IPL and Radiofrequency

By: MICHELE PENDRAK BUSH, O.D.

We have a secret.

We have been working hard behind the scenes – researching, comparing, testing – to bring our patients better dry eye treatments.  By better, we mean technology that is:

• More effective
• Provides a broader range of benefits
• Serves more patients and patient needs
• Allows us to offer services to you with a pricing model that is more accessible
• Has powerful aesthetic benefits

We did not take this lightly.  We got the whole team involved.  We watched the industry carefully for years.  I got feedback from colleagues on what they loved and what they hated.  We met with all of the equipment vendors big and small.  We watched hours of continuing education, read white papers, read opinions, went to demo days, and attended numerous Zoom meetings.  And finally – the day is here.

We are ready to bring what we have determined to be the best technology to you – our patients.  And we couldn’t be more excited!

Here is what we landed on.  And yes I am saving the best for last.

It is no secret that LLLT is everywhere – for good reason.  LLLT uses various wavelengths of light to turn back our cellular clocks by improving cellular metabolism (think Krebs cycle and improved ATP production), reducing oxygen free radicals, and releasing nitric oxide back into the tissues to support vasodilation.  It has also become popular for hair growth, aches and pain, and for its many skin benefits for everything from acne to wrinkle reduction.

As far as dry eye goes, red light retrains the oil (meibomian) glands in our eyelids to produce better quality oil.  This oil normally acts as a moisture seal that floats on top of our tears and prevents evaporation. 

Since 86% of dry eye is evaporative in nature, the vast majority of dry eye patients can benefit from this.  It is also very powerful for treating chalazia (styes) in a quick, comfortable, nonsurgical, hands-off approach. 

The main limitation I have seen with LLLT is that you have to have structurally sound meibomian glands to enjoy the full benefits of LLLT.  Clearly not everyone has that.

5 years ago when we opened the Dry Eye Center, home-based masks had little to no efficacy.  This is slowly starting to change, and now in 2026 there are a few at home LLLT devices that are worth discussing. 

The red and blue LLLT masks we have in the office are still the most powerful medical grade masks I have ever experienced; however, it has become unaffordable for us to continue to repurchase the masks every few months, and we can no longer in good conscience continue to pass this cost on to you when technology is changing so rapidly and there are better technologies to offer on the market. 

So over the early part of 2026, you will see us replace our current LLLT masks with more affordable but still powerful medical grade in-office light therapy panels.

Wow this has also come a long way in 5 years.

Eye care first “stole” IPL from dermatology after dermatology used IPL to treat facial rosacea.  It uses incoherent wavelengths of light to photocoagulate the rogue blood vessels that are the hallmarks of rosacea.  These are not good blood vessels – these are weak blood vessels that leak inflammation.

So what the dermatologists noticed is that when they performed IPL on their patients with rosacea, everyone’s dry eye got better.  This revolutionized the ability to treat patients with ocular rosacea – because up until then all we had was heat.  And unfortunately, heat is a trigger for rosacea since it dilates blood vessels, further causing those weak leaky blood vessels to leak more inflammation.  So putting heat on rosacea was merely making the problem worse.

When IPL came along, it changed everything for this frustrated group of dry eye patients.

Oh and of course the aesthetic world loves IPL because it targets and gets rid of anything red, anything brown (good for age spots, bad for those who have darker skin and therefore can’t get the treatment), and it stimulates new collagen production (think skin tightening and fine lines and wrinkles). 

But IPL has improved significantly.  The devices have gotten more powerful. The handpieces have gotten smaller, so we can get into all of the little nooks and crannies right around the eyelids.  They make specific protection for your eyes in case I feel it is best to treat directly onto your eyelids.  The device cooling is better so IPL no longer “stings” like it used to.  This is all going to result in more clinically powerful results for you – both medically and aesthetically.

So in 2026 you will see us phase out our old IPL device and begin using a new one.

And now . . . the really exciting news . . .

I am so excited to announce that radiofrequency has arrived at the Dry Eye Center!  This is something I have wanted to do for years.

Why? So. Many. Benefits.

First of all – we picked a combination IPL/Radiofrequency device that is from the same company who makes the Morpheus8.

