Advanced upper and lower eyelid IPL with meibomian gland expression
Dry, burning, irritated or watery eyes are not always caused by a lack of tears.
For many people, the problem is Meibomian Gland Dysfunction (MGD). The meibomian glands within the eyelids produce the oily layer of the tear film. When these glands become blocked, inflamed or produce poor-quality oil, tears can evaporate too quickly – contributing to irritation, redness, fluctuating vision and difficulty wearing contact lenses.
At Westmead Eyes Optometrists, we use the Lumenis M22 Optima IPL system as part of an individualised treatment approach for suitable patients with MGD and evaporative dry eye.
For suitable patients, our dry-eye IPL protocol includes:
- Treatment of the upper and lower eyelid regions
- Protective ocular shields during direct eyelid treatment
- A double-pass IPL technique
- Treatment of the surrounding periocular region
- Meibomian gland assessment and expression following IPL
- Individualised treatment settings based on your skin type and clinical findings
The aim is not simply to apply light to the skin. We assess the underlying cause of your dry eye and use IPL as one part of a broader treatment plan where it is clinically appropriate.
IPL Treatment at a Glance
Four-Session M22 Dry-Eye IPL Program
Comprehensive initial treatment course
Individualised IPL treatment across four appointments.
Treatment of the eyelid regions where clinically appropriate.
A double-pass technique may be used over selected treatment areas.
Appropriate ocular protection during direct eyelid treatment.
Gland function is assessed throughout the treatment course.
Meibomian gland expression is performed where indicated.
Why We Use the Lumenis M22 IPL
Not all IPL systems are equivalent. Different devices use different wavelength filters, pulse structures, energy ranges, cooling systems and treatment protocols. Research obtained with one IPL system therefore cannot automatically be applied to every IPL treatment.
The Lumenis M22 is one of the most established and extensively studied IPL platforms used in dry-eye care. Its patented Optimal Pulse Technology is designed to deliver controlled and consistent energy throughout each pulse, while its adjustable filters, treatment tips and energy settings allow treatment to be tailored to the patient’s skin type and clinical findings.
In a randomised study comparing two commonly used IPL technologies, both treatments improved meibomian gland dysfunction. However, the Optimal Pulse Technology used by the M22 produced greater improvements in several objective measures, including meibomian-gland secretion, eyelid-margin findings and tear-film stability.
The combination of an extensively studied IPL platform and an individualised clinical protocol is why we use the Lumenis M22.
Our Treatment Approach
Upper & Lower Direct Eyelid Treatment
For suitable patients, our treatment includes the upper and lower eyelid regions, rather than limiting IPL solely to the cheeks.
Double-Pass IPL
Our dry-eye IPL protocol uses two passes over designated treatment areas rather than a single series of pulses. Settings are individually selected according to the patient’s clinical presentation.
IPL + Meibomian Gland Expression
Our protocol includes meibomian gland expression following IPL. This allows us to assess gland function and assist the release of thickened or obstructed meibum.
Individualised Treatment
Dry eye is not one disease and there is no single IPL setting or protocol suitable for every patient. Treatment areas, energy settings and additional therapies are selected according to your examination findings.
How May IPL Help Dry Eye?
IPL delivers controlled pulses of broad-spectrum light to the skin around the cheeks and lower eyelids. The light is not directed into an unprotected eye, and appropriate eye protection is required throughout treatment.
The precise mechanisms behind IPL are still being investigated. Proposed effects include:
- Reducing abnormal superficial blood vessels associated with eyelid inflammation and ocular rosacea
- Reducing inflammatory activity around the eyelids and ocular surface
- Warming and softening thickened meibomian-gland secretions
- Improving the expression and quality of oils produced by functioning meibomian glands
- Improving tear-film stability
- Reducing eyelid microbial and Demodex-related burden in selected patients
Research supports improvements in meibomian-gland function, tear-film quality and symptoms, but the relative contribution of each proposed mechanism is not fully established.
