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In Depth Look at the D.E.R.M and Tranquileyes Dry Eye Therapy

This is a sponsored post by Eye Eco, a supporter of NewGradOptometry & new graduate optometrists! 😎 

Everyone told me to set myself apart, be unique and provide value that no other optometrist could. They said that was the key to success in private practice optometry.

So I did what they said, and made myself out to be a leader in naturopathic and holistic eye care in San Diego, CA.

In 2013, I began private practice in San Diego, CA bright-eyed and bushy-tailed. It was also the same time that I stumbled upon a podcast called “The Bulletproof Executive,” an amazing resource for holistic and natural healthcare. My lifestyle became “paleo” and I began a personal quest for better health. After seeing too many patients go blind from diabetes, I also decided I wanted to focus my care on full body wellness in relation to eyecare, instead of just eyecare alone.

I had found what would make me unique in practice – a precedence towards treating eye diseases in the most natural way possible. I lectured in the community at least once a month, went around to local businesses to hand out brochures, and emailed every patient after their exam to offer any personal wisdom and advice.

The Tools in My Arsenal

Treating conditions “naturally” isn’t always the standard of care. Personally, I follow the textbook and gold standard way to treat ocular disease, except I put my “natural” spin on things. I would never deprive a patient of a pharmaceutical, surgical, or other treatment option that they need.
  1. Eye Eco Tranquileyes XL
  2. D.E.R.M. Mask
  3. ONYIX / Quartz Shield
  4. Tea Tree Foaming Eyelid and Facial Cleanser
  5. Cliradex Lid Wipes
  6. Eye Eco Moisture Release Eyewear
  7. HRV Monitor from Hearth Math
  8. Hydroeyes Omega-3’s
  9. Vision Therapy Referrals – article coming soon
  10. Meditation guides – article coming soon
  11. Educational guides I have printed up for patients – article coming soon
  12. My list of references on health and nutrition that I e-mail to patients – article coming soon

These are just some of the tools I would use to treat and manage ocular surface disease, binocular vision dysfunction, benign lid mykomia and more.

This article highlights the moist heat and cold therapy products from Eye Eco.

I have found specifically, the Tranquileyes XL mask, to be the single best tool in my arsenal and one that has helped me to build my name as an optometrist who looks at eye health in a natural way. Just last week, Eye Eco released their D.E.R.M. (Dry Eye Relief Mask), and I am extremely hopeful that this product will help to build that reputation even further.

What is Tranquileyes®?

Tranquileyes is a product, created by the company, Eye Eco, based out of Temecula, California. Essentially, Tranquileyes is a patented moist-heat wearable goggle, that helps to alleviate ocular surface disease and therefore, red, dry, sore and tired eyes. Physically, the product is a flexible goggle that combines warm water with an Eye Eco Instant gel pack or Beads pack, which can be heated or cooled.

Advanced XL with Instant and Beads- Blue H

Tranquileyes exists in 4 basic formats, each one serving a different purpose

  1. Tranquileyes Instant XL – (blue pouch)
  2. Tranquileyes Instant – (blue pouch)
  3. Tranquileyes Beads XL – (green pouch)
  4. Tranquileyes Beads – (green pouch)

Below are the differences between all 4, which essentially involves differences in size and heat source.


The product that I stock in my practice is the Tranquileyes Beads XL. First, the size of the XL means an extra 10 minutes of heat, and the “beads” format only requires microwaving the beads to activate heat. With the instant format, it is fast to activate, but you need to boil it in water afterwards in order to get it ready for the next round.

Here is a video of the “Instant” pack warming up.

I do carry a few regular Tranquileyes Beads for the children in my practice who suffer from meibomian gland disease and need a smaller mask. The smaller Tranquileyes is also frequently used for sheltering at night – specifically aqueous deficient dry eye patients and Lagophthalmos.

Key Facts about Tranquileyes

Industry studies, including The International Workshop on Meibomian Gland Dysfunction, have shown applying effective moist-heat to the eyelids is beneficial for all levels of MGD.

The key is having controlled heat (89–108°F, 31.67-42.22°C), duration (up to 20 minutes) and moisture to effectively melt the meibum while hydrating and relaxing the sensitive eyelid skin. – The International Workshop on Meibomian Gland Dysfunction

So that is why Tranquileyes goggles are awesome, because they hit this optimal range and duration.

