Dry eye disease is more than just a nuisance; it’s a chronic condition that can make reading, driving and even keeping your eyes open uncomfortable. Millions of people experience burning, gritty or watery eyes because the surface of the eye isn’t properly lubricated. While artificial tears and over‑the‑counter drops give temporary relief, they don’t address the underlying cause. In most cases the problem starts with the meibomian glands — tiny oil‑secreting glands along the edges of your eyelids that keep your tears from evaporating too quickly. When these glands get clogged or inflamed, the protective oil layer disappears and tears evaporate faster than they should, leaving the surface dry and inflamed. Environmental factors such as indoor heating, air conditioning, and long hours at a computer can accelerate evaporation.

This post takes an in‑depth look at the most popular in‑office dry eye treatments — LipiFlow®, IPL, radiofrequency, low‑level light therapy and manual gland expression. We’ll explain how each procedure works, who might benefit, what to expect during treatment and how to maintain results at home. By the end, you’ll understand why addressing the root cause of dry eye is essential and how a personalized treatment plan can finally give you lasting relief.

Understanding Dry Eye and Meibomian Gland Dysfunction

Dry eye disease has many causes, but meibomian gland dysfunction (MGD) is the most common. In MGD, the oil (lipid) component of your tear film is disrupted. A healthy tear film has three layers: an outer oily layer that slows evaporation, a watery middle layer that nourishes and moisturizes the cornea, and an inner mucous layer that helps tears spread evenly across the eye. When the glands that produce these oils become blocked by thickened secretions, debris or inflammation, tears evaporate faster and the ocular surface becomes dry and inflamed. Symptoms can include burning, stinging, fluctuating vision, light sensitivity and excessive tearing (yes, watery eyes often mean your tears are evaporating too fast). Risk factors include aging, hormonal changes, autoimmune disease, rosacea, contact lens wear and digital eye strain.

Modern dry eye care focuses on restoring gland function rather than simply adding more drops. That’s where in‑office therapies come in: they heat, massage or stimulate the glands to melt and express the thickened oils. These procedures are usually combined with home care — such as warm compresses, omega‑3 supplements and lid cleansing — for long‑lasting results. Below, we compare the leading options.

LipiFlow®: Vectored Thermal Pulsation

How it works: LipiFlow is an FDA‑approved treatment that combines gentle heat with pulsating pressure to unclog blocked meibomian glands. A soft device shaped like a large contact lens fits over your eye, delivering controlled warmth to the inner eyelids while a second component applies gentle pulsations to the outer lids. This combination melts the hardened oils and massages them out of the glands. The treatment lasts about 12–15 minutes per eye, is painless, and you can return to normal activities right away. Most patients feel some relief within a few weeks as the glands start secreting healthy oil again.

Who it’s for: LipiFlow is ideal for patients with moderate to severe MGD, especially if warm compresses or lid scrubs haven’t provided adequate relief. It’s also a good option for contact lens wearers who struggle with comfort or for anyone whose tear break‑up time (TBUT) is very short. In clinical studies, LipiFlow improved symptoms and signs of dry eye for up to a year when combined with daily home care.

What to expect: Before the procedure, your optometrist will perform imaging (meibography) to assess gland structure and function. During treatment, you’ll feel warmth and gentle pressure, but it shouldn’t hurt. Afterwards your eyes may feel slightly more watery or blurred for a day or two while the glands recover. Your doctor may recommend preservative‑free lubricating drops and a hypochlorous lid spray to reduce inflammation.

Intense Pulsed Light (IPL)

How it works: Originally developed for dermatology and rosacea, IPL uses brief pulses of broad‑spectrum light to treat inflammation around the eyelids. The light energy is absorbed by dilated blood vessels and pigmented lesions, reducing inflammation and improving blood flow to the meibomian glands. IPL also helps eradicate Demodex mites and bacteria that contribute to blepharitis. Treatments are usually performed every two to four weeks for three to four sessions.

