Dr. King:
Are your eyes dry? Are you tired of taking all kinds of drops?
Speaker:
Dr. King:
It’s off the cuff.
Speaker:
I love that
Producer:
And I messed with y’all’s mics too.
Dr. King:
No lint right?
Producer:
Hmm?
Dr. King:
No lint, no dandruff. I’m good.
Speaker:
You guys want your pens in your pockets?
No.
Producer:
Okay. Scooch a little Dr. King a little bit more. Elbow. Elbow each other. Yeah. Perfect.
Dr. King:
Don’t touch me
Producer:
But whenever y’all are ready. Um, you can do your intro
Dr. King:
But it’s Friday, not Tuesday it messes me up.
Producer:
That’s true. That’s valid.
Speaker:
At least it’s not 4:30, so
Dr. King:
Okay.
Speaker:
Dr. King:
Hi, I’m Dr. King.
Dr. Cha:
And I’m Dr. Cha
Dr. King:
And welcome to Days of Our Eyes. Do you have dry eye, irritated eyes and some skin fleshing problems? This is not good. Let’s try again.
Producer:
Skin fleshing problems??
Dr. Cha:
That’s okay.
Speaker:
Some flesh-eating bacteria?
Dr. King:
Do you have a ruddy complexion? Let me help. I did not goo today.
Producer:
It was your idea to film today!
Dr. King:
I completely forgot. It was not my idea! I just said we could
Dr. Cha:
And I’m Dr. Cha.
Dr. King:
Welcome to Days of Our Eyes. Today, we wanna talk about intense pulse light therapy. What is it? What does it do? What’s it good for? When should you use it? Who does it work on? Stick around, we’ll let you know. So let’s talk about intense pulse light therapy.
Dr. Cha:
Okay.
Speaker:
Where did it come from, do you know?
Dr. Cha:
Uh, I believe it, uh, originated from dermatological practices. So it’s skin doctors. Why are we talking about a skin procedure when we’re eye doctors, Dr. King?
Dr. King:
Well, good, good question. Our eyes, you know, our eyelids are actually skin, our eyes are, our neighbors to the rest of this area.
Dr. Cha:
All good.
Dr. King:
I am just not well thought out.
So anyway, our eyelids help influence the surface of the eye. Our tears are made in our eyelids.
Dr. Cha:
Mm-hmm.
Dr. King:
So if we have problems with the skin surrounding the eyes, that is gonna affect the surface. We have to have a healthy environment and that starts with the lids in the skin surrounding the eyes. So these dermatologists were treating, um, skin conditions such as rosacea, which is, you know, where we have these blood vessels close to the surface. Skin tends to have a reddish appearance. People blush easily when they treated patients rosacea, which is down here, people’s dry eye actually improved and they’re like, Hey, maybe we’re onto something here.
Dr. Cha:
Mm-hmm.
Dr. King:
So it has evolved over the years that it’s now becoming one of the first line defenses in ocular surface disease or dry eye disease.
Dr. Cha:
Mm-hmm.
Dr. King:
refer back to our previous episodes on ocular surface disease. So IPL or intense pulse light is now used on a daily basis to help treat the ocular surface.
Dr. Cha:
So I mean IPL intense pulse light. What does that mean? Are you gonna shoot lasers at me or…?
Dr. King:
It’s not a laser? Oh it is exactly what it says. It’s very focused light. Now a laser is like hyper-focused light.
Speaker:
How many treatments, um, should the average dry eye patient expect to have
Dr. King:
For a typical um, dry eye treatment? It’s usually around four IPL treatments. Those treatments are typically done about three weeks apart. We treat, we let the skin process, we let it absorb and then we treat again. And by doing that we’re actually building up the treatment and building up um, the effectiveness.
Dr. Cha:
Mm-hmm.
Dr. King:
So it’s a cumulative effect.
Dr. Cha:
Mm-hmm.
Dr. King:
Well that is something that sometimes even I go, what the wavelengths of light tend to treat red or brown. They go, they’re attracted to certain, certain pigments at certain depths and it actually treats inflammation. It’s actually gonna reduce the inflammatory response and it can also stimulate some of the glands, particularly meibomian glands in the eyelids and whatnot and actually rejuvenate those. So there are some studies where you take some pictures of people’s oil glands in their eyelids. Those are called meibomian glands.
Dr. Cha:
Mm-hmm.
Dr. King:
And you take ’em before intense pulse light treatment and after intense pulse light treatment and they actually experience, you know, an invigoration of the glands. They look more robust. One of the problems with ocular surface disease and meibomian gland disease is the glands will atrophy. They’ll actually start to die off. With IPL, we can stop that process and try to reverse it a little bit.
And the effects of IPL last quite a while. They can last six months up to a year.
Dr. Cha:
Mm-hmm.
Um, and what’s nice is you do those initial four treatments, um, usually with also some lid expression such as a LipiFlow after the third treatment is quite often done. Um, but you do these four treatments, it’s not like you’re doing that whole thing every year. Mm-hmm.
Mm-hmm.
Dr. King:
So we put a conduction gel, like an ultrasound gel on the skin and we actually just go across and treat the areas that need to be treated. What’s interesting about IPL and intense pulse light, it’s not just dry eye, it’s anti-inflammatory. Right. We’re going after, um, inflammation in the skin in the layers of the epidermis.
