Published in Ocular Surface

Take a Deep Dive Into OptiLight™ by Lumenis®

This post is sponsored by Lumenis
5 min read
In this session from Eyes On 2022, join Laura M. Periman, MD and Damon Dierker, OD, FAAO, for a deep dive into meibomian gland disease (MGD), the BEISTO method, and how OptiLight™ by Lumenis® can treat five out of the six of the conditions that lead to dry eye.
Laura M. Periman, MD knew she wanted to be a doctor from the age of 12.
“I’ve always loved eyeballs,” she said. “Growing up in the wilds of Montana, I was fascinated with the eyes of frogs and fish and different animals.”
As an undergraduate, she received a scholarship to study at the Oregon Regional Primate Research Center, where she focused on proopiomelanocortin (POMC) gene expression in primates under hormonal conditions. She credits this molecular biology experience as a major stepping stone in her career, as it enabled her to secure a position at Immunex Corporation (now Amgen). Once there, she worked on Enbrel®, which suppresses the immune system. She quickly became interested in inflammation and immunopathophysiology, making medical school a logical next step.
Dr. Periman’s deep scientific perspective, mechanical aptitude, and fascination with the human eye made ocular surface disease an ideal challenge for her, as getting to the root cause of dry eye required both her curiosity and core skill set.

What is BEISTO?

Initially, the only prescription medication for dry eye disease was steroid drops, which still play an important role in immunoregulation and treating flare-ups. However, meibomian gland disease has another more chronic component, which Dr. Periman has simplifies into BEISTO, which stands for:
  • Bugs and bacteria—Demodex mites and bacteria can cause inflammation or blockage of meibomian glands.
  • Enzymatic compromise—Medications, inflammation, and omega-3 deficiency can prevent normal production of healthy meibum.
  • Inflammation—This can be local or systemic.
  • Stasis—If the meibum becomes too thick, it can’t move and clogs the pores.
  • Temperature—Abnormal meibum melts at a higher temperature than normal meibum.
  • Obstruction—Whether from Demodex mites or abnormal meibum, clogged glands cause dry eye symptoms because of the lack of tears.

How does OptiLight™ work?

Using a patented Optimal Pulse Technology (OPT™), OptiLight™ reduces inflammation, alleviates abnormal blood vessels that perpetuate inflammation, decreases Demodex mites, improves tear breakup time, and restores meibomian glands.

To learn more about this technology, check out The Ultimate Guide to Optilight!

“No treatment hits all six causes of dry eye,” said Dr. Periman. “That’s why we layer therapies. But OptiLight™ gets five of the six, and it’s high up in my therapeutic offering window.”
Before offering any therapeutic treatments, Dr. Periman first recommends lifestyle changes, including eating more foods high in omega-3 fatty acids, taking supplements, and eliminating smoking and drinking alcohol.
OptiLight™ is often the next step for treatment because Dr. Periman credits the algorithms, platform, and energy delivery as the basis for FDA approval.
At its core, OptiLight™ applies OPT energy to the skin and eyelids with optimized settings and safety functions as well as a handpiece that fits the contour and geometry of the eye. As a result, OptiLight™ provides FDA-approved treatment that’s comfortable for patients.

How to treat advanced dry eye

For typical patients, Dr. Periman recommends about four treatments spaced about 2 to 4 weeks apart, because that seems to be the optimal interval to see an improvement in MMP-9 indicators.
However, advanced cases might require additional treatments. Because Periman Eye Institute is a dedicated dry eye treatment center, Dr. Periman had learned to spot patients who might need additional care.
“I like to do a re-evaluation at visits three and four to see how things are going,” said Dr. Periman. “Then I check meibomian gland expressibility, osmolarity, and MMP-9 load. If those aren’t adequately controlled while the patient is also following diet and lifestyle changes, then I recommend a few follow-on treatments so patients can receive optimal benefits.”
Dr. Periman also does due diligence to ensure her patients had their prescription medications filled and that her patients aren’t also suffering from allergies.
“As dry eye specialists, we know this disease doesn’t follow an algorithm,” said Dr. Periman. “There is no if-then. It doesn’t work like that. That’s why we have to use all the parts of our brain to develop an appropriate plan and engage our patients. Luckily, I love the challenge.”

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  1. Farrand et al. Am J Ophthalmol 2017;182:90-98.
  2. Lemp MA et al. (2012) Cornea May;31(5):472-8.
Damon Dierker, OD, FAAO
About Damon Dierker, OD, FAAO

Dr. Dierker is Director of Optometric Services at Eye Surgeons of Indiana, an adjunct faculty member at the Indiana University School of Optometry, and Immediate Past President of the Indiana Optometric Association. Dr. Dierker is the Co-Founder and Program Chair of Eyes On Dry Eye, the largest event for eyecare professionals in the industry. He has made significant contributions to raising awareness of dry eye and ocular surface disease in the eyecare community, including the development of Dry Eye Boot Camp and other content resources across dozens of publications.

Damon Dierker, OD, FAAO
Laura M. Periman, MD
About Laura M. Periman, MD

Laura M. Periman, MD, is a board-certified ophthalmologist, fellowship-trained cornea and refractive surgeon, and ocular surface disease (OSD) expert. Dr. Periman completed her ophthalmology residency and cornea/refractive fellowship at the University of Washington in Seattle. She has 15 peer-reviewed publications and has written extensively on ocular surface disease.

Her unique and passionate perspective on OSD stems from her work in immunopathophysiology. She is an innovator and enthusiastic speaker who loves bridging the gap between basic science, clinical practice, and patient compassion. Whether delivering top-line care in the sacred 1:1 patient encounter or expanding awareness of the worldwide impacts of dry eye disease, Dr. Periman thrives on contributing to the greater good.

Dr. Periman is the Founder and Director of Dry Eye Services and Clinical Research at Periman Eye Institute in Seattle, as well as the Founder and Chief Medical Officer of Quench Method, an eye-friendly cosmetics company.

Laura M. Periman, MD
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