Our specialty
Drops manage the symptom. This is the program that treats what is actually causing it — run by optometrists, in an optometry clinic.
Why drops are not enough
The great majority of dry eye is evaporative. You are making enough tears; they are simply evaporating before they can do their job, because the oil layer that should be sitting on top of them is not being produced properly.
That oil comes from the meibomian glands along your lid margins. When those glands become blocked and inflamed — meibomian gland dysfunction — no amount of artificial tears fixes the underlying problem. Drops top up the water. They do nothing for the oil.
Clearing the lid margin, then using light and heat to calm inflammation and restart the glands, treats the cause. That is what the three treatments below do, and why we almost always use them together rather than alone.
The program
Each does a different job. Debridement clears the way, IPL calms the inflammation, and Forma I softens what is stuck so the glands can flow again.
Intense pulsed light
Short bursts of intense pulsed light along the cheekbones and both the upper and lower lids. The light calms the inflammation that drives gland dysfunction and helps restart the meibomian glands that keep your tear film stable.
A layer of ultrasound gel goes on first — it cools the skin and lets the handpiece glide. Your eyes are shielded throughout.
More on Lumecca IPLRadiofrequency
Forma I is the smaller of the two Forma handpieces, and the one we use around the lids. It holds the tissue at a controlled temperature, softening the hardened oil sitting in the glands so it can flow again.
It feels like a warm massage. Nothing about it is uncomfortable, and there is no downtime at all.
More on Forma IClearing the lid margin
Before light or heat can do much, the lid margin has to be clear. Debridement removes the biofilm, keratin and debris that build up along the lash line and block the gland openings.
It is usually the first thing we do, and for some people with mild disease it is most of the answer on its own.
The full course
The way we recommend doing this properly — a complete course rather than treatments bought one at a time.
How a course runs
We look at your tear film, the quality of the oil coming out of the glands, and the state of the lid margins. This is an eye examination rather than a skin consultation, which is the advantage of having it done in an optometry clinic.
Clearing the lash line and gland openings so everything that follows can actually reach them. You go home with lid wipes to keep it clear.
Spaced two to four weeks apart. IPL and RF are never done on the same day — we alternate them, and we will map the schedule out with you.
The CORE 4 do the daily work between appointments, and using them consistently makes a real difference to how well the course works.
We check the glands again at the end of the course. Most people then come back for a top-up treatment once or twice a year.
Questions
Burning, grittiness, watering eyes, fluctuating vision and contact lenses that stop being comfortable by mid-afternoon are the usual signs. The assessment tells us whether your glands are actually blocked, which is what decides if these treatments will help you.
No. Keep using them through the course — they are still doing something useful. Most people find they reach for them far less by the end.
Usually somewhere around the second or third treatment, and it continues to improve for a while after the course finishes. It is a gradual change rather than a switch being flipped.
No. Both are part of the plan, but they are always scheduled separately.
Meibomian gland dysfunction is a chronic condition, so this is management rather than cure. Glands that have already died back do not come back. That is the reason to treat it sooner rather than later — and why most people return for maintenance once or twice a year.
Yes. The Refresh Cleanse is $75 when added to a dry eye treatment, rather than $99 on its own.
Dry eye treatment starts with an assessment, so we can tell you whether your glands will actually respond — and say so plainly if they will not.