Dry Eye Clinic

Our clinics use specialized diagnostic tests to better understand why the eyes are dry, so that the root cause may be treated. Treatments range from simple home therapies to advanced in-office treatments that use InMode's Forma RF and Lumecca IPL technology, which also have added beauty benefits of skin tightening and rejuvenation!

Woman rubbing her eyes because they are dry and irritated – Dry eye clinic – Blocked oil glands expression

Dry eye disease (DED)

Dry eye disease (DED) does not always present with symptoms, so receiving a diagnosis of DED can be confusing.

Whether or not symptoms are present, it is important to manage DED before damage to the ocular tissue occurs, otherwise there could be loss of oil glands and scarring of the cornea. Our clinics recognize that in order to effectively manage dry eye, the root causes must first be identified. We use specialized diagnostic testing such as meibography, to uncover the causes of DED, and devise customized treatment plans for each patient. Preventing DED is equally as important as managing it: We also offer dry eye prevention and management to patients about to undergo cataract or laser surgery, to optimize their surgical outcome and comfort. Dry eye disease management range from simple home therapies to advanced in-office treatments, including some that have been borrowed from dermatology, which have the added benefits of skin tightening and rejuvenation!

Testing for Dry Eye:

  • Tissue stains
  • Meibography
  • Tear osmolarity

Signs & Symptoms of Dry Eye

  • Dry, gritty, scratchy or burning sensation
  • Redness, watery or teary eyes
  • Mucus that make the eyes feel "glued shut" after sleeping
  • Feeling of something in the eye or eyestrain
  • Itching and light sensitivity
  • Unstable vision

Treatment of Dry Eye

  • Artificial tears or ointments containing trehalose
  • Re-esterified triglyceride Omega-3
  • Warm compresses with moist heat mask
  • Sterile Lid hygiene wipes
  • Professional eyelid cleaning (BlephEx)
  • Radio-frequency energy (Forma-I)
  • Intense pulsed light (Lumecca)
  • Meibomian gland expression
  • Topical and oral medication

Dry Eye Treatment with Forma & Lumecca

Side Effects: Tighter Skin, Less Wrinkles, More Even Skin Tone

Both Forma and Lumecca by InMode are technologies that originated in Dermatology, which have been shown to be effective in managing Dry Eye Disease(DED). Forma is Health Canada certified and Lumecca is FDA-approved for treating dry eye. When Forma and Lumecca are combined to treat DED together, the results are even better! Forma uses radiofrequency (RF) energy while Lumecca uses intense pulsed light (IPL), both improving the health and function of the oil glands in the eyelids. Dry eye treatments with Forma and Lumecca are comprised of four sessions spaced 2-4 weeks apart.

Forma Dry Eye Treatment

Side Effects: More Collagen, Tighter Skin

Dry eye treatment with Forma-I /Forma by InMode uses radiofrequency (RF) energy energy to unclog obstructed meibomian glands and to stimulate collagen production in the gland tissues. Once the thickened oils inside the glands have been softened the doctor will gently express the contents from the gland ducts located in both the upper and lower lids. Dry eye treatments using Forma improve the integrity and function of the meibomian glands, and have the added beauty benefit of skin tightening too!

Woman receiving Forma I radiofrequency – dry eye treatment – Meibomian

Standard Forma Dry Eye Treatment ( 50 minutes)

  • Upper and Lower Lids
  • Meibomian Gland Expression

Forma Dry Eye Treatments consist of four sessions spaced 2 to 3 weeks apart, however additional treatments might be needed in more advanced cases. A maintenance session is recommended at least every 6 months to keep the gains from the initial treatment. Forma Dry Eye Treatments have absolutely no down time. Vitamin C supplements before and after treatments are recommended to enhance Forma’s collagen genesis effect. Forma treatments every 1 to 2 weeks will maximize and lengthen the duration of the accompanying skin tightening benefits. Results might vary among individuals and more mature skin may require extended treatment sessions for best results.

