Dry eye treatment: why it happens and how IPL therapy helps
That gritty, burning, tired-eye feeling at the end of the day is rarely "just fatigue." Behind dry eye there is often a specific, treatable problem: tiny eyelid glands that have stopped working properly.
Dry eye is one of the most frequent reasons for an ophthalmology visit, and it is remarkably common. Population studies in Mexico report dry-eye symptoms in roughly 40% to over 50% of people evaluated, more often in women and increasing with age.[1] Yet despite how common it is, dry eye remains poorly understood: many people assume it is simply "not enough tears" and that a few drops will fix it.
The reality, according to the most widely accepted international consensus (the TFOS DEWS II report), is more nuanced. Dry eye is a multifactorial disease of the ocular surface in which the tear film loses stability, causing discomfort, fluctuating vision and, over time, damage to the surface of the eye.[2] And in most cases the problem is not the quantity of tears, but their quality.
Why does dry eye happen?
Our tears are not just water. They have an oily (lipid) layer on the outside that keeps them from evaporating too quickly. That oil is produced by tiny glands along the edge of the eyelids, called the meibomian glands.
When these glands become blocked or stop working well —a condition known as meibomian gland dysfunction, or MGD— tears evaporate too soon. Even if the eye produces enough tears, the surface is left unprotected. This is why TFOS DEWS II identifies MGD as the leading cause of evaporative dry eye, the most common form.[2]
Factors such as prolonged screen use (which reduces blinking), dry environments, hormonal changes, certain medications and aging all make these glands more likely to deteriorate.
How is it diagnosed? The role of digital meibography
This is where treating symptoms diverges from treating the cause. To understand why an eye is dry, listening to the complaints is not enough: you need to see the state of the meibomian glands. That is what meibography makes possible.
Meibography is a non-invasive imaging technique that uses infrared light to photograph the internal structure of the eyelid glands, with no contact and no discomfort for the patient.[3] The image shows how many glands remain, whether they are shortened, dilated or already lost. It is an objective, repeatable tool, which makes it especially useful for grading severity and for measuring whether a treatment is working over time.[3]
At Fundación Castañón, dry-eye diagnosis relies on a digital meibographer: the image of the glands guides the treatment decision, rather than prescribing drops "blindly."
Intense pulsed light (IPL) therapy
When meibography confirms that the meibomian glands are compromised, one of the best-supported treatments is intense pulsed light (IPL). It involves applying pulses of light to the skin around the eyelids; that stimulus generates heat that helps unclog the glands, improves the quality of the oil they produce and reduces inflammation of the lid margin, so tears once again cover the surface of the eye more effectively.
The evidence on IPL has grown substantially. Recent systematic reviews and meta-analyses, pooling multiple randomized controlled trials, conclude that IPL improves both the symptoms and the signs of MGD-related dry eye —including tear film stability— with a favorable safety profile and side effects that are generally mild and transient.[4][5] In most protocols, treatment is delivered in two to four sessions spaced several weeks apart,[4] with the exact number tailored to each patient according to the severity observed.
At Fundación Castañón, treatment is performed with the Eye-Light® system by Espansione Group, which combines intense pulsed light (IPL) with a complementary photobiomodulation technology (LLLT, or "light modulation") delivered through a mask that covers both eyelids. Comparative studies of light-based devices show that both technologies are safe and effective at improving MGD symptoms, and using them together aims to enhance the outcome.[6]
The role of lubricants between sessions
IPL works on the cause; artificial tears support the process by protecting the ocular surface while the glands recover. Between sessions, Fundación Castañón recommends lubricating drops from the Systane® line (Alcon), formulated for dry-eye relief.
It helps to understand the role of each: artificial tears relieve symptoms and protect the ocular surface, but on their own they do not correct gland dysfunction.[7] That is why the most complete approach combines both strategies —treating the cause with IPL and sustaining comfort with lubrication— rather than relying on drops alone.
When to see a doctor
Mild dry eye can be managed with habits and lubrication, but an ophthalmology assessment is worthwhile if you experience:
- A gritty, burning or foreign-body sensation lasting more than a few weeks
- Blurred vision that improves when you blink
- Frequently red or irritated eyes
- Paradoxical excessive tearing (the eye waters a lot but still feels dry)
- Discomfort with contact lenses you used to tolerate well
- Light sensitivity or marked eye strain at the end of the day
Early diagnosis helps protect the meibomian glands before they are lost, since advanced gland damage is not reversible.
Frequently asked questions
Can dry eye be cured?
Dry eye is usually a chronic condition, so the goal is control rather than cure. With the right diagnosis and a sustained plan, most people can reduce their symptoms and protect the ocular surface over the long term.
How many IPL sessions are needed?
It depends on severity. In the literature, protocols typically involve two to four sessions spaced several weeks apart; the exact number is defined by the ophthalmologist after a meibography assessment.
Does IPL therapy hurt?
It is generally well tolerated. Most patients describe a sensation of warmth or small flashes of light, with no need for anesthesia. Reported side effects are mild and transient.
Are lubricating drops enough for dry eye?
Artificial tears relieve symptoms and are part of treatment, but when the cause is meibomian gland dysfunction they do not correct the underlying problem. That is why they are usually combined with treatments that act on the glands.
Clinical perspective
Section intended for healthcare professionals.
The management of MGD-related evaporative dry eye benefits from objective staging prior to treatment. Infrared meibography provides reproducible morphometric information (gland dropout, tortuosity, shortening) that, integrated with functional testing (tear break-up time, osmolarity, ocular surface staining and OSDI/SPEED questionnaires), allows the patient to be phenotyped and candidates for light-based therapies to be selected.[3]
Evidence accumulated in meta-analyses of randomized controlled trials supports IPL as an effective intervention on symptoms (OSDI, SPEED) and signs (TBUT, meibum quality) in MGD, with a favorable safety profile; typical protocols involve two to four sessions and are often enhanced with meibomian gland expression.[4][5] Comparative studies of IPL versus LLLT suggest benefits with both modalities and a rationale for combined use.[6] Maintenance lubrication is conceptualized as adjunctive ocular-surface therapy, not as etiologic monotherapy in the evaporative phenotype.[7] Response should be monitored with objective parameters and serial meibography.
If you have persistent dry-eye symptoms, it's worth finding out the cause. The Ophthalmology team at Fundación Castañón can assess you with digital meibography and explain which plan fits your case: book an assessment or message us on WhatsApp.
References
- Hernández-Zimbrón LF, et al. Dry eye syndrome: a literature review (prevalence in the Mexican population). Revista de la Facultad de Medicina UNAM. 2021. https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026-17422021000500046
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Tear Film & Ocular Surface Society. 2017. https://www.tfosdewsreport.org/
- Pult H, et al. Meibomian gland assessment in routine ophthalmology practice (infrared meibography). PMC. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9964065/
- Peira E, et al. Effectiveness and safety of intense pulsed light therapy for dry eye symptoms due to meibomian gland dysfunction — A systematic review and meta-analysis. Acta Ophthalmologica. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12069959/
- Miao S, et al. Intense pulsed light (IPL) therapy for meibomian gland dysfunction (MGD)-related dry eye disease: a systematic review and meta-analysis. Lasers in Medical Science. 2022. https://link.springer.com/article/10.1007/s10103-022-03690-1
- Comparison of Light-Based Devices (IPL vs LLLT) in the Treatment of Meibomian Gland Dysfunction. PMC. 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401307/
- Labetoulle M, et al. A Decade of Effective Dry Eye Disease Management with Systane Lubricant Eye Drops. Clinical Ophthalmology. PMC. 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8200152/