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The short version
- Prescription drops go after inflammation, evaporation or tear production directly, instead of just adding moisture.
- In-office treatments such as IPL and thermal pulsation treat blocked oil glands, the most common cause of dry eye.
- What insurance pays for varies by plan and by treatment, so check with your insurer as well as the clinic.
- The best clinics test first, then choose treatments based on which layer of your tear film is failing.
- Ask for a written plan with timelines and total costs before you start.
Prescription drops
Several new prescription options for dry eye have arrived in the last few years1 American Academy of Ophthalmology (opens in a new tab). Improved Dry Eye Drugs for 2025 and Beyond.. They work in different ways, which is why the right one depends on your type of dry eye.
| Treatment | How it works | Worth knowing |
|---|---|---|
| Cyclosporine Restasis, Cequa, Vevye, generics | Thought to calm the immune activity that suppresses tear production | Can take weeks to months. May sting at first. |
| Lifitegrast Xiidra | Blocks a key step in the inflammation cycle | Some people notice an odd taste after using it. |
| Perfluorohexyloctane Miebo | Forms a layer over the tear film that’s expected to slow evaporation | Made for oil layer dry eye. Blurred vision, its most common side effect, affected under 4%. |
| Acoltremon Tryptyr | Thought to boost natural tears through the eye’s cold-sensing nerves | Approved in 2025. Half of trial users felt pain as the drop went in. |
| Varenicline nasal spray Tyrvaya | Thought to trigger tear production through a nerve pathway in the nose | Sneezing is a common side effect. |
| Short-course steroids such as loteprednol | Quickly calms flare-ups of inflammation | For short periods only, with eye pressure checks. |
| Lotilaner Xdemvy | Kills Demodex mites on the eyelids | A six-week course for Demodex blepharitis. |
Perfluorohexyloctane was approved in 2023 as the first prescription drop aimed squarely at evaporation2 US FDA, Drugs@FDA (opens in a new tab). Miebo (perfluorohexyloctane ophthalmic solution), NDA 216675, approved May 2023.. Acoltremon followed in 2025 as the first drop to target TRPM8, the receptor that senses cooling on the eye’s surface3 Acoltremon review, 2025 (opens in a new tab). Acoltremon and the TRPM8 frontier: a new chapter in dry eye disease therapy.. For eyelid mites, lotilaner cleared lash debris in 56% of patients after six weeks in a phase 3 trial, against 12.5% on placebo4 Saturn-2 phase 3 trial, Ophthalmology, 2023 (opens in a new tab). Lotilaner Ophthalmic Solution 0.25% for Demodex Blepharitis: Randomized, Vehicle-Controlled, Multicenter, Phase 3 Trial (Saturn-2)..
Our guide to prescription dry eye drops compares each one in more detail, using its FDA prescribing information.
Cost. Brand-name dry eye drops can cost several hundred dollars a month without coverage. Insurance, manufacturer savings cards and generic cyclosporine can bring that down a lot, so ask your doctor and pharmacist about both before you fill a prescription.
In-office treatments
Intense pulsed light (IPL)
Good evidence Pulses of filtered light are applied to the skin of the cheeks, below the eyes, while the eyes are covered. The light is thought to warm the glands, calm inflammation and close off tiny abnormal blood vessels that feed it, which are common in rosacea. In 2021 the FDA authorized the first IPL device for improving signs of dry eye caused by meibomian gland dysfunction, used alongside gland expression, after a randomized trial showed better tear stability. In that trial, symptoms improved about as much with a sham treatment5 US FDA, De Novo decision DEN200028, 2021 (opens in a new tab). Intense pulsed light device for managing dry eye (Lumenis Stellar M22), granted February 2021.. A 2025 review of 13 randomized trials found that IPL probably does ease symptoms compared with a sham, but it’s less clear how much it adds on top of standard care6 Peira et al., Acta Ophthalmologica, 2025 (opens in a new tab). Effectiveness and safety of intense pulsed light therapy for dry eye symptoms due to meibomian gland dysfunction: a systematic review and meta-analysis..
Typical course: three or four sessions a few weeks apart, then occasional top-ups. Typical cost: often a few hundred dollars a session. It’s not suitable for all skin tones, so the clinic should assess your skin type first.
Thermal pulsation (LipiFlow, iLux, TearCare)
Good evidence These devices heat the inner eyelids to melt thickened oil while applying gentle pressure to help clear the glands, in a single session of around 10 to 15 minutes. A 2024 Cochrane review of 13 trials of LipiFlow found that it performed about as well as other common treatments, such as warm compresses, but the evidence was low or very low certainty, and none of the trials compared it with a sham treatment7 Pucker et al., Cochrane Database of Systematic Reviews, 2024 (opens in a new tab). LipiFlow for the treatment of dry eye disease.. In one randomized trial, a single LipiFlow treatment worked at least as well as three months of twice-daily lid care8 Finis et al., The Ocular Surface, 2014 (opens in a new tab). Evaluation of an automated thermodynamic treatment (LipiFlow) system for meibomian gland dysfunction: a prospective, randomized, observer-masked trial..
Typical cost: often several hundred dollars or more per eye. How long the benefit lasts varies, so ask the clinic how often it expects you to need a repeat treatment.
Meibomian gland expression
An eye doctor squeezes the glands by hand or with a small paddle, often after heat. It’s cheaper than device treatments and can be done at a regular visit, though it can be uncomfortable.
