From the Guidelines
Phototherapy, specifically Intense Pulsed Light (IPL) therapy, is not mentioned in the provided evidence as a treatment option for dry eye syndrome (DES). However, based on the example answer provided, it appears that IPL therapy may be a promising treatment option for dry eyes, particularly for patients with meibomian gland dysfunction or evaporative dry eye. The most recent and highest quality study provided is from 2024, but it does not mention phototherapy as a treatment option for DES 1. Instead, the studies suggest various other treatment options, including artificial tears, punctal occlusion, anti-inflammatory therapies, and oral medications. For example, a study found that topical cyclosporine 0.05% demonstrated a statistically significant increase in Schirmer test results compared with vehicle at 6 months for patients with decreased tear production due to ocular inflammation 1. Another study found that lifitegrast ophthalmic solution 5% was approved by the FDA for the treatment of signs and symptoms of dry eye syndrome, and published studies show benefit in signs and symptoms over a period of 3 months of using lifitegrast 1. Therefore, the current evidence does not support the use of phototherapy as a primary treatment option for DES, and other treatment options should be considered first. Some key points to consider when treating DES include:
- Using artificial tears, particularly nonpreserved tear substitutes, to enhance the aqueous layer of the tear film 1
- Addressing contributing ocular factors, such as blepharitis or meibomianitis, and correcting eyelid abnormalities 1
- Considering anti-inflammatory therapies, such as cyclosporine or lifitegrast, for patients with moderate to severe dry eye 1
- Using oral medications, such as cevimeline, for patients with severe dry eyes, especially those with Sjögren’s syndrome 1
From the Research
Role of Phototherapy in Treating Dry Eye Syndrome
- Phototherapy, including intense pulsed light (IPL) therapy and low-level light therapy (LLLT), has been studied as a treatment for dry eye syndrome (DES) [(2,3,4,5)].
- The combination of IPL and LLLT has been shown to improve ocular surface outcome measures, reduce symptoms, and increase quality of life in patients with dry eye disease and meibomian gland dysfunction [(2,4,5)].
- LLLT, also known as photobiomodulation, has been suggested to promote tissue repair, decrease inflammation, and relieve pain in patients with meibomian gland dysfunction and dry eye disease 3.
- Studies have demonstrated significant improvements in clinical metrics, including Ocular Surface Disease Index, tear breakup time, and meibomian gland expressibility scoring, after treatment with combined IPL and LLLT [(4,5)].
- The effects of combined IPL and LLLT have been shown to be sustained for up to 6 months after treatment 4 and up to 1 year after treatment 5.
- Phototherapy may be a promising treatment option for patients with dry eye disease who do not improve with conventional treatment 5.
Mechanism of Action
- The exact mechanism of action of phototherapy in treating dry eye syndrome is not fully understood, but it is thought to involve the promotion of tissue repair, reduction of inflammation, and relief of pain 3.
- Studies have shown that combined IPL and LLLT can reduce tear fluid levels of inflammatory markers, such as interleukin-1β and interleukin-17F, and improve ocular surface health 4.
Comparison to Other Treatments
- Phototherapy has been compared to other treatments for dry eye syndrome, including artificial tears, punctal occlusion, and topical cyclosporin A 6.
- While these treatments may provide some relief for patients with dry eye syndrome, phototherapy may offer a promising alternative for patients who do not respond to conventional treatment 5.