.
Omega-3 – Triglyceride Form
Oral supplements to support overall eye health.
Prescription Cyclosporine Drops (Restasis, Cequa, Vevye)
Managing inflammation to promote a healthier ocular surface.
Prescription Meibo Drops
This new, non-aqueous, preservative-free, soothing eye drop can help relieve symptoms in weeks.
Prescription Tyrvaya
This nasal spray helps enhance the eye's natural tear flow and has been effective in patients who have failed other artificial tear therapies.
Prescription Xiidra Drops
Targeting inflammation for improved tear production and reduced symptoms.
ProKera Amniotic Membrane
A therapeutic, biologic, contact-lens-like device that rapidly rehabilitates moderate or severe dry eye.
Punctal Occlusion with Punctal Plugs
Conserving tears by blocking the drainage ducts, aiding in moisture retention.
Tea Tree Oil-Based Lid Cleanser
Combating bacterial overgrowth on the eyelids, a common contributor to dry eye.
Tear Substitutes, Drops, and Gels
Providing immediate relief and maintaining optimal tear balance.