For the optometric physician, the economic signal is clear: Medical aesthetics is currently outpacing nearly every other healthcare vertical.1 While traditional medical markets and device sectors are stabilizing at a respectable 4 to 6% compound annual growth rate (CAGR),2,3,4 medical aesthetics is charting a trajectory closer to 12 to 14% through 2030.1,5
These are growth rates typically reserved for high-velocity technology sectors rather than established medicine. To understand the magnitude of this opportunity, we must contextualize it against the growth rates of our traditional peers.
Trends in healthcare market growth
Current market intelligence (2025 through 2030) reveals a distinct hierarchy in healthcare growth. The data shows medical aesthetics growing at roughly double the rate of traditional eyecare,2,3 and triple the rate of primary care.4
Figure 1: Healthcare market growth comparison (2025 through 2030).1-7 By comparison, the broader elective healthcare services market is growing at approximately 9%,2 while the mature pharmaceutical sector averages around 6.1%.3 By integrating ocular aesthetics, we are not merely adding a service, optometrists are aligning our practices with the most robust growth engine in the modern healthcare landscape.
Figure 1: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Bridging the gap: From economics to disease modification
The surge in medical aesthetics is not merely vanity‑driven; it is powered heavily by the “pre‑juvenation” shift.1 Younger demographics are seeking regenerative, non-invasive treatments to preserve tissue health before damage occurs.1,5
From a preventive medicine standpoint, this overlap is especially relevant to modern optometric practice. Because chronic meibomian gland dysfunction (MGD) is a progressive disease, early intervention is critical, particularly from a preventive medicine perspective.8,9
Treatments that reduce inflammation and restore periocular tissue health can optimize long‑term outcomes and reduce disease burden.8,10 Technologies such as intense pulsed light (IPL), radiofrequency (RF), and low-level light therapy (LLLT) exemplify this convergence. Traditionally utilized in aesthetic settings for skin rejuvenation, these platforms are now being marshaled by optometric physicians to treat functional pathology.11
This affirms optometry’s medical authority in this shared space and has effectively birthed the subspecialty of ocular aesthetics, positioning the optometrist at the forefront of this evolving clinical model.
Operational integration: The medical-first model
A common barrier for optometric physicians is the fear of becoming "salespeople" or diluting their medical brand. However, when ocular aesthetics is framed through the lens of tissue health, the conversation shifts from selling beauty to prescribing outcomes.
Successful integration does not require turning a clinic into a day spa. It requires a subtle shift in the diagnostic workflow to focus on structure and function, then connect those findings to specific therapeutic interventions.
The structure-function consult
Rather than leading with device names, you link the patient’s symptoms to their anatomy and pathophysiology. Patients are usually seeking relief from “tired,” “heavy,” or “red” eyes, and not asking for IPL or RF by name.
Consult script: "Mrs. Jones, your dry eye is driven by two distinct problems: deep inflammation and gland obstruction. To treat the root cause, we use combination therapy. We utilize light therapy to target the inflammation and radiofrequency heat to melt the obstruction. These technologies work together to restore function better than either one alone. A beneficial side effect is that this combination also tightens the skin and improves texture around the eyes."
In this medical‑first model, your recommendation remains grounded in disease, with aesthetic improvement as an expected secondary benefit rather than the primary goal.
Ocular aesthetic procedures
Integration requires a strategic mix of technologies. The following list identifies the primary instrument categories and the leading FDA-cleared platforms commonly utilized in the optometric aesthetic suite.