What IPL Cannot Do
IPL cannot be assumed to:
- Regrow meibomian glands that have already been lost
- Permanently cure meibomian gland dysfunction
- Treat every cause of dry eye
- Guarantee that lubricating drops will no longer be required
- Resolve symptoms caused predominantly by aqueous tear deficiency, exposure or neuropathic eye pain
It is more accurate to say that IPL may improve the function of the remaining meibomian glands in suitable patients.
What Does the Research Show?
A recent systematic review evaluated 13 randomised studies of IPL for dry-eye symptoms caused by meibomian gland dysfunction.
Compared with sham or placebo treatment, IPL probably produced a clinically meaningful improvement in symptoms. However, when IPL was added to other standard dry-eye treatment, the size of the additional benefit was less certain. The review also found that safety reporting varied between studies, meaning uncommon adverse effects could not be estimated confidently.
This supports IPL as a legitimate treatment option while reinforcing several important points:
- IPL works best for appropriately selected patients
- Treatment results are not identical for everyone
- IPL is generally one component of a broader treatment plan
- Symptoms and clinical findings should both be monitored
- More treatment does not automatically mean a better result
Who May Benefit From IPL?
IPL may be considered where an assessment identifies:
- Meibomian gland dysfunction
- Evaporative dry eye
- Thickened or difficult-to-express meibomian secretions
- Eyelid-margin inflammation
- Ocular rosacea or visible eyelid telangiectasia
- Recurrent chalazia or styes associated with meibomian-gland obstruction
- Persistent dry-eye symptoms despite appropriate home treatment
- Reduced contact-lens comfort associated with tear-film instability
Dry-eye symptoms alone do not establish that IPL is appropriate. The underlying causes must first be assessed.
Why Is a Dry-Eye Assessment Needed?
Dry eye is not one single condition. Symptoms may result from meibomian gland dysfunction, insufficient tear production, inflammation, incomplete blinking, medication effects, eyelid disease, autoimmune conditions, environmental exposure or heightened ocular-surface nerve sensitivity.
A dry-eye assessment may include:
- Discussion of symptoms and previous treatments
- Review of medications and relevant medical history
- Examination of the eyelids and ocular surface
- Meibomian-gland assessment
- Meibography
- Tear-film stability testing
- Corneal staining
- Assessment of tear production
- Evaluation for blepharitis or Demodex
- Consideration of incomplete blinking or eyelid closure
IPL is recommended only when we believe it is likely to address an important contributor to your symptoms.
Treatment Process: What to Expect
IPL treatment is generally quick and non-invasive. Your exact instructions may vary according to your skin type, eye health and treatment plan.
Before Your Appointment
- Avoid excessive sun exposure and fake tanning beforehand
- Do not apply make-up or active skincare products on the treatment day
- Tell us about your medications and recent procedures
- Advise us of any photosensitivity or previous pigment changes
Instructions may differ according to your skin type and treatment area.
During Treatment
- The skin and treatment area are cleansed
- Your skin type is assessed and suitable settings are selected
- Protective ocular shields or eyewear are applied
- Cooling gel is placed on the skin
- Controlled IPL pulses are delivered
- The meibomian glands are assessed or expressed where appropriate
A typical treatment appointment takes approximately 15–20 minutes.
After Treatment
- Most patients can return to normal activities immediately
- Follow the skincare and sun-protection instructions provided
- Mild warmth, redness or skin sensitivity may occur temporarily
- Contact us if you experience an unexpected or significant reaction
The response is monitored throughout your treatment course.
How Many IPL Sessions Are Needed?
Our usual initial dry-eye IPL program consists of four sessions spaced over approximately two to three months.
Some patients notice an improvement after one or two sessions. Others do not experience their full response until the treatment course has been completed.
The recommended schedule may vary according to your skin type, meibomian-gland function, ocular rosacea, eyelid inflammation and response to treatment.