Forma Contraindications:

  • Pacemaker or internal defibrillator
  • Permanent metal implants ( e.g. dental) in the treatment area
  • Treatment within 1cm from cochlear implants in the ear
  • Cosmetic fillers in the last 6 months, Botox within the last 7 days
  • Pregnancy and nursing
  • Under 18 years of age unless with parental consent

Cautions for Forma:

  • Current or history of skin cancer, suspicious or active lesions, or premalignant moles (Avoid treatment if you have active or suspicious lesions in the treatment area.)
  • HA/collagen/fat/silicone fillers and injections within the last 6 months, and Botox within the last 7 days
  • A history of diseases stimulated by heat, such as recurrent Herpes Simplex (cold sores, zoster blisters) in the treatment area ( Valtrex 500mg can be taken twice a day for 2 days prior to treatment, and 5 days after treatment for prophylaxis. Genital Herpes is not a concern.)
  • Severe systemic illness or disease
  • Impaired immune system due to immunosuppressive diseases or use of medications
  • Use of Isotretinoin (Accutane) within the last 6 months
  • Poorly controlled diabetes with vascular complications (Due to poor healing.)
  • Any surgical procedure in the treatment area within the last three months or before complete healing
  • Facial laser resurfacing, facial dermabrasion, and deep chemical peeling within the last three months
  • History of skin disorders such as keloid scarring, abnormal wound healing, as well as very dry and fragile skin
  • Vitiligo (Best to avoid because heat can alter pigmentation.)

Day of Forma Treatment:

  • Please arrive without creams or makeup on the treatment area and have your hair tied back.

What to Expect after Forma:

  • Your skin will appear pink for a few hours, but it is fine to wear make-up. You may experience mild swelling

Potential Forma Side Effects:

  • Skin will look pink or red
  • Mild edema or swelling
  • Blistering and crusting
  • Mild pain

Most side effects will resolve within hours.

Blistering and crusting are rare, however if these occur, please apply a thin layer of over-the-counter antibiotic such as Polysporin 3 times a day and notify the clinic.


Lumecca Dry Eye Treatment

Side Effects: Reduced Dark Spots, Improved Skin Tone

Dry eye treatment with Lumecca by InMode uses intense pulsed light (IPL) in combination with meibomian gland expression to improve the health of the ocular surface. IPL was first used in Dermatology to treat facial skin damage including wrinkles, age spots, and dilated blood vessels, and has made its way into Ophthalmology. IPL is an effective treatment of dry eye because it decreases inflammation, reduces telangiectasia, kills Demodex mites, and is particularly beneficial to patients with Rosacea. Dry eye treatments using Lumecca improve the integrity and function of the meibomian glands, and have the added beauty benefit of rejuvenating and brightening the skin too!

Woman with ocular rosacea receiving Lumecca IPL – dry eye treatment for Meibomian – gland disease

Standard Lumecca Dry Eye Treatment (50 minutes)

  • Treatment Areas: Tragus to Tragus, Central Forehead, Medial Cheeks & Nose
  • Meibomian Gland Expression

Lumecca Dry Eye Treatment with Upper Lids (60 minutes)

  • Treatment Areas: Tragus to Tragus, Upper Eyelid, Central Forehead, Medial Cheeks & Nose
  • Meibomian Gland Expression

Lumecca Dry Eye Treatments consist of four sessions spaced 2 to 4 weeks apart depending on your Fitzpatrick Skin Type, and additional treatments might be needed in more advanced cases. A maintenance session is recommended at least every 6 months to keep the gains from the initial treatment. Lumecca Dry Eye Treatments can cause redness and sensitivity after treatment, however there is no downtime. Please note that it is necessary to protect the skin against UV radiation and avoid direct sun exposure and tanning of the treated areas 4 weeks before and 4-6 weeks after IPL treatments.

Lumecca Contraindications:

  • Fitzpatrick V-VI skin type (rarely burns or easily tans), or if you have melasma
  • Tanning within the last 3-4 weeks
  • Use of Isotretinoin (Accutane) within 6 months prior to treatment or current use of doxycycline
  • Not for treatment over tattoos or permanent makeup
  • Cosmetic fillers in the last 6 months, Botox within the last 7 days
  • History of skin cancer, active or suspicious lesions in the treatment area
  • Pregnancy/nursing mothers
  • Under 18 years of age unless with parental consent

Cautions for Lumecca:

