Recent Developments in Ocular Surface Disease: IVIZIA, Miebo, and IPL Therapy
March 1, 2025
Ocular surface disease (OSD) remains a prevalent and evolving challenge in eye care, with advancements in treatments providing new hope for patients suffering from dry eye disease (DED), meibomian gland dysfunction (MGD), and related conditions. DED can make your vision fluctuate, create blur, haloes, and discomfort. Blame can be placed on LASIK, PRK or cataract surgery, when often the surface of your eyes is the problem. DED increases in prevalence as we get in our 40s and 50s or older. It’s about 20 times more prevalent in woman vs. men. DED can be very frustrating, can take a toll on your mental health, and quality of life. It can take a lot of time, money, and effort to effectively treat it. The good news is that there are some really cool new treatments discussed below.
In this article, we explore the latest developments in three significant areas: IVIZIA lubricating drops, Miebo (formerly Meibo), and intense pulsed light (IPL) therapy.
IVIZIA: A Next-Generation Artificial Tear
IVIZIA, developed by Théa Pharmaceuticals, is a preservative-free artificial tear solution designed to provide enhanced relief for dry eye sufferers. I have found it amazingly helpful, and unlike Meibo drops, it’s affordable! It’s between $8 and $12, which is fantastic for something that works-and there’s a coupon on the IVIZIA.com site. I have been recommending it for the past few months, and had unequaled good feedback from the patients to whom I’ve recommended it. Unlike traditional artificial tears, IVIZIA contains two key ingredients:
- Trehalose: A sugar with antioxidant properties that protects cells from oxidative stress, a known factor in dry eye pathophysiology.
- Hyaluronic Acid (HA): A molecule that retains moisture and enhances lubrication on the ocular surface.
Studies suggest that IVIZIA may provide longer-lasting hydration and symptom relief compared to conventional artificial tears. Its preservative-free nature makes it particularly beneficial for patients with sensitive eyes or those who require frequent use of lubricants. Additionally, the inclusion of HydraGlyde technology ensures extended hydration, improving the stability of the tear film and reducing discomfort from ocular dryness (8).
Miebo (Perfluorohexyloctane): A Novel Approach to Dry Eye Treatment
Miebo (formerly Meibo) is an innovative prescription eye drop designed specifically for evaporative dry eye disease, a condition commonly associated with MGD. Approved by the FDA in 2023, Miebo is the first and only drug that directly targets tear film evaporation by stabilizing the lipid layer (8). However, it’s ridiculously, stupidly expensive: GoodRx.com says, “Prices start at $747” Can you imagine? Have they no shame? I had a patient a couple of weeks ago whose friend had bought Miebo drops in Spain and said they were “very inexpensive” and worked (in her opinion) better than IVIZIA, but that she liked them both. And at one one hundredth of the cost. I’ve been practicing 28 years, and I have no idea the games that big pharma plays with these costs.
How Miebo Works
Unlike traditional artificial tears that primarily hydrate the eye, Miebo contains perfluorohexyloctane, a semifluorinated alkane that spreads across the ocular surface to reduce excessive tear evaporation. This mechanism helps improve tear film stability and prevent irritation associated with meibomian gland dysfunction. The main “breakthrough” is that it stays on your eyes for much longer, thereby reducing the frequency of instillation, and lets the surface of the eye heal because it’s not drying out all the time. It does work, in spite of the cost. However, IPL costs about the same as a bottle of Miebo, and is also a fantastic (fairly) new and growing segment of the treatment options for DED.
Clinical Findings
Clinical trials demonstrated that Miebo significantly improved both signs and symptoms of dry eye disease, offering relief from irritation, burning, and fluctuating vision. Patients using Miebo reported improved comfort without the blurring effect sometimes experienced with lipid-based eye drops (8).
IPL Therapy: Expanding its Role in Ocular Surface Disease
Intense pulsed light (IPL) therapy, originally used in dermatology for treating rosacea and acne, has gained traction in ophthalmology as an effective treatment for MGD and dry eye disease. Recent studies highlight IPL’s ability to reduce inflammation, improve meibomian gland function, and even address underlying conditions like Demodex blepharitis (6). Researchers don’t know exactly how it works, but it works.
Recent Research on IPL Therapy
1. Meibomian Gland Dysfunction (MGD)
- A 2023 study published in Scientific Reports found that IPL therapy improved meibum quality, enhanced gland expressibility, and reduced inflammatory markers like MMP-9. However, it did not significantly alter tear osmolarity, suggesting that IPL primarily benefits gland function and inflammation rather than overall tear composition (6).
2. Demodex Blepharitis
- A 2024 study by Huo et al. showed that IPL was highly effective in treating Demodex mite infestations. After three IPL sessions, 83% of patients with Demodex blepharitis were free of mites, making IPL a promising alternative to traditional lid scrubs and tea tree oil treatment (6).
3. Ocular Rosacea
- A scoping review in 2024 analyzed five studies on IPL for ocular rosacea, revealing that 91% of patients experienced significant symptom improvement. IPL reduced redness, irritation, and inflammation associated with the condition (6).
4. Post-Surgical Dry Eye (LASIK & SMILE)
- A 2024 study in the Asia-Pacific Journal of Ophthalmology investigated IPL’s role in managing post-LASIK and SMILE dry eye. The results showed that IPL helped stabilize the tear film, improved patient comfort, and enhanced long-term gland health (6).
Challenges in IPL Adoption
Despite its benefits, IPL is not yet widely integrated into optometric practices. A 2024 survey of U.S. optometrists found that only 26.6% currently offer IPL, with cost and concerns about return on investment (ROI) cited as primary barriers (7). However, among those who do offer it, 82.8% rated their ROI as “fair” or “good,” and patient demand for IPL treatments continues to rise (7). The device costs about $90K, and the disposables on top of that.
Conclusion
Advancements in ocular surface disease treatment are rapidly evolving, offering new hope to patients suffering from dry eye and meibomian gland dysfunction.
- IVIZIA provides long-lasting hydration and antioxidant protection for dry eye patients. You could buy about 100 bottles for the same price as 1 full retail priced bottle of Miebo. Takes my breath away!
- Miebo represents a breakthrough in treating evaporative dry eye by reducing tear film evaporation and stabilizing lipid layers.
- IPL therapy continues to expand its role, showing significant benefits for MGD, Demodex blepharitis, ocular rosacea, and post-surgical dry eye. IPL can also rejuvenate your skin! Two birds, one stone. IPL is an exciting modality.
While challenges remain in widespread adoption—particularly for IPL—the growing body of clinical evidence supports these treatments as essential tools in modern dry eye management. As technology and research advance, practitioners will have more options to provide effective and personalized solutions for patients suffering from ocular surface disease.
There are probably 100 different ways to treat DED, and it often takes patience to find what works for you, is affordable, and not terribly disruptive to you life. It can be effectively treated, and these three treatments are moving the needle on DED in a good way, in my opinion.
Dr. Matthew R. Sharpe
