IPL

I have a new favorite toy!

It’s called the Lumenis Optilight IPL (Intense Pulsed Light) and is the first and only IPL FDA approved for dry eyes.

I have very dry eyes.

I am always staring at something intently- whether it is my computer, my phone, or my patient’s eyes- I don’t blink enough. And blinking is what squeezes the oils out of my Meibomian glands to lubricate my eyes. So my reduced blink rate dries out my Meibomian glands and causes them to degenerate. This is what Meibomian gland degeneration looks like:

Once your Meibomian glands degenerate, they stop secreting the oils that lubricate your eyes, and then you are 100% dependent on artificial tears to lubricate your eyes. Here is a picture of functioning Meibomian glands secreting oil and Non-functioning Meibomian glands not secreting oil:

Before IPL, I used to Lipiflow my Meibomian glands, which heats them up to 108 degrees and squeezes all the gunk out of them so they don’t get clogged and degenerate and can continue to secrete oils to lubricate my super dry eyes. It works great and my eyes feel amazing after the treatment, but Johnson and Johnson charges me so much for the applicators for the treatment that I am hesitant to do the treatment on myself. A Lipiflow treatment at my office costs $900.

My material costs for IPL is less than that of Lipiflow. I charge $400 for an IPL treatment, which is less than most Dermatologists in my area charge for the same IPL treatment for skin treatments.

So IPL was originally used by Dermatologists to remove wrinkles and hyperpigmentation and acne and rosacea and lesions on skin, which I can also do with my IPL because I opted to pay extra for the Aesthetic component. It’s great, and my patients often ask me to IPL cysts, lesions, and hyperpigmentation on their face while I am performing IPL on their Meibomian glands and eyelid lesions.

Here are some before and after pictures:

This is a picture of Meibomian Glands before IPL treatment. See how the Meibomian glands in the circled area have degenerated and are more bent and shorter than they should be?

Now this is a picture of Meibomian Glands after IPL treatment:

See how the Meibomian glands in the circled area look straighter and longer and healthier?

This is after 4 IPL treatments scheduled 2-4 weeks apart, which is what Lumenis recommends for dry eye based on their studies that show 4 treatments spaced 2-4 weeks apart cause 6.3x more glands to express oil and 2.7x improvement in tear break up time (how fast your tears evaporate on your eyes).

I have also started dabbling in Aesthetics because of my love for “Dr. Pimple Popper”. I love popping eyelid pimples, also known as hordeolums, chalazians or styes, which often happen when your Meibomian glands get clogged and infected and have pus coming out of them.

.I love popping eye pimples and squeezing the pus out. It is very satisfying… for me.

Anyways, IPL works great for eye pimple popping. Performing IPL on an eye pimple is like magic. Sometimes I can pop it right after in the office, and sometimes it goes away in days or weeks as opposed to the months that it used to take without IPL when I just told my patients to warm compress it until it went away slowly.

IPL is really great at treating the underlying inflammation that causes things like eye pimples. I always recommend patients who get recurrent eye pimples to get preventative treatments before they get an active eye pimple. I want to prevent the eye pimples before they happen because after they happen they often cause that Meibomian gland to degenerate and disappear completely. And then you have one less oil secreting gland to lubricate your eyes.

I’ve also noticed that the wavelength of intense pulsed light used in the dry eye treatment, 590 nm, is the same wavelength used to treat acne, Rosacea, and hyperpigmentation. It seems to be the magic wavelength that treats everything. It is my new favorite wavelength,

Anyways, I started this IPL blog because I wanted a space to post a before and after gallery of IPL magic. Here are some before and after pictures of just 1 IPL treatment:

Also, I have kind of been experimenting on myself. I have a ton of freckles all over my face. And I have been testing out the IPL on myself, one freckle at a time.

So I started with the freckle above the inner corner of my left eye:

Day 1 after IPL at 590 nm wavelength at 17 joules I had a scab. I may have used a little too high intensity. I have done IPL on myself from 9 joules to 18 joules. 11 joules is the low intensity I use for dry eye therapy. 18 joules is the intensity for laser hair removal (yes my IPL device also does laser hair removal which I have also done on myself).

Day 2 post IPL I still had a scab. The scab got a little raised.

Day 3 the scab fell off and the freckle above my eye looks much lighter.

I have been getting IPL monthly on my Meibomian glands as well as on my face. It’s my secret to looking young. I’ll try to post more pictures over time as I try to get rid of all the hyperpigmentation and skin damage of 34 years of not applying sunscreen on my face (sunscreen makes my eyes sting!). I also have some friends who also come in for IPL treatments monthly that I can ask if I can post before and after photos of. Or maybe I’ll just ask Lumenis if they have any good content I can post. Their stuff will probably look more professional than me and my friends taking selfies.