Who it’s for: IPL is especially effective for patients with inflammatory dry eye associated with ocular rosacea, eyelid redness or telangiectasia. It’s also helpful if you have a lot of lid margin inflammation or Demodex blepharitis. Patients often notice improvement in redness and burning after the first two sessions, with cumulative benefits over time.

What to expect: Your doctor will place shields over your eyes and apply a cooling gel to the treatment area. You’ll feel quick flashes of warm light as the handpiece is passed over the cheeks and lids. Mild redness or swelling may occur for a few hours afterwards. You should avoid sun exposure or tanning for a few weeks before and after treatment. As with other procedures, IPL works best when combined with lid hygiene and nutritional support.

Radiofrequency (RF)

How it works: Radiofrequency (RF) therapy uses electromagnetic energy to gently heat the skin and deeper tissues around the eyes. This controlled heat melts the thickened meibum and stimulates collagen production, which helps firm and tighten the eyelids. A typical session lasts 15–20 minutes per eye, and most patients need three to four treatments spaced a few weeks apart. RF can be combined with meibomian gland expression or IPL for enhanced results.

Who it’s for: RF is a good option if you have mild to moderate MGD and also want subtle cosmetic benefits like reduced fine lines or sagging. It’s especially helpful for patients whose glands produce thicker oil that doesn’t respond well to heat alone. Younger patients with early signs of gland dysfunction may also benefit from RF to preserve gland structure.

What to expect: During treatment you’ll feel a warming sensation as the handpiece is moved around the lids and brows. There’s no downtime; you can return to work immediately. Your doctor may follow RF with manual expression to expel melted oils. To maintain results, continue daily heat masks and lid cleansing at home.

Low‑Level Light Therapy (LLLT)

How it works: Also known as photobiomodulation, LLLT uses specific wavelengths of red and near‑infrared light to stimulate cellular metabolism, reduce inflammation and promote healing. Patients wear a mask that emits light directly onto the eyelids for about 15 minutes. Unlike IPL, LLLT doesn’t produce heat; instead it works at the mitochondrial level to calm inflammation and encourage gland function.

Who it’s for: LLLT is ideal for patients with mild to moderate MGD or inflammatory conditions who may not tolerate heat‑based treatments. It’s also useful for maintaining results after other therapies, or for people with Demodex blepharitis who need to reduce eyelid inflammation gently.

What to expect: Treatments are completely non‑invasive and painless. You’ll sit or lie with the mask in place while the light does its work. A series of three to four sessions spaced one week apart is typical, and many people choose maintenance sessions every few months.

Manual Gland Expression and Other Options

Manual Expression: In this straightforward procedure, your optometrist or ophthalmologist uses a sterile instrument to gently squeeze the meibomian glands and express the thickened oils. It’s often performed after warm compresses, IPL or RF treatments to clear out residual blockage. Some patients describe pressure or mild discomfort, but the process is quick and the relief can be immediate.

Other emerging treatments: In recent years, other thermal pulsation devices like iLux® and TearCare® have entered the market. These systems deliver heat to the eyelids using soft applicators, followed by manual expression. Your eye care professional can help you choose which device is best based on your anatomy and severity of disease. Some practices also offer meibomian gland probing or medicated gland irrigation for severe scarring.

Do In‑Office Treatments Really Work?

The short answer is yes — when they’re customized to the patient and combined with consistent home care. Clinical studies show that thermal pulsation, IPL and RF can improve tear film stability, increase meibomian gland secretion and reduce symptoms for months or even years. However, no single treatment cures dry eye forever. Think of these therapies as a reset for your glands: they clear out blockages and restore flow, but you still need to maintain the results.