 For those of you in the know – you are welcome.

 For those of you who do not know – the Morpheus8 is THE microneedling device.  It is basically an in-office, non-surgical facelift.  It is wildly popular in the aesthetic world.  We figured any company with that kind of reputation must be doing something right.

 And by the way – if you guys tell us there is a demand for it, we do have a future option to purchase the Morpheus8 handpiece and offer this service in the office.  There are dry eye benefits including treating styes and tightening loose eyelid skin.  Turns out healthy skin = healthy lids = healthy eyes.  And you would be amazed how much the position of your eyelids impacts dry eye.

 But back to radiofrequency.

Let’s talk about stimulating collagen.

This is a very important benefit.  Radiofrequency does this in a big way.  One of the barriers many of my dry eye patients have to getting the most out of their dry eye treatments is their gland structure.  Glands can very easily shorten, atrophy, constrict, form scar tissue at the opening, or drop out completely.  These oil glands are made of collagen.  So what we have been seeing with radiofrequency is that its ability to stimulate collagen production has enabled patients with less than perfect gland structure to benefit from it.  These are patients who would have had limited treatment efficacy with anything else previously.

Radiofrequency is also going to help me fill a huge treatment gap – namely, anybody with concerns with their eyelid anatomy.  This is something I see in a lot of my patients, and on top of not being aesthetically pleasing, it can cause a number of dry eye problems.

Let’s talk about loose eyelids specifically.  They can cause incomplete lid seal and overnight drying.  This is something that occurs in 8 in 10 dry eye patients, causing them to wake up feeling like their lids are sticking to their eyes.  Loose eyelids also lead to us having less powerful blinks, which mean less natural exfoliation along the lid margin with each blink, which means more build up of dead cells and scar tissue formation, which blocks our meibomian glands along our eyelid margin from secreting oil.

Additionally, loose eyelids can lead to tearing.  Our eyes can tear for a number of reasons, but one of them may be that our puncta, or drains (little holes located in the nasal corner of each eyelid), are not in contact with the white part of our eye.  When this happens, our tears can’t drain properly from our eyes to our nose, leading them to spill down our cheeks instead.

So just imagine if I could tighten all of that up for my patients!

MiboFlo is what I call our “OG” dry eye treatment.  We have had it for over a decade now – it is an oldie but a goodie.  MiboFlo  is an ultrasound heat treatment for the eyelids that melts the clogged up oil in our meibomian glands and stimulates our glands to secrete clear oil.  It is a soothing, comfortable, more affordable favorite among patients.

 For now, it is not going anywhere.  This is mainly because of its affordability – we would like to keep an affordable treatment option for our patients.  Unfortunately there are not aesthetic benefits to MiboFlo .

From a patient’s perspective, when you are in the treatment chair MiboFlo  and Radiofrequency (RF) are going to feel the same.  I describe RF as MiboFlo  on steroids since RF has so many more benefits – collagen synthesis, aesthetic benefits, and skin tightening being the big ones.  So if we find that RF ultimately phases out MiboFlo  based on demand, we may revisit this in the future.

 Since opening the Dry Eye Center, we have had so many heartwarming moments that remind us all why we do what we do.  These are patients who can finally see clearly, whose eyes are no longer red, whose eyes are comfortable for the first time in a long time, who have “tried everything” and worried that nothing would ever work.  Those moments are so rewarding. 

 But unfortunately we have also had some discouraging moments.  I try to be very selective about who I choose which treatments for, but sometimes there are still those times when a patient feels as though they did not achieve the treatment outcome that they were hoping for.  If you have ever felt that way, please know that I have always shared your frustration when this occurs.  With these ever expanding and more powerful new treatment tools in our toolbox, these frustrating moments should be minimized even further.  So if that was ever you, please consider checking out what we now have to offer.  So much has changed.

 I am so excited for what 2026 holds for all of us, and I can’t wait to see all of you in the Dry Eye Center!  Please call us at 610-265-2020 to schedule a dry eye evaluation with me (Dr. Pendrak) if you want to see if any of these treatments are appropriate for you.  And be on the lookout for announcements from us regarding things such as launch events and more fun opportunities to become familiar with what the Dry Eye Center has to offer this year.