  • Temperature range: 101–110°F/38.33-43.33°C
  • Duration: last up to 25 minutes

The 4 Basic Functions of Tranquileyes

Tranquileyes essentially focuses on four key elements to deliver a controlled moist-heat therapy.

Humidity is at roughly 80-96%. This stabilizes the tear film and hydrates eyelid skin, promoting circulation and healing while leaving the eyes and skin hydrated.
Temperatures of 101-110°F / 38.33-43.33°C are reached to loosen oils in the meibomian glands.
12-25 minutes of moist-heat which allows for improved patient comfort, regardless of MGD severity.
Maximum coverage for eyes and surrounding tissue. Coverage not only replenishes moisture to your eyes, but also to the skin around your eyes.


  • To activate Tranquileyes Instant, all you need to do is “crack” this little sensor inside the pouch. This begins a chemical reaction resulting in the pouch becoming 101–110°F.
  • To de-activate Tranquileyes Instant, all you need to do is boil some hot water, put the pouch in the water, wait a few minutes and they will return to normal.
  • To activate Tranquileyes Beads, place the beads within 2 cups of water for 45 seconds in the microwave.
  • There is no deactivation for Tranquileyes Beads. They simply return to their normal state when you are finished using them.

Moist Heat vs. Dry Heat

In my research prior to bringing in a warm compress mask to my practice, there were lots of products that used dry heat. Yet, if you look deeper, you will notice that dry heat causes issues that can bother our patients in subtle ways, specifically the skin around the eyes. If you are going to fix something, it is not a good idea to cause a new problem!

I have used warm and dry heat masks, and my personal preference is moist heat. Moist heat feels better both during and after the therapy, and the extra humidity helps to deliver sustainable heat. With humidity being a good thing for dry eye, it makes sense to leave the eyes in a more humid, rather than dry environment. The humidity is critical as it helps stabilize the tear film, accelerates heat transfer, promotes circulation and healing, and hydrates the surrounding eyelid skin.

- Loosens the oils in Meibomian Glands

- Penetrates deeply, hydrating the eyelid and surrounding skin

- Increases relative humidity to help stabilize tear film

- Promotes circulation

- Slows tear evaporation
- Pulls moisture away from the eyelid and sensitive surrounding skin

- Decreases relative humidity

- Increases instability of tear film

- Counter to anti-aging objectives for most women

Case Study of Tranquileyes

Below is a case study using the Oculus® Keratograph5M, which shows how effective a 20 minute Tranquileyes™ moist-heat treatment can be in improving tear film breakup time.

  • 35 year old female
  • working 8–10 hours in front of a computer screen in an air-conditioned office
  • complaining about dry eye discomfort
  • was examined with the OCULUS® Keratograph5M before and after using the Tranquileyes™ XL moist-heat for 20 minutes

Here are the NIKBUT results for the right eye:

before and after tranquileyes

Case Study Data Analysis

Tearfilm Breakup (first)4.01
Tearfilm Breakup (average)7.48
Total Time of NIKBUT Exam - (Patient could keep her eyes open without blinking)10.77

Tranquileyes Performance Studies

The charts below indicate the temperature retention and the percentage of relative humidity retention of the Tranquileyes system. These tests were performed by Eyeeco using a hygrometer to measure the temperature and relative humidity.

Key: For graph interpretation

tranquileyes legend

Comparing Tranquileyes Beads and Beads XL

Notice that the temperature stays in the optimal range for the optimal duration, with the XL mask lasting longer. Notice that the humidity is stable and in an optimal range to promote dry eye improvement.

tranquileyes beads tranquileyes beads XL

Comparing Tranquileyes Instant and Instant XL

Notice that the temperature stays in the optimal range for the optimal duration, with the XL mask lasting longer.

tranquileyes instant tranquileyes instant XL

Comparing an OTC Competitor (Flaxseed Mask and Moisture Beads)

Notice the inability for the Flaxseed mask to reach optimal temperature and that humidity is insufficient. Notice that the OTC moisture beads become dangerously hot.

flaxseed mask moisture beads

Here is a summary table that goes over the specifics of each of their products.

