Hello. I’m Dr. Jinhag Baik, an ophthalmologist and head director of nuneHIM Eye Center on Siheung-daero in Guro-gu, Seoul.
Seoul winters are cold outside and dry inside. Once the office heaters come on in November, a lot of people notice their eyes burning, feeling gritty, or getting tired by mid-afternoon. If you’ve looked into treatment options, you’ve probably come across IPL (intense pulsed light), and the first questions are almost always the same: Is one session enough? How many do I need? And how long will it last?
The short answer: IPL for dry eye is a course, not a one-off. Most clinical trials used 3–4 sessions spaced 2–4 weeks apart, and the effect can fade after several months. It works best as part of ongoing eyelid care, not as a replacement for it.
What IPL actually treats
Your tear film has an oily outer layer that slows evaporation. That oil comes from the meibomian glands along the edges of your eyelids. When these glands become blocked or produce poor-quality oil, tears evaporate too quickly. This is meibomian gland dysfunction (MGD), the main driver of evaporative dry eye.
IPL targets MGD. According to the US FDA’s review, the light is applied to the skin of the cheeks and nose, from one ear (tragus) to the other, while the eyes are fully covered with protective shields. It’s usually followed by meibomian gland expression (MGX), where the clinician gently presses the lids to clear blocked glands.
Two things worth knowing:
- How IPL works isn’t fully understood. A 2017 review noted the clear link between dry eye and facial skin inflammation such as rosacea, and that IPL has long been used for rosacea, but concluded that its mechanism in dry eye is not well understood.
- IPL doesn’t increase the amount of tears you make. In a 2015 trial, tear film stability and the oil layer improved, but tear meniscus height (a measure of tear volume) did not change.
In 2021, the FDA granted De Novo authorization to an IPL device, creating a new device type for managing dry eye due to MGD. The authorization is for adults 22 and older with moderate-to-severe MGD and Fitzpatrick skin types I–IV, and it’s intended as an add-on to expression, artificial tears and warm compresses.
Does it work? What the trials show
When reading IPL studies, separate two kinds of results: signs (test results such as tear break-up time) and symptoms (how your eyes feel). They don’t always move together.
| Study | Design | Main findings |
|---|---|---|
| Craig 2015, New Zealand | 28 patients; one eye IPL, the other sham; 3 sessions (days 1, 15, 45) | Non-invasive break-up time 14.1 s vs 8.6 s; 82% of treated eyes improved by ≥1 lipid layer grade; 86% reported fewer symptoms in the treated eye |
| Piyacomn 2020, Thailand | 114 patients, randomized, double-masked, sham-controlled; 3 sessions (days 0, 15, 45) | At 6 months, break-up time 5.23 s vs 3.11 s; OSDI symptom score 24.3 vs 32.7 (lower is better); no adverse events after IPL |
| Toyos 2022, USA | 88 patients, randomized; IPL + expression vs sham + expression; 4 sessions, 2 weeks apart | Break-up time 4.0→6.0 s vs 3.8→4.5 s; symptom scores improved in both groups with no difference between them |
The last study matters most for real-world practice, because almost everyone who gets IPL is also getting expression and home care. The FDA review records the same pattern: the tear break-up time goal was met, but a symptom benefit over the control group was not shown.
The bigger picture: meta-analyses
- Cochrane review (2020): Only 3 trials (114 people) existed. Break-up time likely improved by about 2 seconds (low certainty), while the effect on symptoms was very uncertain.
- Systematic review and meta-analysis (2025, 13 trials):
| Comparison | Difference in OSDI symptom score | Certainty |
|---|---|---|
| IPL vs sham or no treatment (4 trials, 280 people) | 16 points better | Moderate |
| Standard care + IPL vs standard care alone (7 trials, ~590 people) | 7 points better | Very low |
| Adverse effects (10 trials, 746 people) | Mild, transient events reported in 4 trials | Very low |
The authors set 7 points as the smallest difference patients would notice. So IPL probably helps compared with doing nothing, but when it’s added to standard care, the extra benefit sits right at that threshold, and the evidence is very uncertain. They concluded that more research on IPL as an add-on is needed.
- Network meta-analysis (2026, 47 trials, 3,581 patients): IPL-based treatments ranked consistently well for symptom relief at 2–4 months. This was an indirect comparison of short-term results, and the authors called for longer comparative studies.
How many sessions?
| Study | Sessions | Interval |
|---|---|---|
| Craig 2015 | 3 | Days 1, 15, 45 |
| Piyacomn 2020 | 3 | Days 0, 15, 45 |
| Rong 2018 | 3 | 4 weeks |
| Toyos 2022 | 4 | 2 weeks |
| Arita 2019 (hard-to-treat MGD) | 8 | 3 weeks |
All but one of the 13 trials in the 2025 meta-analysis used 2–4 sessions. Each session is short; the FDA review lists typical treatment time as under 10 minutes. Results are usually assessed several weeks after the final session, so judging IPL after a single visit isn’t realistic.
How long does it last?
This is where honesty matters: the effect is not permanent.
- In a 2018 trial (one eye IPL, the other sham, 3 sessions 4 weeks apart), the IPL eyes were better at 1, 3 and 6 months, but there was no difference at 9 months.
- In a 2019 trial of hard-to-treat MGD (8 sessions), improvements built up gradually and were seen at 24 and 32 weeks, so stubborn cases may take longer to respond.
- A 2015 retrospective series reported a median of 7 treatments plus 4 maintenance visits, but it had no comparison group.
- A 2024 review listed cost, access and limited duration of effect as drawbacks.