  • A history of diseases stimulated by heat, such as recurrent Herpes Simplex (cold sores, zoster blisters) in the treatment area (Valtrex 500mg can be taken twice a day for 2 days prior to treatment, and 5 days after treatment for prophylaxis. Genital Herpes is not a concern.)
  • Severe systemic illness or disease
  • Impaired immune system due to immunosuppressive diseases or use of medications
  • Use of Isotretinoin (Accutane) within the last 6 months
  • Poorly controlled diabetes with vascular complications (Safe in controlled diabetics but only on the face, not on extremities.)
  • Any surgical procedure in the treatment area within the last three months or before complete healing
  • Facial laser resurfacing, facial dermabrasion, and deep chemical peeling within the last three months
  • History of skin disorders such as keloid scarring, abnormal wound healing, as well as very dry and fragile skin (In the unlikely event of a blister forming, scarring can happen.)
  • Diseases which may be stimulated by light at the wavelengths used, such as history of Systemic Lupus Erythematosus, Porphyria, and Epilepsy
  • Vitiligo
  • Treating over tattoos or permanent makeup (OK to treat the rest of the face, but not lips, brows and eyelids.)
  • Excessively tanned skin from sun, tanning beds or tanning creams and sprays within the last two weeks (IPL targets pigment and tanned skin as pigment near the surface, so IPL can cause burns on freshly tanned skin. OK to treat older tans (3-4 weeks), but not active tans like youwould get from basking in the sun for an hour without sunscreen.)
  • Current or prior history of Gold Therapy (IPL can heat up the gold fragments.)

Pre Lumecca Instructions:

  • Avoid sun exposure and tanning beds for at least 4 weeks prior to and post treatment.
  • Avoid self-tanning products for 2 weeks prior to treatment.
  • Inform the doctor if you are taking blood thinners or aspirin and ibuprofen on a regular basis.
  • Avoid alcohol for 2 days prior to treatment.
  • Inform the doctor if you have taken Accutane in the past 12 months.
  • Have ice packs in your freezer ready for post IPL care if necessary.

Day of Lumecca Treatment:

  • Please arrive without wearing contact lenses, creams or makeup on the treatment area, and have your hair tied back.

What to Expect after Lumecca:

  • Your skin will appear pink for a few hours, but it is fine to wear make-up.
  • Brown spots and freckles MAY appear darker, you may experience a coffee ground like appearance over treated areas - please allow them to fade on their own, do not rub them off or exfoliate for 7-10 days.
  • Cold compresses (5 minutes on and 10 minutes off - wrap compress to avoid direct contact before applying to skin) will relieve redness and swelling.

Potential Lumecca Side Effects:

  • Skin will look pink or red
  • Mild edema or swelling
  • Mild hyper or hypo pigmentation
  • Burning / stinging
  • Temporary discolouration /bruising of the skin
  • Blistering and crusting
  • Mild pain
  • Facial hair loss

Most side effects will resolve within one week other than facial hair loss. Blistering and crusting are rare, however if these occur, please apply a thin layer of over-the-counter antibiotic such as Polysporin 3 times a day and notify the clinic. Please do not pick at the skin nor expose it to dirty surfaces.

Post Lumecca Care:

  • Use mild cleansers and moisturizers daily on your skin.
  • No hot showers for 48 hours.
  • Avoid taking aspirin, Ibuprofen, consuming alcohol, heavy exertion and activities which may cause flushing for 2 days after treatment.
  • Avoid harsh topical products such as retinols and glycolic acid products for one week post treatment.
  • Avoid direct sunlight on the treated area and use a sunscreen with SPF 30 or greater (every two hours if outdoors) for 4 to 6 weeks after treatment.
  • No swimming in pools with chemicals such as chlorine for 48 hrs.
  • No hot tubbing for 48 hours.
  • Avoid activities that cause excessive perspiration for 48 hrs post treatment.
  • Do not pick at or remove any loosening or peeling skin.
  • No electrolysis, facial waxing or hair removal products for 14 days after treatment.

BlephEx

For Eyelid 'Plaque'

BlephEx is a quick and gentle in-office treatment to address blepharitis by removing excess bacteria, toxins and debris along the lid margins. If you suffer from dry eyes or are unable to wear contact lenses comfortably, BelphEx might be just what you need.

Clean eyelid – Blepharitis – BlephEx – Contact lens intolerance

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