How Safe and Effective are Home-Based Radiofrequency and Light Treatments for Dry Eye Care?
Happy New Year! I thought it would be appropriate to start the new year with a common thread among some dry eye sufferers I’ve advised over the past year. The common question is – since office-based treatments are so expensive and because some similar technologies are now being offered for self-treatment home care – why can’t I just buy a radiofrequency unit and a light-based unit, and do my own treatments? These treatments could perhaps replace some office treatments, or be used as an office treatment “extender,” or optimizer?
When a particular RF unit was singled out, I found an Amazon link to an eerily similar device for $99. There was very poor grammar in their marketing brochure, suggesting a poor understanding of English language. Some foreign countries have substantial road blocks to product liability and if they fry some eyeballs, there isn’t much recourse. A FB post I did to address a question from a dry eye sufferer helped explain my take on these cheap, “fix it at home” technologies:
I can’t speak to specific “Over The Counter” (OTC) products like this one, but generally speaking, the aim of RF (off label, as it has yet to be studied and approved for this use by the FDA), is to heat directly over the eyelid area, to melt and allow adequate expression of the waxy obstructions in the oil glands of the tear system. Because RF can penetrate deeply through the skin and eyelid tissues, I’ve found it extremely useful for this purpose. I also used special thermal imaging cameras to track this temperature and found if you don’t get to the common “melting point” of the waxy plugs obstructing these glands (around 42-43C) then you never really get that adequate expression. That same temperature can also affect the cornea or clear “window” of the eye, as it resides directly under the lids. Doctors using this technique will use special eye shields to protect the cornea and to assist in the expression of the waxy obstructions. The OTC tools I’ve seen do not appear to have a temperature monitoring system (it goes off by time and not the temperature) so it is hard to know if they can unclog the glands. They also doesn’t have anything to protect the cornea if you do get it that hot, so I personally cannot endorse them. As far as getting the aesthetic benefits, the prescription strength RF devices have good scientific studies to back up true clinical results we see but I didn’t see any such studies for the OTC units. Any form of deep heat can temporarily improve the appearance of fine lines and wrinkles by swelling the skin, but the long-term improvement comes from the specific stimulation of the cells that make and repair collagen and elastin. I’d be interested to see peer reviewed, dry eye studies using these home-based, OTC units. I’m working with some RF companies (as are other doctors) to increase acceptance of RF worldwide for dry eye treatments, which requires ongoing studies and training specific for dry eye diseases.
Low Level Light Therapy (LLLT) is a world-wide growing trend, using relatively low levels of light in certain spectrums found to benefit a variety of medical ailments. LLLT encompasses a wide range of light energies and spectra and has many scientific studies to support biological influences that may be beneficial for a wide range of problems (& some units may have been FDA approved for the treatment of those problems - so the manufacturer can claim it is FDA-certified) – but as far as dry eye disease goes, it has no where near the level of study (nor specific FDA approval for that specific indication) as many other treatments, including IPL, which was approved over a year ago, specifically for the treatment of dry eye disease.
There are numerous anecdotal reports and some limited published reports of dry eye benefits, so some companies are selling these units to eye doctors – and while there are an increasing number of those doctors using this technology for the purpose of treating dry eye, I have not been able to find enough peer reviewed, scientific data to support the safety and efficacy of LLT for dry eye-related disease. At least the majority of these office-based “eye” units have been specifically tested for eye safety and have USA-based companies representing them, – so product liability is likely to be well regulated. Units you can buy and use at home can provide over 10,000 lux of light energy – and that amount of light energy is certainly sufficient to cause harm to an eye if not appropriately shielded. Filters can bring that light into a spectrum like an IPL’s when treating dry eye – so while there may be efficacy for some units – the proof of safety and how well they work remains to be sufficiently validated before many of us would recommend it for our patients using office-based care – and even more so for home-based treatments.
As usual, I recommend working with a dry eye specialist who can offer a range of proven dry eye care treatments, who can take some time to answer your questions and provide a well explained treatment plan specific to your dry eye needs.
Here’s to a healthier, happier 2023!