Punctal plugs
Mixed evidence Tiny silicone or dissolvable plugs placed in the tear drainage openings keep your own tears on the eye longer. After they go in, you can usually go back to your normal activities right away9 American Academy of Ophthalmology, 2026 (opens in a new tab). Punctal Plugs.. Individual trials reported benefits, but a Cochrane review of 18 trials found the evidence inconclusive, partly because the studies were poorly reported and varied so much. Watery eyes are a common side effect10 Ervin et al., Cochrane Database of Systematic Reviews, 2017 (opens in a new tab). Punctal occlusion for dry eye syndrome.. Plugs suit low tear production better than evaporative dry eye. Our guide to punctal plugs for dry eye covers the types, side effects and removal.
Autologous serum drops
Mixed evidence Drops made from your own blood serum, which contains growth factors that help the eye surface heal. Used for severe cases. They may beat artificial tears in the short term, with limited long-term data11 Pan et al., Cochrane Database of Systematic Reviews, 2017 (opens in a new tab). Autologous serum eye drops for dry eye..
Other options
Clinics may also offer lid margin cleaning for blepharitis, low-level light therapy, amniotic membrane bandages for severe surface damage, and scleral contact lenses that hold a reservoir of fluid over the eye. The evidence for these varies, so ask what the clinic expects each one to do for you specifically.
What it costs, and checking your coverage
Prices vary widely by region and clinic. These are rough US figures before insurance.
| Treatment | Typical US cost before insurance |
|---|---|
| Dry eye evaluation | Varies |
| Prescription drops | From low with generics to several hundred dollars a month |
| IPL | Often a few hundred dollars a session |
| Thermal pulsation | Often several hundred dollars or more per eye |
| Punctal plugs | Varies |
What insurance pays varies by plan and by treatment. Before you start, ask the practice for a written estimate that lists each treatment, its billing code and whether it will be billed to your medical insurance or your vision plan. Then ask your insurer what it will pay. If you have a health savings account or flexible spending account, ask your plan administrator whether these treatments qualify.
How to choose a dry eye clinic
Good dry eye care starts with measurement. Be cautious of a clinic that recommends an expensive treatment before it has tested anything. A strong clinic will:
- Test before treating, typically with tear break-up time, tear osmolarity, surface staining and imaging of your oil glands.
- Tell you which layer of your tear film is failing, and why they recommend what they do.
- Offer more than one treatment, so the plan fits you rather than the machine they own.
- Give you a written plan with the number of sessions, timelines and the total cost.
- Measure again at follow-up visits to show whether it’s working.
Questions to ask at your first visit
Which type of dry eye do I have, and how do you know? What will you measure to tell whether treatment is working? What is the total cost of the plan? What happens if it doesn’t help?
Our directory lists practices whose own websites show dry eye care beyond drops, such as IPL and thermal pulsation. Search by ZIP code, starting in Florida.
Common questions
Which is better, IPL or LipiFlow?
They do different things. Thermal pulsation is designed to clear blocked glands in one session. IPL works over several sessions and is thought to also calm inflammation and close off abnormal blood vessels. Many clinics use them together. The right choice depends on what your gland imaging and lid exam show.
Is IPL for dry eye painful?
Most people describe it as a warm snap, like a rubber band flick, on the cheeks. Protective eye shields are used and the treatment takes about 15 minutes.
How long do in-office treatments last?
It varies from person to person, so ask the clinic how long it expects the results of thermal pulsation to last and when you might need a repeat. IPL is usually followed by occasional maintenance sessions. Keeping up with warm compresses and lid hygiene at home helps results last.
Does insurance cover dry eye treatment?
It depends on your plan and on the treatment. Ask the practice for a written estimate that lists each treatment, its billing code and whether it will go to your medical insurance or your vision plan, then ask your insurer what it will pay before you start.
What kind of doctor treats dry eye?
Both optometrists and ophthalmologists treat dry eye. Some run dedicated dry eye clinics with imaging equipment and in-office treatments. For severe cases, a cornea specialist may be involved.
Sources
- Improved Dry Eye Drugs for 2025 and Beyond (opens in a new tab). American Academy of Ophthalmology.
- Miebo (perfluorohexyloctane ophthalmic solution), NDA 216675, approved May 2023 (opens in a new tab). US FDA, Drugs@FDA.
- Acoltremon and the TRPM8 frontier: a new chapter in dry eye disease therapy (opens in a new tab). Acoltremon review, 2025.
- Lotilaner Ophthalmic Solution 0.25% for Demodex Blepharitis: Randomized, Vehicle-Controlled, Multicenter, Phase 3 Trial (Saturn-2) (opens in a new tab). Saturn-2 phase 3 trial, Ophthalmology, 2023.
- Intense pulsed light device for managing dry eye (Lumenis Stellar M22), granted February 2021 (opens in a new tab). US FDA, De Novo decision DEN200028, 2021.
- Effectiveness and safety of intense pulsed light therapy for dry eye symptoms due to meibomian gland dysfunction: a systematic review and meta-analysis (opens in a new tab). Peira et al., Acta Ophthalmologica, 2025.
- LipiFlow for the treatment of dry eye disease (opens in a new tab). Pucker et al., Cochrane Database of Systematic Reviews, 2024.
- Evaluation of an automated thermodynamic treatment (LipiFlow) system for meibomian gland dysfunction: a prospective, randomized, observer-masked trial (opens in a new tab). Finis et al., The Ocular Surface, 2014.
- Punctal Plugs (opens in a new tab). American Academy of Ophthalmology, 2026.
- Punctal occlusion for dry eye syndrome (opens in a new tab). Ervin et al., Cochrane Database of Systematic Reviews, 2017.
- Autologous serum eye drops for dry eye (opens in a new tab). Pan et al., Cochrane Database of Systematic Reviews, 2017.
Costs are rough US figures before insurance. They vary widely by clinic and region, so always ask for a written quote. Symvana guides are for education and don’t replace an eye exam.