Aqueous Deficient Dry Eye10-15 minutes Moist-Heat
Daily/Daytime Shelter
Release Eyewear
Evaporative Dry Eye (MGD)10-20 minutes Moist-Heat DailyTranquileyes™ XL
Blepharitis10-15 minutes Moist-Heat DailyTranquileyes™ XL
Styes / Chalazion10-12 minutes Moist-Heat
up to 4 Times Daily
Stye Kit

Cold Therapy Use

Lots of my patients with dry eyes also have allergies. I tend to see the two disease states go hand-in-hand. For my patients with moderate to severe dry eye, but also with moderate allergies, I instruct them to use the cold compress mask when allergies flare up.

All they need to do is moisten the pocketed beads or instant gel packs (in their liquid state) and place them into the freezer for 30 minutes. After chilling, place them into the back of the goggle for a 15 minute cold therapy.

The cold compress decreases inflammation quickly and naturally. Patients with allergies tend to rub their eyes excessively, making the condition worse, but the cold compress mask prevents the patient from rubbing their eyes. This is also great for lid and under eye puffiness which is often directly related to eye dryness.

Information About The D.E.R.M.™

This mask just came out in March 2015, and I plan on using the D.E.R.M. mask in my practice as an “entry-level” option, and then prescribing Tranquileyes Beads XL once the patient warms up to the idea of compresses.

The contents of the beads within are made from Silica, which is an inert substance and therefore isn’t harmful to your eyes. The silica beads absorb moisture from the air and release it when heated in the microwave.

D.E.R.M. can be used as a moist-heat or cold therapy just like the Tranquileyes mask. You can place the mask directly into the microwave for 20 seconds, or enhance the performance by placing a liner moistened with water over the mask before heating. By placing the liner between the eyes and the mask, patients will get the moisture that will help to treat the disease and feelings of fatigue. The moisture also has a soothing effect that helps with tired eyes resulting from dry eye. The liner costs the patient less than 5 cents and also helps keep the mask clean.


I will be using the D.E.R.M. as an entry level mask for my patients with dry eye because it is less expensive, and therefore easier to get the “patient on board” with your treatment. The caveat is that 20 seconds in the microwave only gets you around 5-9 min of moist-heat versus the 20 min you get with the Tranquileyes XL.

Yet still, this mask offers a Relative Humidity of 94%–90% and Heat Temperature of 84–104°F / 28.9–40.0°C, which is phenomenal compared to others out there.

Here are some comparisons of the D.E.R.M to other masks…

  • warm washcloths – do not get hot enough
  • flaxseed masks – no moisture and can cause other problems
  • other types of warm compress – can get dangerously hot / significant drop in moisture

D.E.R.M. dry eye mask

Why I Didn’t Choose Other Competitors

Well first, I want to say why I have personally used Eye Eco for the last 2+ years.

  • Their warranty is unbeatable. If the patient doesn’t like it, Eye Eco just ships you a new one to replace your inventory, no questions asked.
  • I use the product myself and so does my family. Everyone really respects the quality.
  • We live in a generation of “identity” and people care about how they look… Tranquileyes comes in black, blue, sage, pearl, lavender, bronze, platinum, hot pink, soft pink.
  • It’s VERY moist and feels better than other masks I have tried.
  • The liner on the D.E.R.M. mask helps keep it clean and so it lasts longer… Not the case with other masks.
  • They look great when stocked on the shelves in the practice.
  • Suzanne and the Eye Eco team actually care about optometry and aren’t in it all for the money. That passion and drive is lost in healthcare and I want to support someone who really cares about the profession.
  • The profit margins are better than any other product I explored (Eye Eco tells us that the avg practice profit is $15k per year).
  • Tranquileyes are made locally in Temecula, California.

How I Use Tranquileyes In My Practice

I prescribe Tranquileyes or D.E.R.M. when I see these disease states:

  • Internal Hordeolum
  • External Hordeolum
  • Chalazion
  • Blepharitis
  • Aqueous Deficient Dry Eye
  • Evaporative Dry Eye
  • Meibomian Gland Dysfunction
  • Demodex
  • Rosacea related dry eye

My script is pretty simple when it comes time to prescribe it.

After taking a good look at your eyes, I am certain that the reason for your symptoms is an underlying disease called Dry Eye. (I then go on to explain the disease pathophysiology). It is important that we begin by treating the underlying cause of your symptoms in a natural way. I personally do not want to jump right into “heavy medications” or “expensive therapies” until we try something very simple, natural, and cost effective.

