Pillar 02 · Dry Eye
The PSEC Dry Eye Program · Bellevue Eastgate
20+ years of dry eye specialty. IPL + LLLT equipment incoming 2026. We treat the inflammation underneath your symptoms — not just the symptoms.
Why most dry eye treatment fails
Dry eye is an inflammatory condition — not a hydration deficit
If you're reading this, you've probably used artificial tears for months. They didn't fix the problem. Someone told you "just keep using the drops."
Both are common. Both are wrong. The drops you've been using are managing the symptomsof inflammation. The drops don't treat the inflammation itself.
In 2026, the standard-of-care for chronic and inflammatory dry eye targets the root cause — meibomian gland inflammation — with IPL + LLLT.
Your dry eye lead
Dr. Jennifer Andrews · 20+ years treating dry eye in Seattle
Dr. Andrews has been treating dry eye and complex contact lens patients in the Seattle community since 1994. Past President of King County Optometric Physicians. Past Trustee of Optometric Physicians of Washington. Developed the Garfield High School Read Right vision screening program and the Eye Exam Exhibit at the Seattle Children's Museum.
The 6-step PSEC workup
Why we do more than "use these drops"
Step 01
Symptom Intake
OSDI (Ocular Surface Disease Index) score, lifestyle questionnaire, current drop usage.
Step 02
Meibomian Gland Imaging
Tomographic imaging of the oil glands at lid margin. You can't treat what you can't see.
Step 03
Tear Breakup Time + Osmolarity
Measurement of tear film stability and concentration.
Step 04
Schirmer + Phenol Red Thread
Measurement of natural tear production.
Step 05
Ocular Surface Staining
Fluorescein + lissamine green dyes show micro-damage to cornea + conjunctiva.
Step 06
Lid + Lash Assessment
Demodex (microscopic mites) + blepharitis + meibomian gland expression.
This workup is 45-60 minutes total. We bill the diagnostic codes to your medical insurance when applicable. Most patients have 80-100% of the workup covered.
Treatment paths
Your plan is based on YOUR result · not a template
Path A
Mild aqueous-deficient dry eye
- Preservative-free artificial tears (specific brand)
- Omega-3 supplementation
- Warm compress protocol (proper technique)
- Re-check at 6 weeks
Path B
Evaporative + Meibomian Gland Dysfunction (most common)
- Meibomian gland expression (in-office, 15 min)
- IPL therapy series — 4 sessions over 6-8 weeks
- LLLT therapy (often combined with IPL)
- Lid hygiene (Avenova / hypochlorous acid spray)
- Re-check at 12 weeks
Path C
Severe + Sjögren's-related
- Prescription anti-inflammatory (Restasis, Xiidra, Miebo, Cequa)
- Punctal occlusion (temporary or permanent plugs)
- Autologous serum tears in severe cases
- Co-management with rheumatology
- Often combined with IPL/LLLT
Pricing transparency
What it costs · what insurance covers
| Service | Cash-pay | Insurance |
|---|---|---|
| Initial dry eye workup (60 min) | $200 | 80-100% covered by medical insurance |
| Meibomian gland expression (15 min) | $150/session | Sometimes covered (CPT 0207T) |
| IPL single session | $400-$500 | Not covered · HSA/FSA eligible |
| IPL 4-session series (typical) | $1,500-$2,500 package | Not covered · HSA/FSA · CareCredit |
| LLLT single session | $150-$300 | Not covered · HSA/FSA |
| Punctal plug insertion (1 plug) | $150-$300 | Often medically billed (CPT 68761) |
HSA, FSA, and CareCredit accepted on all IPL/LLLT services. Most patients use HSA/FSA for the cash-pay portions — these qualify as eligible medical expenses.
“Most patients I see have been told 'use more eye drops' for years. That's a symptom approach, not a treatment approach. The 2017 TFOS DEWS II consensus shifted dry eye to a meibomian-gland-and-inflammation disease — and IPL plus low-level light therapy is what we built the Bellevue program around. Four sessions of OptiLight, four weeks apart. Most patients see meaningful relief by session three.”
FAQ
Patient questions
Does insurance cover IPL?
No US health insurance covers IPL for dry eye as of 2026. HSA, FSA, and CareCredit financing all apply.
How fast will I feel better?
Most patients feel notable improvement after sessions 2-3 of an IPL series. The full effect is typically visible at the 8-12 week post-series re-check.
Is IPL painful?
Most patients report a brief warm sensation (similar to a rubber-band snap) during each pulse. No anesthesia required. Protective eye shields provided. Most patients describe it as 'uncomfortable for 30 seconds total' — not painful.
How often will I need maintenance after the initial series?
60-70% of patients benefit from one maintenance session every 6-12 months after the initial 4-session series. Some patients are symptom-free for 12-24 months.
I have very dark skin (Fitzpatrick VI). Can I get IPL?
IPL settings are calibrated to skin phototype. Patients with very dark skin require modified protocols. We assess this at the initial consult. In rare cases, alternative therapies (LLLT alone) are recommended.
How does PSEC's dry eye program differ from a med-spa offering IPL?
Med-spa IPL is typically aesthetic (rosacea, skin rejuvenation) — not specifically tuned for dry eye disease. PSEC's IPL is delivered by an OD specialist with 20+ years of dry eye expertise, calibrated to the meibomian gland setting.
I'm a Microsoft / Amazon / tech-worker dry eye sufferer from staring at screens. Will this help?
Very likely yes. Computer-vision-syndrome dry eye is one of the most common patterns we see at our Bellevue Eastgate office. IPL + LLLT + lifestyle protocol addresses the underlying inflammation + meibomian gland dysfunction.
Free 20-minute dry eye consult with Dr. Andrews
Primary-source evidence
Sources cited on this page
- [1]Stapleton F, et al. TFOS DEWS II Epidemiology Report. The Ocular Surface 2017;15(3):334-365. Dry eye disease prevalence ranges from 5% to 50% across populations; meibomian gland dysfunction is the most common cause. View source →
- [2]Vora GK, Gupta PK. Intense pulsed light therapy for the treatment of evaporative dry eye disease. Current Opinion in Ophthalmology 2015;26(4):314-8. IPL reduces meibomian gland dysfunction inflammation and improves tear film stability. View source →
- [3]FDA 510(k) K203519 — Lumenis OptiLight (April 2021). The first and only FDA-cleared intense pulsed light (IPL) device for the treatment of dry eye disease. View source →
- [4]Stonecipher KG, Komatsu CC, Walker B. Combined low level light therapy and intense pulsed light therapy for the treatment of dry eye disease: a 6-month follow-up. Clinical Ophthalmology 2020;14:4439-4445. View source →
- [5]Schiffman RM, et al. Reliability and validity of the Ocular Surface Disease Index (OSDI). Archives of Ophthalmology 2000;118(5):615-21. The OSDI is the validated 12-question dry eye severity instrument. View source →