From the Guidelines
Phototherapy is not a recommended treatment option for dry eye syndrome (DES) based on the provided evidence. The most recent and highest quality study, 1, does not mention phototherapy as a treatment option for dry eye syndrome. Instead, it recommends treatments such as permanent punctal occlusion, autologous serum and autologous plasma rich in growth factors drops, and rigid gas-permeable scleral lenses for severe dry eye.
Treatment Options for Dry Eye Syndrome
- Permanent punctal occlusion can be accomplished by means of thermal or laser cautery, with thermal cautery being more effective but not readily reversible 1.
- Autologous serum and autologous plasma rich in growth factors drops have been reported to improve ocular irritation symptoms and conjunctival and corneal dye staining in patients with Sjögren’s syndrome and GVHD 1.
- Rigid gas-permeable scleral lenses have been used successfully in the treatment of severe dry eye for years, but may be limited by fitting difficulties, cost, and patient willingness and ability to manage lens insertion and removal 1.
Importance of Comprehensive Dry Eye Management
It is essential to address contributing ocular factors such as blepharitis or meibomianitis and eyelid abnormalities resulting from blepharitis, trichiasis, or lid malposition 1. Artificial tears, particularly nonpreserved tear substitutes, are a safe and effective modality for treating dry eye, especially when used frequently and chronically 1.
Medications for Dry Eye Syndrome
- Cyclosporine 0.05% has been shown to be effective in treating dry eye, particularly in patients with moderate to severe dry eye, by reducing inflammation and improving tear film quality 1.
- Lifitegrast ophthalmic solution 5% has been approved by the FDA for the treatment of signs and symptoms of dry eye syndrome, with published studies showing benefit in signs and symptoms over a period of 3 months 1.
In summary, while phototherapy may be a promising treatment option for dry eyes, the provided evidence does not support its use as a recommended treatment option for dry eye syndrome. Instead, a comprehensive approach to dry eye management, including artificial tears, medications, and surgical procedures, should be considered.
From the Research
Role of Phototherapy in Treating Dry Eye Syndrome (DES)
- Phototherapy, including low-level light therapy (LLLT) and intense pulsed light (IPL) therapy, has been studied as a treatment for dry eye syndrome (DES) 2, 3, 4, 5.
- LLLT has been shown to improve tear film production and stability, as well as reduce ocular discomfort symptoms in patients with DES 3, 4.
- IPL therapy, often used in combination with LLLT, has been found to improve meibomian gland function and reduce inflammation in patients with evaporative dry eye disease 2, 5.
- The mechanism of action of photobiomodulation (low-level light therapy) is thought to promote tissue repair, decrease inflammation, and relieve pain 4.
- Clinical studies have demonstrated the efficacy and safety of combined light therapy (IPL + LLLT) in improving clinical and molecular outcomes in patients with recalcitrant evaporative dry eye disease with meibomian gland dysfunction 5.
Benefits of Phototherapy for DES
- Improves tear film production and stability 3.
- Reduces ocular discomfort symptoms 3, 5.
- Decreases inflammation 4, 5.
- Promotes tissue repair 4.
- Relieves pain 4.
Studies on Phototherapy for DES
- A retrospective study found that combined light therapy (IPL + LLLT) improved ocular surface outcome measures in patients with meibomian gland dysfunction and dry eye disease 2.
- A prospective study demonstrated that serial sessions of a novel LLLT device for home treatment of dry eye disease significantly improved tear film production and stability, as well as ocular discomfort symptoms 3.
- A review of the literature on photobiomodulation (low-level light therapy) in meibomian gland dysfunction and dry eye disease found that the technique is suggested to promote tissue repair, decrease inflammation, and relieve pain 4.
- A prospective study evaluated the effects of combined light therapy (IPL + LLLT) on clinical and molecular outcomes in evaporative dry eye disease with meibomian gland dysfunction, finding significant improvements in clinical metrics and reductions in inflammatory markers 5.