Intense pulsed light (IPL)
IPL is the workhorse of the dry eye and aesthetic clinic. It uses broad-spectrum light to target chromophores (hemoglobin and melanin), treating both the inflammation of rosacea/MGD and aesthetic concerns like age spots and telangiectasia.11,12
Key IPL devices include:
- Lumecca (InMode): Widely regarded as one of the most powerful IPL platforms on the market, Lumecca delivers high-peak power that allows for effective treatment in fewer sessions than traditional devices. Its specialized "Lumecca-I" protocol is specifically optimized for periocular use, targeting the vascular roots of dry eye and ocular rosacea while clearing age spots and sun damage.13
- OptiLIGHT (Lumenis): The first and only IPL FDA-approved for the management of dry eye disease. It uses patented Optimal Pulse Technology (OPT) to deliver consistent, precise energy for safe and effective treatment of MGD and rosacea.14
- Sciton BBL HERO (Sciton): Utilizing "BroadBand Light" (BBL) technology, this platform is distinct from traditional IPL due to its high-energy rapid output (HERO). It allows practitioners to treat the entire face in minutes with a "motion" technique, rather than static stamping. It is highly effective for both ocular rosacea management and significant skin photorejuvenation.15
Figures 2 and 3: Top: Resolution of nasal telangiectasia and erythema using InMode Lumecca IPL. Bottom: Clearance of dorsal hand pigmentation using InMode Lumecca IPL, demonstrating the platform's versatility beyond the periocular zone.
Figure 2: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 3: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Radiofrequency (RF)
RF technology uses electrical energy to generate heat in the dermis, stimulating collagen production (tightening) and melting meibomian gland obstructions (MGD treatment).16
Commonly-used RF devices include:
- Forma-I (InMode): A leading RF option in optometry, with a specialized bipolar handpiece specifically designed for the upper and lower eyelids. It provides precise thermal control to melt meibomian obstructions and stimulate collagen, effectively treating MGD while tightening lid laxity without downtime.17
- OptiPLUS (Lumenis): A dual-frequency RF device designed to complement the OptiLIGHT IPL that offers monopolar and bipolar modes so you can customize the depth of heat penetration for different tissue types and clinical needs.18
- NuEra Tight (Lumenis): A temperature-controlled RF platform utilizes FocalRF technology to dial in the exact frequency required to target specific skin depths, from superficial tightening to deep tissue remodeling.19
- TempSure Envi (Cynosure): Monopolar RF specifically designed with small handpieces for delicate periocular areas. Its Therapeutic Logic Control (TLC) activates a timer only when tissue reaches therapeutic temperature, ensuring consistent dosing every time.20
- Pelleve (Cynosure): An established RF system for non-ablative skin tightening. It uses a "gliding" technique to gradually heat the deep layers of the skin, offering a comfortable, massage-like experience for patients with mild to moderate facial wrinkles.21
Figures 4 and 5: Addressing both functional and aesthetic eyelid concerns with radiofrequency; (top) successful resolution of bilateral chalazia highlights the therapeutic utility of RF in ocular surface disease, and (bottom) enhanced skin texture and lid tightening demonstrate the aesthetic benefits of the same technology.
Figure 4: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 5: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figures 6, 7, and 8: The dual impact of combination IPL and RF protocols. By addressing the underlying inflammatory components of MGD and chalazia, these treatments simultaneously provide aesthetic improvement in lid texture and redness, illustrating the intersection of ocular health and aesthetics.
Figure 6: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 7: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 8: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
RF microneedling
This hybrid technology combines the mechanical stimulation of microneedling with the thermal energy of radiofrequency. Needles penetrate the dermis to deliver heat directly to deeper tissue layers, promoting significant collagen remodeling and scar reduction.22
Devices that feature RF microneedling include:
- Morpheus8 (InMode): One of the industry leaders in fractional RF technology. Morpheus8 penetrates up to 4mm to remodel subdermal adipose tissue and tighten skin.
