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Cash-pay dry eye marketing often outpaces available evidence

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Key Takeaways

  1. 41% of procedure pages made unqualified efficacy claims, while only 9% disclosed risks and 4% cited peer-reviewed evidence.
  2. Evidence discordance was highest for ZEST (50%), radiofrequency (46%), and BlephEx (37%), compared with less than 2% for intense pulsed light and LipiFlow.

Marketing claims for cash-pay dry eye procedures on U.S. practice websites often outpace the available evidence, according to data from a cross-sectional analysis presented at AAO 2026.

Researchers reviewed websites from 386 practices across 25 U.S. metropolitan areas offering intense pulsed light (IPL), LipiFlow, radiofrequency (RF), BlephEx, ZEST, and iLux. Overall, 41% of pages made unqualified efficacy claims, while only 9% disclosed risks and 4% cited peer-reviewed evidence.

The degree of discordance with published evidence varied significantly by procedure. Discordance was reported on 50% of ZEST pages, 46% of RF pages, and 37% of BlephEx pages, compared with <2% of IPL and LipiFlow pages. Compared with IPL, the adjusted odds of discordance were 83 times higher for ZEST, 58 times higher for RF, and 51 times higher for BlephEx (all P < 0.001).

FDA status was misrepresented on 10% of pages, while med spas had 10 times higher odds of red flags than optometry practices (P = 0.017). Only 4.9% of pages displayed procedure pricing. The findings point to a need for guidelines addressing the marketing and disclosure of cash-pay dry eye procedures.

Reference

Bair H. Online marketing claims vs published evidence for cash-pay dry eye procedures across 386 US practices. Presented at: American Academy of Ophthalmology 2026 Annual Meeting; October 9-12, 2026; New Orleans, LA.

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