Dr. Cha:
Mm-hmm.
Dr. King:
and we can actually use different filters, go after rosacea, rosacea’s a skin condition. We can go after the meibomian glands. It’s more dry eye. We can even treat pigmented lesions such as cafe ole spots or age spots like I have lightened mine up pretty good. Hopefully we have a good gauze filter to
Dr. Cha:
Dr. King:
But depending on the wavelength light we use, we can treat at different depths and different conditions.
Dr. Cha:
I mean we even treat ocular rosacea.
Dr. King:
Yes.
Dr. Cha:
Right. There’s uh, dry eyes that come from rosacea of the skin, but sometimes you could have it just in the skin in and around the eyes, the eyelids. Right. And that causes pretty gnarly dry eye.
Dr. King:
Yeah. It’s really uncomfortable. Those folks that have those red-rimmed eyes. If you’re walking around and your eyes are always just the edges of ’em are always looking red. Quite often that’s a condition called ocular rosacea and intense pulse light. IPL is custom-designed for that type of problem. Oh. And it’s got one really cool side effects that a lot of my patients like
Dr. Cha:
Side effect?
Dr. King:
Yeah. The side effect of it tends to smooth the skin. The skin looks a little refreshed.
Dr. Cha:
Mm-hmm.
Dr. King:
I had one patient tell me, she goes, I know my dry eyes better, but my kids say I look better. So that’s always a win.
Dr. Cha:
Dr. King:
The folks that wanna avoid this are very directly pigmented. There are, and now we’re actually getting into radio frequency and some other things that we’re gonna be able to treat all skin types. The other things is, if you’re on any sort of photos, sensitizing medications such as tetracyclines, um, um, a lot of acne medications, uh, your ISO retinoids and stuff,
Dr. Cha:
Even certain steroids. Correct? Corticosteroids?
Dr. King:
Yep. You shouldn’t be on steroids at the time of treatment. Um, so there, you know, there are certain medical reasons we would not do this. That’s why you wanna see your local eye doc that, that does this. Um, and they’ll be able to look at your health status. Um, and you do wanna avoid when you’re going through these treatments, you do wanna avoid excessive sun exposure. ’cause we are in wavelengths of light that are contained in the UV spectrum too. So we don’t want to overexpose the skin to those kinds of lights. We ask you to use sunblock while you’re going through your treatments.
Dr. Cha:
Mm-hmm.
Dr. King:
Um, That’s a two, there’s two answers to that. One is, you know, IPL is dropless, which is nice. Yes. You know, we’re treating the skin, we’re treating around the eyes. Um, so those, some folks aren’t good at doing drops. And a lot of times when it comes to ocular surface disease though, there is no one silver bullet. It’s a very complex condition. So I position IPL along with something else usually too. Maybe a drop, maybe just an at-home lid therapy. Um, but it’s fabulous. And then some of this other stuff can, can support it. Right. Um, does that make sense? Does that answer your question? Yeah.
Dr. Cha:
Like you said, it’s no silver bullet. You know, there’s no cure to dry eye.
Dr. King:
No. This is a chronic progressive disease and we are gonna do everything we can to battle it.
Dr. Cha:
Right. So, you know, just like you said, just having the IPL treatment doesn’t mean that you’ll be cured forever.
Dr. King:
No.
Dr. Cha:
You still have to, you know, our patients still have to be cognizant of their eyes and, you know, do what’s best for ’em. They can’t just stare at a screen all day, you know
Dr. King:
Ohhh yeah,
Dr. Cha:
IPL It’s, it’s really unique and great because it truly treats the underlying cause of dry eye a lot. A lot of the therapies that we use, uh, especially like something like a lubricating drop, artificial tear, even like a, uh, a corticosteroid that you put into your eye. Um, it treats the symptoms and you know, it tries to target the underlying cause of inflammation. A lot of times it’s almost like a bandaid solution, right. Hopefully it gets you over the hump, you know, that you’re experiencing if it’s like a flare up. But IPL treats the, the vessels that are the source of the inflammation, right. That cause you to have dry eye.
Dr. King:
We’re Yeah. Because we’re still learning how is all this inflammation getting there? Where is it coming from? How’s it translating onto the ocular surface? So if we can use these tools and IPL is turning out to be an invaluable tool to get at that underlying inflammation, then we reduce the need for all these drops and stuff. It’s really not just about putting drops on the eyes, it’s about getting the surface back in balance. We don’t want the tears to be toxic to the surface. We want the tears to be healthy and feed the surface of the eye. And a lot of those tears are made in the glands, in the eyelids. So let’s fix em’
Dr. Cha:
Dr. King:
So we hope you learned something about IPL today and, um, hope I wasn’t too preachy. You know, sometimes I get all serious, you know
Dr. Cha:
Dr. King:
Anyway, um, thanks for watching Days of our Eyes. I’m Dr. King. And
Dr. Cha:
I’m Dr. Cha.
Dr. King:
And if you like what you saw today, please hit subscribe and hit like, and if you have any questions, drop ’em in the box. We’ll do our best to answer for you. And everybody, have a great day. See you next time.