- Its chromophore-independent technology bypasses the epidermis to deliver energy directly to the subdermal layers, making it safe for all Fitzpatrick skin types (including Type VI).23
- Its specialized small tips allow for safe, potent rejuvenation of the periorbital scallops and malar bags, and it is commonly indicated for non-surgical upper and lower lid blepharoplasties.22,23
- VirtueRF (Cartessa): A versatile platform offering adjustable depths for customized treatments. It features a unique "Smart RF" handpiece with robotic precision delivery (RPD) to minimize trauma and discomfort, making it an excellent option for anxious patients.24
- Potenza (Cynosure Lutronic): Offers four different RF modes (monopolar and bipolar) for diverse skin types. Its signature "Fusion Tip" drives topicals deep into the dermis during treatment, allowing for enhanced delivery of exosomes or PRP directly into the skin.25
- Sylfirm X (Benev): Known for its dual-wave technology (continuous and pulsed wave) to treat pigmentation and redness. This allows it to treat vascular pigmentary issues like melasma and rosacea redness that other RF microneedling devices might exacerbate.26
- Secret RF (Cutera): A fractional RF system designed for skin revitalization and photodamage. It offers highly adjustable needle depths (0.5mm to 3.5mm), making it adaptable for treating everything from fine periocular lines to deep acne scars.27
Figures 9 and 10: Surgical-grade outcomes achieved via non-invasive radiofrequency microneedling (Morpheus8) without the associated downtime. A single session effectively reduced upper lid dermatochalasis to mimic a surgical blepharoplasty (top) and provided forehead resurfacing to resolve a traumatic scar and reduce fine lines (bottom). These cases illustrate robust tissue remodeling without surgical recovery.
Figure 9: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 10: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Dynamic muscle stimulation (DMSt)
DMSt targets the muscular layer (specifically the orbicularis oculi) rather than the skin or glands alone. By stimulating muscle contractions, it rehabilitates blink mechanics and improves lower lid tone.28
The primary device in this category includes:
- OptiLIFT (Lumenis): Designed to treat lid laxity and improve blink dynamics in dry eye patients. It is the only device specifically engineered to target the neuromuscular component of the ocular surface.28,29
Figure 11: Periocular improvement following a series of combined RF and DMSt treatments, demonstrating enhanced lid tone, smoother skin texture, and reduction in dry eye symptoms through improved blink dynamics and meibomian gland performance.
Figure 11: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Low-level light therapy (LLLT)
LLLT (or photobiomodulation) uses non-thermal specific wavelengths of light to stimulate cellular activity (ATP production) and reduce inflammation.30 It is painless and requires no gel.
Commonly used LLT devices include:
- Equinox (Marco): A mask-based LLLT system widely used for treating MGD, chalazia, and rosacea. Its hands-free design allows for high clinical throughput, as staff can set it up and leave the room while the patient undergoes treatment.30
- Eye-Light (Espansione Group): Combines LLLT (Light Modulation) with OPE (Optimal Power Energy) IPL for a dual-action treatment. This allows practitioners to treat the upper and lower lids simultaneously with light modulation while targeting the lower lid with thermal energy.31
Gentle facial aesthetics: The safe entry point
For patients whose primary concern is "looking better" but who carry risks for MGD or dry eye, gentle facial platforms offer a critical bridge. Unlike harsh chemical peels or generic spa facials that can exacerbate ocular irritation, systems like Hydrafacial and OxyGeneo are designed to be ocular-safe.32-34
They provide an immediate aesthetic improvement: hydration, skin tone, and "glow," while mechanically removing the biofilm and debris that fuel inflammation.32,33 This category often serves as a low-barrier introduction to the aesthetic suite, converting "beauty-first" patients into long-term candidates for advanced dry eye therapy.
Hydrafacial
Hydra-dermabrasion devices cleanse, exfoliate, and hydrate the skin using a vacuum-based tip and specific serums.
Two devices that feature hydra-dermabrasion include:
- Hydrafacial Syndeo (The Hydrafacial Company): A flagship system known for its patented Vortex-Fusion technology. It integrates cloud-based data tracking to log patient treatments and preferences, ensuring a consistent and personalized experience. The Perk Eye attachment is a key differentiator, offering a specific protocol to gently exfoliate and hydrate the delicate periocular skin without irritation.32
- DermaFacial (SO Esthetics): A customizable hydro-facial platform often used as a cost-effective alternative. It offers similar exfoliation and infusion capabilities but with a more simplified interface and lower consumable costs.33
OxyGeneo
OxyGeneo is a three‑step facial treatment (exfoliate, infuse, oxygenate) that leverages the Bohr effect to trigger endogenous oxygenation of the skin.34
A key device with OxyGeneo technology includes:
- GENEO X (Pollogen / Lumenis): The latest platform offering OxyGeneo technology combined with ultrasound and neo-massage. It uses a unique "oxypod" capsule that reacts with the gel to create CO2 bubbles on the skin surface, driving oxygen-rich blood to the treatment area.34 This systemic oxygenation improves skin health without the heat or ablation of energy-based devices.34
Plasma energy
Plasma devices operate on the principle of sublimation—turning solid tissue directly into gas—by ionizing gases in the air between the device tip and the skin to create a small electrical arc.35 This arc ablates the superficial epidermis with minimal lateral heat spread, causing precise contraction and tightening.35
Accessible devices that use plasma energy include:
- NuVissa Plasma Pen (NuVissa): Designed specifically for delicate periocular tissues, NuVissa utilizes "Plasma Arc" technology to allow for controlled tissue retraction and skin tightening of the upper and lower lids.