There is no standard maintenance schedule. Whether and when to repeat treatment should depend on your symptoms and how your glands look on follow-up exams. If IPL helped last winter and your eyes are dry again this year, that usually reflects MGD being a chronic condition, not a failed treatment.
Who it suits, and who it doesn’t
| Likely a reasonable option | Think carefully or avoid |
|---|---|
| MGD confirmed on examination | Dry eye mainly from low tear production |
| Symptoms persist despite warm compresses, lid hygiene and artificial tears | Very dark skin (Fitzpatrick V–VI) |
| Moderate-to-severe signs and symptoms | Recent heavy sun exposure or tanning |
| Photosensitizing medication | |
| Moles, pigmented, precancerous or cancerous lesions in the treatment area | |
| Active eye infection, uncontrolled infection or immunosuppression |
These cautions come from the FDA indication, the exclusion criteria of the US trial and the 2025 review.
Side effects
Reported side effects were mostly mild and temporary: stinging or heat during treatment, redness or swelling afterward. The FDA review also lists blistering, burns, temporary skin color change, post-inflammatory hyperpigmentation, scarring and reactivation of cold sores (herpes simplex). In one trial, partial eyelash loss occurred due to clinician error. Proper eye protection is essential. The FDA states that serious safety consequences are possible if eye protection isn’t worn as instructed.
Winter tips if you work at a screen
- A large US study of eye clinic visits found dry eye diagnoses were more common in winter (18.7%) than in summer (15.3%); the authors suspected dry, heated indoor air.
- In lab studies, dropping humidity from 40% to 5% for an hour thinned the oil layer and made the tear film less stable, and cold air was linked to a thinner oil layer too. Cold commutes into heated offices are hard on your tears.
- Point heater and car vents away from your face, consider a humidifier (and keep it clean), make warm compresses part of your routine, blink fully, and rest your eyes regularly during screen work.
- If you’re starting IPL, plan the 3–4 visits around year-end work and holidays so the course isn’t interrupted.
Bottom line
IPL is a reasonable add-on for evaporative dry eye caused by meibomian gland dysfunction, typically given as 3–4 sessions a few weeks apart. It probably helps compared with no treatment, but the extra benefit on top of good home care is less certain, and the effect can wear off after several months. The first step is finding out whether your dry eye actually comes from your meibomian glands.
nuneHIM Eye Center | Dr. Jinhag Baik, Ophthalmologist 5F Kwanghee Bldg, 551 Siheung-daero, Guro-gu, Seoul (near Guro Digital Complex and Gasan Digital Complex stations) http://www.nunehim.com | Naver booking: https://booking.naver.com/booking/13/bizes/923695
This article is for general medical information as of November 2026, based on published studies and the US FDA’s device review. It is not a recommendation for any specific procedure. Whether IPL is suitable, and how many sessions you need, depends on an individual examination by an ophthalmologist.
References
- Craig JP, et al. Prospective trial of intense pulsed light for the treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2015;56:1965–70. https://pubmed.ncbi.nlm.nih.gov/25678687/
- Piyacomn Y, et al. Efficacy and safety of intense pulsed light in patients with meibomian gland dysfunction. Cornea. 2020;39:325–32. https://pubmed.ncbi.nlm.nih.gov/31764289/
- Toyos R, et al. Intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction: a randomized controlled study. PLoS One. 2022;17:e0270268. https://pubmed.ncbi.nlm.nih.gov/35737696/
- Cote S, et al. Intense pulsed light (IPL) therapy for the treatment of meibomian gland dysfunction. Cochrane Database Syst Rev. 2020;CD013559. https://pubmed.ncbi.nlm.nih.gov/32182637/
- Peira N, et al. Effectiveness and safety of intense pulsed light therapy for dry eye symptoms due to meibomian gland dysfunction: a systematic review and meta-analysis. Acta Ophthalmol. 2025;103:371–9. https://pubmed.ncbi.nlm.nih.gov/39611367/
- Noyman DBE, et al. Technological interventions for dry eye disease: a systematic review and network meta-analysis of 3-month outcomes. Ophthalmol Ther. 2026;15:1721–59. https://pubmed.ncbi.nlm.nih.gov/41933265/
- Rong B, et al. Long-term effects of intense pulsed light combined with meibomian gland expression in the treatment of meibomian gland dysfunction. Photomed Laser Surg. 2018;36:562–7. https://pubmed.ncbi.nlm.nih.gov/30251914/
- Arita R, et al. Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction. Ocul Surf. 2019;17:104–10. https://pubmed.ncbi.nlm.nih.gov/30445177/
- Toyos R, et al. Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study. Photomed Laser Surg. 2015;33:41–6. https://pubmed.ncbi.nlm.nih.gov/25594770/
- Gupta AS, et al. Intense pulsed light treatment for the management of meibomian gland dysfunction. Curr Opin Ophthalmol. 2024;35:322–8. https://pubmed.ncbi.nlm.nih.gov/38813738/
- Dell SJ. Intense pulsed light for evaporative dry eye disease. Clin Ophthalmol. 2017;11:1167–73. https://pubmed.ncbi.nlm.nih.gov/28790801/
- Kumar N, et al. Seasonal variation in dry eye. Ophthalmology. 2015;122:1727–9. https://pubmed.ncbi.nlm.nih.gov/25912217/
- Abusharha AA, Pearce EI. The effect of low humidity on the human tear film. Cornea. 2013;32:429–34. https://pubmed.ncbi.nlm.nih.gov/23023409/
- Abusharha AA, et al. Effect of ambient temperature on the human tear film. Eye Contact Lens. 2016;42:308–12. https://pubmed.ncbi.nlm.nih.gov/26595213/
- US Food and Drug Administration. De Novo decision summary DEN200028. 2021. https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200028.pdf
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