Low Level Light Therapy (LLLT) for eyes

Low level light therapy (LLLT) is a light based photobiomodulation therapy (PBMT). It has only recently been adapted for use in ophthalmology for eye disease, but its safe and effective use has been well established for years in other medical disciplines. The technology was originally employed by NASA to treat astronauts in space.

LLLT is a non-contact, painless, safe and effective system that uses light and heat production to treat dry eye disease, meibomian gland dysfunction, blepharitis and ocular surface disorders. It can also be used as a non-surgical treatment of chalazion in adults and children. In addition it can help with contact lens discomfort that is due to dry eye, and can help to prevent and treat dry eye following cataract surgery.

LLLT is not the same as red light therapy, which acts only on the surface of the skin. LLLT works at a deeper biological level, generating endogenous heat through powerful LED lights that stimulate ATP production and therefore energy production in cells. It is termed ‘low level’ as the energy densities are much lower than other forms of light/laser therapy that we commonly use in medicine.

What is Low Level Light Therapy? (Photobiomodulation Therapy)

LLLT or PBMT is a technique that has been used by dermatologists for many years and has now been adapted by the ophthalmic industry to treat ocular surface disorders. LLLT uses low levels of red light to reduce pain and inflammation, promote regeneration of different tissues and nerves, and prevent tissue damage. It is termed ‘low level’ as the energy densities are much lower than other forms of light/laser therapy that we commonly use.

How does LLLT work?

The exact biological mechanism is thought to be the stimulation of Cytochrome-C Oxidase (CCO) within mitochondrial chromophores, following absorption of red light. This stimulates a cascade of events:

·       The light stimulates mitochondria, causing upregulation of adenosine triphosphate (ATP) production, leading to activation of cell proliferation, tissue repair, and regeneration.

·       LLLT stimulates protein synthesis, which enhances and stabilises the lipid tear film layer, providing significant relief of ocular surface symptoms.

·       LLLT reduces pain and inflammation, promotes regeneration of different tissues and nerves, and prevents tissue damage.

How is LLLT delivered to the eyes?

The delivery of LLLT to the eyes is through a mask that sits on the face, covering the forehead, eyelids, and maxillary sinuses. The Espansione Meibomask system delivers red light and also releases endogenous heat to 42°C. The red light and heat penetrates the eyelid tissue to a degree that is unable to be accessed with warm compresses.

What is the treatment process?

The treatment is very simple, relaxing and enjoyable. The duration of treatment is about 15 minutes, so it is fast, painless, safe and provides immediate relief. You recline in a chair with a face mask on, which applies heat and light directly to the closed eyelids and surrounding tissues. The heat zones span from the forehead, over and around the eye area, and down to the cheeks, leaving your nose and mouth clear so you can breathe comfortably. Treatments are performed one week apart for a minimum of 3 treatments and can be repeated as needed.

Before Treatment

·       Remove or don’t wear makeup, including mascara, as the heat will make it melt and run and it may interfere with the absorption of the light.

·       Remove or don’t wear contact lenses for this treatment as they may dry out on the eyes.

·       Remove hearing aids, earrings and piercings, as the metal can heat up.

·       Cover eyelash extensions (ideally don’t have them or remove them).

·       Avoid sunburn or chemical, physical or enzymatic skin peels before or after treatment.

·       Avoid photosensitising medication. Common examples include certain antibiotics (tetracyclines, fluoroquinolones), diuretics (hydrochlorothiazide), NSAIDs (like naproxen), some heart medications (amiodarone), retinoids, and oral contraceptives.

After Treatment

·       Stay out of direct sunlight for the first 48 hours following treatment, as your skin may burn.

·       Do not use any chemical, physical or enzymatic skin peeling during the treatment cycle.

·       Don’t take any photosensitising medications during the treatment cycle (see list above).

Contraindications to Treatment

·       Pregnancy

·       Presence of active cancer in the treatment area

·       Hypersensitivity to light or history of light-induced disorders e.g. epilepsy or migraine

·       Presence of non-removable piercings in the area (they will burn!)

·       Active sunburn or recent chemical/physical or enzymatic skin peels (you will burn!).

Low level light therapy is a gentle effective treatment that can reduce the chronic discomfort of dry eye and blepharitis, and is an effective non-surgical treatment of eyelid styes or chalazia. The Espansione Meibomask treatment has been clinically proven to be safe and effective and has the backing of considerable research to give you confidence in this particular treatment. It is a wonderful way to experience the true medicine of “first, do no harm” and of using light as a form of true healing.

References:

1.     https://espansionegroup.it/solutions/meibomask/