- Clinically, it is also utilized for treating conjunctivochalasis (CCH) and uncapping meibomian glands (removing hyperkeratinized obstructions), bridging the gap between aesthetic tightening and dry eye management.36,37
- Jett Plasma Lift Medical (Jett Medical): Distinguished by its Direct Current (DC) technology, this device creates a stable, continuous plasma beam. Unlike Alternating Current (AC) pens that create erratic "sprays," the DC beam allows the practitioner to "scan" or paint the tissue rather than just placing individual dots. This precision allows for deeper remodeling and a thinner crust (scab) formation, leading to faster healing times.38
- Plexr (Gruppo GMV): A pioneer of "Soft Surgery" non-surgical blepharoplasty. It generates plasma through a wireless technique that does not conduct electricity through the patient's body (unlike many other pens). This "pure plasma" ionization ensures that damage is strictly limited to the superficial epidermis, preserving the basal lamina and minimizing the risk of scarring.39
Figure 12: Before and 2-week post-treatment appearance following conjunctivochalasis treatment using the NuVissa Plasma Pen. The top column demonstrates pre-treatment findings with a reduced inferior tear reservoir on cobalt blue illumination. The bottom column shows the 2-week post-treatment appearance with improved inferior tear meniscus formation and tear reservoir continuity following conjunctival tissue reduction.
Figure 12: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Figure 13: NuVissa Plasma Pen treatment for conjunctivochalasis. The top panels show intra-procedural plasma application to redundant inferior bulbar conjunctiva, with bottom panels demonstrating 1-week post-operative improvement in conjunctival contour.
Figure 13: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Video 1: Conjunctivochalasis reduction with the NuVissa Plasma Pen is a key intervention in ocular aesthetics and medical dry eye care. By eliminating redundant conjunctival tissue, this procedure reduces chronic bulbar hyperemia and mechanical irritation while restoring normal tear reservoir dynamics, resulting in improved tear film stability and whiter, quieter, healthier-appearing eyes.
Video 1: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Neurotoxins and fillers
These injectables are the cornerstone of non-surgical periocular rejuvenation. Neurotoxins work by inhibiting acetylcholine release at the neuromuscular junction, effectively relaxing the orbicularis oculi and corrugator muscles to smooth dynamic wrinkles.40
Fillers, primarily hyaluronic acid (HA) based, restore lost volume in the periorbital fat pads. They are essential for addressing the "hollow" look associated with tear trough deformities and structural aging.41
Injectables that could be used in ocular aesthetics include:
- Botox Cosmetic (Allergan/AbbVie): A gold standard for treating dynamic lines in the upper face. In the ocular suite, it is most commonly indicated for lateral canthal lines ("crow’s feet") and glabellar lines ("11s"). It is also utilized for the "chemical brow lift," where strategic injection into the depressor muscles allows the elevators to lift the brow arch, opening the eye aperture.40
- Dysport (Galderma): Known for a slightly wider field of effect compared to Botox, making it an excellent choice for larger surface areas like the forehead. Its diffusion characteristics can offer a softer, more natural "feathered" look for extensive crow's feet that extend down the cheek.42
- Xeomin (Merz Aesthetics): A "naked" neurotoxin, meaning it is double-filtered to remove complexing proteins. This purity reduces the risk of antibody formation, making it the preferred choice for patients who have developed resistance to other toxins or those seeking a "cleaner" formulation.43
- Juvéderm Collection (Allergan/AbbVie): A family of HA fillers using Vycross technology to cross-link molecules for durability and smooth integration.