Dr. Matt Geller
Dr. Matt Geller

If your dry eye ever gets bad enough, we can go down that road, but right now, the Tranquileyes XL or D.E.R.M. dry eye mask is your best option. (I then show them a sample). Just microwave these beads in water for 45 seconds, relax with the mask on once per evening for 20 minutes, and see me back in 1 month. If we find that this therapy isn’t working, the company offers a complete warranty and we will get you your money back.

How to Bring Tranquileyes Into Your Practice

There is no doubt in my mind that you have plenty of dry eye patients, and the majority of us just tell them to “use a warm washcloth.” I am not sure about your patients, but my patients NEVER use washcloths… They simply don’t take me seriously. They return the next year with the same symptoms and problems.

On the contrary, if we get our patients to invest a couple of bucks into a Tranquileyes or D.E.R.M. mask, they will be compelled to use it and therefore treat their MGD and dry eye.

tranquileyes colors mask

Here is how to get Tranquileyes, D.E.R.M. and other Eye Eco products in your practice.

  • Step 1: Fill out the form below with your information -or- call Eye Eco at 1-888-730-7999
  • Step 2: Tell them you read the article we posted and you were curious about placing an order.
  • Step 3: They will send you a form to fill out that specifies your order details.
  • Step 4: There is a minimum order of 12 masks. This minimum is reduced to 6 for our readers! They will ship them along with great marketing materials.

I want to quickly mention that their team is awesome. I have worked with them for almost 2+ years now and can say that they are the easiest ophthalmic product company to work with. That is worth the world to me…

Here are PDF catalogues so you can read more about their products.

CovalentCareers 600×120 Seekers New Product

About Matt Geller

Matthew Geller
Dr. Matt Geller is a technology entrepreneur with a track record of developing successful online platforms to solve problems in the healthcare space. Matt is an optometrist in San Diego and is the founder of OptometryStudents.com, NewGradOptometry.com and the co-founder of CovalentCareers.com!


  1. It’s encouraging to see increasing acceptance of holistic approaches in Optometry. Medicine, too is opening up to holism with last years approval of Integrative Medicine as the newest official medical specialty. Although, on reflection, it is a bit oxymoronic that holism should be accepted as a ‘specialty’, still progress is good… Please reply or PM me if there is something you would like to see me work on… Right now I am working up a launch for a new remote biocommunication technology about to be released out of Europe that will allow your patients to access benefits of preventive telemedicine through their home internet connection. These are truly exciting times to be in the healing field.

    • Matthew Geller

      Hey Dr. Glen,

      The area of holistic care is certainly an untapped one. If you would like to write a guest article on the topic, just let me know! Thanks for the support and kind words! Best of luck with the new biocommunication technology.

  2. I am guessing I already know the answer to my question, however, I will ask anyway. Are you having any luck with Medicare/other health insurances covering part or any of the cost of these products for your patients? If so under what code? Thanks!

    • Matthew Geller

      Hey Ari,

      I have never tried to have any insurance company cover these types of products. Here is my logic behind it… Say like I bill for tear film insufficiency, 375.15, and I bill a 92102 CPT code for a basic exam work up, that is pretty much the extent of things that I can bill for a basic dry eye visit. Basically, companies who have a product that they feel should be covered by insurance can submit for approval for a CPT code through CMS. For example, Prokera just got coverage to bill for their specialty contact lens under a specific CPT code, and congrats to them on that hard work. Yet there is no way CMS just hands out CPT codes or that insurance companies make exceptions. Imagine they reimbursed every doctor for Omega-3’s? They would probably go bankrupt! So I believe the answer it no, they will not reimburse for their “consumer” products.

      That brings us to the other side of the conversation. I find it easier sometimes to get patients to pay for a Tranquileyes mask and Omega-3’s then to take a free bottle of artificial tears. Once you identify the right patient and take the time to explain this stuff to them, they are instantly on board. I take a good 5-6 min to explain my holistic way of treating dry eye and my patients REALLY appreciate it. These patients are in need and NO ONE else takes the time to explain things to them. They will happily purchase the product once you tell them you will help to improve their pain and redness.

      Let me know if you have other questions, but in summary – insurance companies probably will not reimburse, but it is extremely easy to get cash paying patients on these products.

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