To maximize success, most doctors recommend a three‑pronged approach:

• Daily lid hygiene: Use a gentle hypochlorous spray (try a hypochlorous acid lid spray) to cleanse the lash line, remove debris and reduce bacteria. Follow with a warm compress using a microwaveable heat mask or gel pack.
• Nutrition: Take an omega‑3 supplement such as PRN DE3 Dry Eye Omega-3 to support gland health and reduce inflammation.
• Lubrication: Apply preservative‑free artificial tears like Thealoz® Duo  throughout the day to protect the ocular surface and lock in moisture.

When Should You Consider In‑Office Therapy?

It might be time to move beyond eye drops if:

• Your eyes still feel dry, gritty or watery despite using drops multiple times per day.
• Warm compresses and lid scrubs provide only short‑term relief.
• You wear contact lenses and struggle with comfort or end‑of‑day dryness.
• Your optometrist has diagnosed you with meibomian gland dysfunction, evaporative dry eye or blepharitis.
• You notice vision that fluctuates with blinking or worsening fatigue after screen time.

During your consultation, your doctor will examine your glands, measure tear film quality and discuss your lifestyle. Based on those findings, they’ll recommend one or more in‑office therapies and explain the expected results. In many cases, combining treatments — such as an IPL series followed by thermal pulsation — provides the most comprehensive relief.

Maintaining Results at Home

In‑office procedures jumpstart gland function, but the day‑to‑day work happens at home. A typical maintenance routine includes:

• Applying a Canopy Humidifier to keep your environment at 40–50% humidity.
• Using a heat mask like the BlinkJoy Sleep Mask for 10 minutes each night to melt residual oils.
• Spraying your lids with hypochlorous acid spray to remove biofilm and soothe inflammation.
• Taking omega‑3 supplements and staying hydrated.
• Limiting screen time or following the 20‑20‑20 rule to reduce blink‑related evaporation.

Consistency is key. Many patients schedule maintenance treatments every six to twelve months, especially if they live in dry climates or spend long hours on digital devices.

The Bottom Line

In‑office dry eye therapies represent a major advance in ocular surface health. Instead of masking symptoms, these procedures address the root cause — blocked meibomian glands. When paired with daily eyelid hygiene, nutrition and lubricating drops, they provide meaningful and long‑lasting relief. If you’ve been living with burning, watery or gritty eyes, talk to your eye doctor about a custom treatment plan. A few short sessions could restore your comfort and clarity, letting you get back to work and play without distraction.

For more expert‑approved products and personalized advice, explore our full dry eye collection at Eye Drop Shop.

References

1. Arita, R., Fukuoka, S., Morishige, N., & Asai, K. (2017). "Efficacy of Thermal Pulsation Treatment for Meibomian Gland Dysfunction in Japanese Patients." American Journal of Ophthalmology, 174, 92-99.
    https://pubmed.ncbi.nlm.nih.gov/28387645/
   
   
2. Toyos, R., McGill, W., & Briscoe, D. (2015). "Intense Pulsed Light for the Treatment of Dry Eye Disease Due to Meibomian Gland Dysfunction." Ocular Surface, 13(3), 277-284.
    https://pubmed.ncbi.nlm.nih.gov/26163726/
   
   
3. Shin, Y. J., & Choi, W. (2020). "Radiofrequency Treatment for Meibomian Gland Dysfunction." Clinical Ophthalmology, 14, 3773-3780.
    https://pubmed.ncbi.nlm.nih.gov/33282667/
   
   
4. Arance-Gil, A., et al. (2021). "Low-Level Light Therapy for Dry Eye: A Review of Clinical Evidence." Journal of Clinical Medicine, 10(15), 3262.
    https://pubmed.ncbi.nlm.nih.gov/34351566/
   
   
5. Finis, D., et al. (2014). "Meibomian Gland Dysfunction Treatment with Manual Expression Combined with Doxycycline: A Randomized Controlled Trial." Cornea, 33(12), 1334-1340.
    https://pubmed.ncbi.nlm.nih.gov/25380622/