How Long Do the Benefits Last?
The duration of improvement varies between patients. Some maintain benefits for several months, while others experience an earlier return of symptoms.
Maintenance treatment may be considered according to your symptoms, tear-film findings and meibomian-gland function. We do not automatically recommend maintenance IPL at one fixed interval for everyone.
How Many IPL Sessions Are Needed?
Our usual initial dry-eye IPL program consists of:
Four IPL sessions spaced over approximately two to three months.
Many research and manufacturer protocols use four sessions separated by approximately two to four weeks.
The appropriate schedule may vary according to:
- The severity of meibomian gland dysfunction
- Skin type
- Ocular rosacea
- Eyelid inflammation
- The amount of remaining gland tissue
- Response to earlier sessions
- Other treatments being used
Some patients notice an improvement after one or two sessions. Others do not experience their full response until the treatment course has been completed.
IPL should not be judged solely on how the eyes feel immediately after the first session.
Treatment Options & Pricing
Treatment is recommended only after an assessment confirms that IPL is appropriate for your condition.
Dry-Eye IPL Package
Four-session treatment course
- Four Lumenis M22 IPL sessions
- Meibomian-gland assessment
- Gland expression where appropriate
- Treatment-response review throughout the course
Additional or maintenance sessions: $300 each
Chalazion and Stye IPL
Per treatment session
- For selected chalazia or recurrent styes
- Most suitable for newer lesions
- Older lesions may require additional treatment
- Assessment required before treatment
IPL Photofacial
Four-session cosmetic package
- Facial redness and visible vessels
- Pigmentation and sunspots
- Rosacea-related skin changes
- Separate skin assessment required
Additional sessions: $400 each
How Long Do the Benefits Last?
The duration of improvement varies.
Some patients maintain benefits for several months, while others experience an earlier return of symptoms. Maintenance treatment may be considered according to symptoms, tear-film findings and meibomian-gland function.
We do not automatically recommend maintenance IPL at a fixed interval for every patient.
Ongoing management may still include:
- Warm compresses
- Eyelid hygiene
- Lubricating eye drops
- Prescription medication
- Treatment for Demodex or blepharitis
- Changes to screen and blinking habits
- Environmental modifications
- Occasional gland expression
- Management of ocular rosacea
IPL Safety and Suitability
IPL is generally well tolerated when the patient is appropriately selected, suitable settings are used and the eyes are correctly protected. However, IPL is a medical light treatment and is not risk-free.
Possible Side Effects
Temporary effects are usually mild, but may include:
- Pain or discomfort during treatment
- Temporary redness, warmth or swelling
- Skin irritation or sensitivity
- Temporary worsening of symptoms
- Pigmentation changes
- An inadequate treatment response
Burns, tissue damage or eye injury are uncommon but possible if unsuitable settings or inadequate eye protection are used.
Who May Not Be Suitable?
IPL may not be suitable, or may require additional caution, where there is:
- Recent tanning or significant sun exposure
- Use of photosensitising medication
- An active skin or corneal infection
- Recent eye or facial surgery
- A suspicious lesion in the treatment area
- A history of significant pigment changes or abnormal scarring
- A skin type for which suitable settings cannot be selected
- An inability to use the required ocular protection
What Results Can You Realistically Expect?
A suitable patient may experience:
- Reduced burning or irritation
- More stable vision
- Improved contact-lens comfort
- Better-quality meibomian-gland secretions
- Improved tear-film stability
- Reduced eyelid inflammation
- Less frequent or less severe flare-ups
- Reduced reliance on lubricating drops
However:
- Not every patient responds
- Improvement may be gradual
- Some symptoms may remain
- Additional treatments may still be required
- Results cannot be guaranteed
- Dry-eye symptoms may return over time
We assess treatment using both your reported symptoms and objective findings involving the eyelids, meibomian glands, tear film and ocular surface.
