Intense pulsed light (IPL) therapy is a unique form of treatment that involves the use of light to help biomodulate cells within the skin. For many years, it has been used as a non-invasive cosmetic procedure to treat a variety of skin conditions, including skin rejuvenation, unwanted hair removal, vascular lesions (e.g., telangiectasias, hemangiomas), and rosacea.1 The technology was pioneered in the area of ophthalmology, particularly for the treatment of meibomian gland dysfunction (MGD) and associated dry eye disease, by Rolando Toyos, MD and colleagues roughly 10 years ago,2 and today its utilization by eye care practitioners (ECPs) has grown exponentially.3
IPL uses a xenon flash lamp to produce a light output of wavelengths in the range of 400 to 1200 nm.2 With regard to MGD, IPL appears to serve as a “wake-up call,” stimulating the cells responsible for secreting meibomian gland oils. Simultaneously, IPL helps to regress dilated, superficial blood vessels that facilitate the delivery of inflammatory cells and proteins to the eyelids and their respective glands, reducing cytokine levels within the tissues. Additionally, this intense broad-spectrum light also imparts antimicrobial benefits, helping to eradicate Demodex mites in their in-vitro state, and reducing the overall bioburden associated with anterior and posterior blepharitis.4-6
In the United States today, there are a number of IPL devices available for use by ECPs, though none more recognizable than the OptiLIGHT by Lumenis, the company responsible for first pioneering IPL, and a worldwide leader in this technology. OptiLIGHT has the distinction of being the first and only FDA-approved IPL device for the management of dry eye disease due to MGD.
With this information in mind, the Eyes On Eyecare Editorial Team set out to better understand the unique characteristics, opportunities, and challenges facing optometrists who may be using IPL in their practices, or planning to incorporate this technology soon. We wanted to gauge the current pulse of the profession regarding IPL, in order to better understand current trends, perspectives, and the needs of practicing ODs. Finally, we wanted to understand just where IPL fits into the current treatment paradigm for dry eye disease, and why.
To see the results of this survey, download the report—or keep reading for a preview of our findings!
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2024 IPL Report
Learn where IPL fits into the current treatment paradigm for dry eye disease, and why.
The 2024 IPL Report includes:
- Demographic information regarding the types of optometrists who currently utilize IPL, as well as their practice characteristics and geographic locations within the US;
- The most common devices purchased and utilized by optometrists for IPL in the US;
- Frequently reported barriers to IPL adoption by optometrists, and the return on investment (ROI) currently experienced by ODs;
- The most common first-line therapies for patients with dry eye disease, and how IPL may play an increasingly important role;
- And more!
Who’s who in the 2024 IPL Report
This survey was conducted in September 2024 and solicited responses from practicing eye care professionals in the United States (US). It includes verified responses from 503 optometrists (ODs), of which:
- 257 self-identified as private practice ODs
- 90 self-identified as corporate ODs
- 156 self-identified as practicing in other settings
Graduation years of the respondents ranged from 1980 to 2024, although the largest percentage (33.2%) graduated within the last 5 years. The state with the greatest representation was California (n=93; 18.5%), and the states with the lowest representation were Alaska, Oklahoma, and North Dakota, with one respondent each (0.2%). No practitioners from the following states responded to the survey: Kansas, South Dakota, Vermont, West Virginia, and Wyoming. 15 respondents were located outside of the US as part of the Veterans Administration or a branch of the military. Approximately 25% claimed to be practice owners.
In terms of practice settings, nearly two-thirds (66.8%) of respondents listed their clinical focus as Primary Care / Family Practice, with ~10% selecting Ocular Disease, 8% listing Cornea & Contact Lens, and 7.6% reporting a focus on Dry Eye.
Access to IPL in Current Practice
Just over one-quarter (26.6%) of respondents reported owning or having access to IPL within their existing practice setting. Of those who do not presently offer this service, 30% have plans to bring an IPL device into their practices within the next 1-2 years. The three greatest barriers preventing the adoption of IPL into practice were identified as:
1. Cost (39.1%);
2. Not an area of clinical focus (36.8%);
3. Concerns generating consistent ROI (11.2%).
Of the 120 ODs who claimed to have IPL within their practices, the specific device identified by more than half of respondents was the Lumenis OptiLIGHT/Lumenis Optima IPL/M22 (79.2%) and the Inmode Envision (17.5%).
For the 112 ODs who indicated that they planned to add IPL within 1-2 years, cost was identified as the most significant factor affecting their choice of device (54.5%), followed by feedback from colleagues (15.2%) and ability for the device to scale with practice (5.4%).
Adoption and ROI
When looking at ways to increase patient adoption and usage of IPL within the practice, ODs who currently use IPL within their practices (134 respondents) identified two main factors: reduced costs and broader insurance coverage.
At the same time, those ODs who currently own or utilize IPL, the overwhelming majority (82.8%) rated their ROI as Fair or Good, with an additional 6% rating it as Excellent. When asked how likely they would be to recommend purchasing an IPL device to colleagues (on a scale from 1 to 10, with 1 = not at all likely and 10 = extremely likely), the average response was favorable at 6.66.
Insights Into Dry Eye Management
When asked to rate their overall understanding and knowledge about IPL therapy for dry eye (on a scale from 1 to 10, with 1 = not at all knowledgeable and 10 = extremely knowledgeable), the results were quite varied, with an average of 5.78. This suggests that there is a significant need for additional education surrounding IPL therapy for dry eye disease at the present time within optometry.
Respondents also discussed their current regimen for managing dry eye within their practices. Not surprisingly, first line therapy for most individuals (63.8%) was identified as artificial tears. Conservative treatment using warm compresses and lid hygiene ranked second, with 27.2%, and Rx treatments (e.g., topical cyclosporine, lifitegrast, etc.) were somewhat surprisingly ranked third with only 4.6%. This is consistent with the current consensus among experts that prescription drugs, nutritional supplements and mechanical procedures like IPL are substantially underutilized as initial therapies for dry eye disease, despite mounting evidence to suggest their potential efficacy and inherent value.
When asked specifically where they believed IPL falls in the treatment cycle for dry eye, only 6.6% suggested it should be employed as treatment for mild (Stage 1) dry eye disease, while the overwhelming majority (76.9%) indicated that it would be appropriate for moderate (Stage 2-3) disease.
Overall, respondents reported a moderate familiarity with IPL therapy and its role in managing dry eye disease. While many have integrated IPL into their practices with positive feedback on ROI, the survey highlights a significant opportunity for additional education on optimizing IPL treatment protocols and understanding new device options as they enter the market.
