Dry eye disease (DED) remains one of the most common conditions we face in eyecare. According to the TFOS DEWS III Epidemiology Report, prevalence varies significantly by age, sex, and diagnostic criteria, ranging from approximately 4.7% to 62.9% when both symptoms and signs are required.1
The disease is multifactorial, with both aqueous-deficient, evaporative, and mixed subtypes contributing to patient burden. For years, we have leaned heavily on lubricants, anti-inflammatory drops, and thermal or mechanical gland therapies.
An exciting frontier in ocular surface care is neurostimulation, the concept that targeted electrical stimulation can restore function to dysfunctional tear and blink pathways. Most of us are already familiar with intense pulsed light (IPL), radiofrequency (RF), and neurostimulation devices such as TrueTear and iTEAR.
Now, dynamic muscle stimulation (DMSt) is emerging as a complementary therapy that targets the mechanical side of dry eye disease by retraining the blink and improving the structural support of the eyelids.2
What is dynamic muscle stimulation?
DMSt is a non-invasive form of neuromuscular electrical activation designed to engage the small, fatigue-prone muscles around the eyes. These include the orbicularis oculi, a critical driver of blink force and tear distribution.
Through controlled microcurrent pulses, DMSt induces brief, repetitive contractions that mimic natural blinking and promote physiologic muscle recruitment patterns.2-4 Recent clinical evidence suggests that periocular DMSt can meaningfully enhance orbicularis strength, reduce lower lid laxity, and normalize blink completeness in patients with evaporative dry eye.2
Functional gains observed after serial treatments included:2
- Improved lid apposition to the globe
- Stronger blink closure
- Measurable increases in tear film stability and meibomian gland function
Collectively, these findings position DMSt as a restorative therapy for one of the most overlooked components of ocular surface homeostasis: eyelid and blink mechanics.
Mechanism of action and relevance to dry eye
Blinking is central to ocular surface integrity, providing mechanical compression of the meibomian glands and uniform redistribution of the tear film. Disruption of this process, whether from orbicularis weakness, lower lid laxity, or incomplete blinking, contributes directly to lipid layer instability and tear evaporation.2
DMSt appears to act by reactivating neuromuscular pathways that have become underutilized or weakened over time. Repetitive stimulation of the periocular muscles strengthens contraction amplitude and improves lid position, which in turn facilitates more efficient meibomian expression and tear film renewal.2-4
Across early clinical evaluations, treatment led to consistent improvements in tear breakup time, glandular function, and blink metrics, supporting the role of eyelid rehabilitation as a legitimate therapeutic target in modern dry eye management.2
By addressing mechanical rather than purely inflammatory or secretory contributors to disease, DMSt complements traditional pharmacologic and procedural approaches. It restores the blink to a more physiologic pattern, closing the gap between neuromuscular stimulation and ocular surface rehabilitation.
The OptiLIFT System: Lumenis dynamic muscle stimulation in practice
In 2025, Lumenis, known for the OptiLIGHT IPL platform, introduced OptiLIFT, a DMSt system designed to improve blink function, eyelid tone, and tear film stability.4 OptiLIFT uses gentle, low frequency electrical impulses to activate and strengthen the orbicularis oculi and periorbital muscles, enhancing blink mechanics and tear distribution.2-4
Mechanism and clinical rationale
OptiLIFT provides rhythmic stimulation of the periocular muscles, producing visible yet comfortable contractions that replicate the physiologic blink cycle. This controlled neuromuscular activation enhances local circulation, supports lymphatic drainage, and promotes tighter lid apposition against the globe.2
The resulting improvement in blink dynamics directly supports more uniform lipid layer expression and better tear film stability.2-4 Clinical evaluations have demonstrated quantifiable improvements in lid position, blink amplitude, and gland performance, accompanied by longer tear breakup times and reductions in OSDI symptom scores.2,3
These changes reflect both functional rehabilitation and subtle tissue tightening, outcomes that are particularly valuable for patients with age-related lid laxity or evaporative DED secondary to mechanical dysfunction.3,4
For optometrists, OptiLIFT provides a procedure-based bridge between functional, structural, and aesthetic outcomes, aligning with the modern direction of ocular surface care.2,4
Evidence to date on DMSt
Pilot studies and early case series continue to show improvements in blink completeness, tear breakup time, and patient comfort after DMSt treatment.2 Ongoing research is expected to further validate its role in comprehensive dry eye management.