Key IPL and Dry Eye Research
Select a study below to read a patient-friendly summary of its findings.
Effectiveness and Safety of IPL for Dry Eye Due to Meibomian Gland Dysfunction 2025
Systematic Review and Meta-analysis
This review examined 13 randomised studies of intense pulsed light treatment for dry-eye symptoms associated with meibomian gland dysfunction.
Compared with placebo or sham treatment, IPL probably produced a clinically meaningful improvement in dry-eye symptoms.
The additional benefit when IPL was combined with standard dry-eye treatment was less certain. Safety reporting also varied between studies, meaning that uncommon adverse effects could not be estimated confidently.
View the published researchTFOS DEWS III: Management and Therapy 2025
International Dry-Eye Management Report
This international report reviewed the available treatments for dry-eye disease, including technology-based treatments used for meibomian gland dysfunction.
IPL is recognised as one treatment option for selected patients with meibomian gland dysfunction and evaporative dry eye.
The report also reinforces that dry eye has multiple possible causes. Treatment should therefore be selected according to the individual patient’s symptoms, clinical findings and underlying condition.
View the published researchCurrent Practices and Considerations in IPL Therapy 2025
Review of IPL Treatment Protocols
This review examined clinical studies involving IPL treatment for dry eye and meibomian gland dysfunction.
It identified considerable variation in the IPL devices used, energy settings, wavelength filters, treatment areas, intervals between sessions and additional therapies.
This means that results obtained with one IPL device or protocol cannot automatically be applied to every form of IPL treatment. Device selection, practitioner training and individualised treatment settings remain important.
View the published researchIntense Pulsed Light Treatment for Meibomian Gland Dysfunction 2024
Clinical Review
This review examined recent clinical evidence for IPL treatment in patients with meibomian gland dysfunction.
The available studies support potential improvements in dry-eye symptoms, tear-film stability, meibomian-gland secretion and eyelid-margin inflammation.
The authors also noted that IPL is frequently combined with treatments such as meibomian-gland expression and other forms of dry-eye management.
View the published researchIPL of the Upper and Lower Eyelids With Gland Expression 2024
Prospective Multicentre Study
This study examined IPL delivered around the upper and lower eyelids together with meibomian-gland expression.
Improvements were reported in dry-eye symptoms, tear-film stability and measures of meibomian-gland function.
Some patients with more severe meibomian gland dysfunction showed greater improvement. However, the results do not establish that the same treatment protocol is appropriate for every patient.
View the published researchLumenis IPL and Meibomian Gland Expression 2022
Randomised Controlled Study
This multicentre randomised study examined Lumenis IPL combined with meibomian-gland expression in people with moderate-to-severe meibomian gland dysfunction.
Treatment improved several clinical signs associated with dry-eye disease and meibomian gland dysfunction.
The study contributed to the clinical evidence supporting the use of Lumenis IPL as an adjunctive treatment for selected patients with meibomian gland dysfunction.
View the published researchIs IPL Right for You?
You may benefit from the Lumenis Optima M22 IPL for dry eye if you experience:
- Dry, irritated, or red eyes from Meibomian Gland Dysfunction (MGD)
- Loss of eyelashes
- Chronic blepharitis or Demodex-related symptoms
- Chalazion or styes you want to treat without surgery
- Sunspots, facial redness, broken capillaries, or pigmented acne scars
- Uneven skin tone or ageing skin with fine lines
IPL works best on fair to medium skin types (Fitzpatrick Skin Types I–IV). We’ll assess your skin and eye health to confirm if this treatment is suitable for you
IPL may also be used in selected paediatric cases where appropriate.
Book a Dry-Eye and IPL Assessment
No referral is required.
Contact us on (02) 9635 8464 or 04988 OPTOM, or book an appointment online.
You can also download our IPL information form before your appointment.
This page provides general information and does not replace an individual eye examination, diagnosis or personalised medical advice.