- Juvéderm Volbella XC is specifically favored for the tear trough region due to its lower water affinity and soft consistency. This provides a natural fill for under-eye hollows without the Tyndall effect.42,44
Legal considerations and staffing for ocular aesthetics
As optometric physicians expand into advanced procedures, the legal framework shifts from diagnostic medical management to a complex interventional model.
Scope and supervision
The regulatory landscape for aesthetic procedures varies significantly by state. Some states allow optometrists to perform IPL, RF, and minor surgical procedures independently; others require specific certifications, laser privileges, or medical director agreements.45
A practical starting point is to review your state board’s definitions of “surgery” and “energy‑based modalities.” In many jurisdictions, a procedure primarily indicated for ocular disease (e.g., MGD or rosacea) falls within optometric scope, whereas the identical procedure performed solely for cosmetic purposes may require different oversight.45
Strategic delegation and workflow
To maximize profitability and clinical volume, successful practices often employ a hybrid delivery model. Procedures that rely on automated protocols or established safety profiles, such as RF, LLLT, and DMSt, are frequently delegated to trained technicians (state board permitting). This allows for a "parallel column" of revenue that does not require the physician’s direct continuous presence.46
Physician-led care is often best for high-precision or energy-based modalities, ensuring superior tissue monitoring, risk management, and reinforcing both medical necessity and the patient-doctor relationship.
Staff support is critical regardless of who holds the handpiece. Technicians can manage the "bookends" of each visit by obtaining informed consent, applying an anesthetic, placing eye shields, and delivering post-procedure instructions. This ensures the doctor can focus on diagnosis and treatment planning.
Consent documentation should emphasize realistic expectations ("improvement, not perfection"), potential risks, and the likely need for maintenance therapy.
Practice management and marketing
Introducing cash‑pay services into an insurance‑based practice requires a shift in psychology. You are not selling luxury; you are prescribing solutions that insurance has failed to cover for a chronic, quality‑of‑life‑limiting disease.
The "Global Period" approach (Bundling)
Avoid selling single sessions. In the medical model, we treat conditions until remission. Therefore, aesthetic and dry eye procedures should be presented as a course of therapy.
A typical bundle might include a series of four IPL/RF sessions spaced 2 to 4 weeks apart and packaged as an “Ocular Surface Restoration” or “MGD Reset” program. Presenting this as a single global fee improves adherence, because patients who commit upfront are more likely to complete the regimen than those paying visit‑by‑visit.47
Internal marketing: The silent screener
You do not need large external campaigns to launch an ocular aesthetics program; your schedule already contains ideal candidates.
Adding a brief periocular aesthetics/dry eye checklist to your technician intake (for example, “Are you bothered by drooping eyelids, redness, or tired‑looking eyes?”) allows staff to quietly flag prospects. When a patient has already acknowledged a concern, your recommendation becomes a natural medical solution rather than a sales pitch.
The surgical gatekeeper
By embracing ocular aesthetics, you position yourself as the primary care provider for the periocular adnexa, managing non‑surgical preservation, disease modification, and the surgical referral pipeline.
Building a close relationship with an oculoplastic surgeon creates a bidirectional network: you refer advanced ptosis or dermatochalasis for surgical correction, and you receive post‑blepharoplasty patients back for dry eye management and long‑term ocular surface maintenance.
Conclusion
The modern optometric physician is an interventional specialist, capable of managing not just the visual axis but the entire periocular adnexa. By integrating ocular aesthetics, you are not abandoning your medical roots; you are deepening them.
Recognizing that form and function are inseparable, you can leverage light, heat, neuromuscular stimulation, gentle facials, plasma, neurotoxins, and fillers to restore tissue health and stability. In doing so, you offer patients what they have always wanted: eyes that not only see better, but also look and feel better over the long term.