Table 1: Functional and symptomatic improvements following periorbital DMSt.2
| Clinical Parameter | Baseline (Mean ± SD) | Post-Treatment (Mean ± SD) | Change / Improvement |
|---|---|---|---|
| Lower lid distraction test (LLDT, mm) | 11.1 ± 2.2 | 5.3 ± 1.3 | ↓ -52% |
| Snap-back test (normal, %) | 30% | 93.3% | ↑ +63% |
| Blink rate (normalized, %) | 36.7% | 93.3% | ↑ +56.6% |
| Blink quality (normalized, %) | 0% | 73.3% | ↑ +73.3% |
| Meibomian gland function (mMGS score) | 31.2 ± 7.3 | 6.8 ± 4.4 | ↓ -78% |
| Tear film stability (TBUT, seconds) | 2.4 ± 0.8 | 9.1 ± 2.2 | ↑ +279% |
| Ocular Surface Disease Index (OSDI score) | 59.7 ± 20.3 | 27.9 ± 15.7 | ↓ -53.2% |
Table 1: Courtesy of James G. Chelnis, et al.
While OptiLIFT remains the only ophthalmic-targeted DMSt system with published clinical data, several other energy-based devices offer complementary benefits for the periocular region. OptiPLUS and Forma-I both utilize radiofrequency to improve lid laxity, gland function, and eyelid apposition via thermal remodeling.5,6
InMode’s Envision platform also includes Morpheus8, which delivers microneedling radiofrequency up to 4mm deep to remodel the dermis and subdermal layers, tightening skin and improving contour.7,8 However, unlike OptiLIFT, Morpheus8 does not stimulate muscle contraction.
This distinction is critical, as OptiLIFT’s therapeutic effect is rooted in direct neuromuscular activation that produces rhythmic blink-like contractions, restoring dynamic eyelid function. These technologies collectively support eyelid position, gland output, and tear distribution, but OptiLIFT remains unique in its ability to act directly on muscle tissue.
Figure 1: 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 1: Courtesy of Bradley A. Daniel, OD, FAAO, FAAOMS, Dipl. ABO.
Clinical implementation and patient selection
DMSt can be offered as an in-office therapy or, with certain systems, as a home adjunct. Protocols vary from weekly induction sessions to periodic maintenance.
Ideal candidates include individuals with:2
- Evaporative DED with MGD
- Incomplete blinking or lid laxity
- Refractory symptoms despite standard care
Educate patients that DMSt is an adjunctive, functional therapy, not a one-time cure. It works best when integrated into a customized dry eye regimen.
Key takeaways
- Dynamic muscle stimulation (DMSt) is a neurostimulation-based advancement in dry eyecare.
- DMSt improves periocular muscle activity via gentle electrical stimulation that leads to complete blinks, better gland expression, and lipid stability.
- OptiLIFT and OptiPLUS, developed by Lumenis, use RF-based technology to improve eyelid tone, lid laxity, and tear film stability.
- OptiLIFT uniquely combines RF with DMSt to activate periocular muscle fibers and enhance blink quality, while OptiPLUS delivers thermal RF to support meibomian gland function and dermal tightening, making both devices effective for ocular surface disease and eyelid rejuvenation.
- Morpheus8 and Forma-I are part of the Envision system by InMode, combining microneedling RF (Morpheus8) and bipolar RF (Forma-I) to improve periocular skin tone, reduce lower lid laxity, and enhance lid apposition.
- These technologies promote dermal remodeling and skin tightening, making them valuable adjuncts in ocular surface therapy for dry eye disease and aesthetic eyelid concerns.
- DMSt and RF platforms together represent the next generation of functional and aesthetic ocular surface therapy.
