How do I get Ikervis in the UK?

[quattroboy]

I am 6 m post lasik.

Is there any evidence that Prokera can help Lasik dry eye?
I searched the forum and just found one person who benefited from prokera. He was post lasik but mostly AD.

My problem is nerve damage so growth factors is what I need, which includes serum drops (AST, PRP, PRGf), AMT (Prokera ideally for me) or Oxervate (brand new just licensed).

What is the route cause of your dry eye apart form LASIK MGD, AD?

[MGD1701]

Nerve damage
How to detect this and what are symptoms/causes? Thanks.

[quattroboy]

Nerve damage
How to detect this and what are symptoms/causes? Thanks.

Well poking the eye with the sharp corner of a rolled up tissue and watching your reaction. Mr. Walker could poke my right eye all day long!

Going for a confocal microscopy on the 18th, for a second opinion.

[ebi1368]

My problem is nerve damage so growth factors is what I need, which includes serum drops (AST, PRP, PRGf), AMT (Prokera ideally for me) or Oxervate (brand new just licensed).

What is the route cause of your dry eye apart form LASIK MGD, AD?

I am sure nerve damage is one factor for me. I also have Rosacea which all started after lasik.

Why AMT is better for you? I do not have access to confocal here in Canada. Otherwise I would get it.

[quattroboy]

I am sure nerve damage is one factor for me. I also have Rosacea which all started after LASIK.

Why AMT is better for you? I do not have access to confocal here in Canada. Otherwise, I would get it.

I also have mild MGD.

Growth factors are the treatment for nerve damage.

Serum drops would also help but very hard to get in the UK and expensive (£500 per month).

Oxervate was Mr. Walker suggestion but it's cutting-edge, just licensed in both Europe and US. NHS have withdrawn access to it because of it's cost (£15k I've read for 8 weeks).

That leaves AMT (prokera) which is more readily available in the UK from Scope at around £1500 per eye. Still searching for someone locally who will give it ago. So far only found suggestions are in London.

[Meibum Ian]

I also have mild MGD.

Growth factors are the treatment for nerve damage.

Serum drops would also help but very hard to get in the UK and expensive (£500 per month).

Oxervate was Mr. Walker suggestion but it's cutting-edge, just licensed in both Europe and US. NHS have withdrawn access to it because of it's cost (£15k I've read for 8 weeks).

That leaves AMT (prokera) which is more readily available in the UK from Scope at around £1500 per eye. Still searching for someone locally who will give it ago. So far only found suggestions are in London.

Have you seriously considered PRP drops from vissum in Alicante? Far cheaper than NHS, and likely superior. The PRP is more concentrated in growth factors and undiluted by saline

[Meibum Ian]

Finally managed it..

Been on an Ikervis private prescription since June, and been trying to get it on the NHS since. Lots of problems getting GP and private consultant to agree / understand each other's perspective etc.

Had a followup NHS appointment at the eye hospital today, with all the usual pointlessness that entails (no tests except to look at staining. Said I couldn't have aqueous deficiency because I'm young and male etc).

I asked for an Ikervis prescription, and was told that it was something they'd only prescribe as a last resort (FFS). Strongly argued my case and he did then agree to write one. Probably just to get rid of me.

Result!

[Alix]

@Meibum Ian Well done! That is exactly what I did when I got my punctal plugs inserted! (Unfortunately they didn't work for me, but anyway.....).
How long did it take for you to see improvement from using Ikervis?

[Meibum Ian]

About 3 months in maybe, but I also started fingerprick blood drops and then PRP drops..

[MGD1701]

Finally managed it..
Had a followup NHS appointment at the eye hospital today, with all the usual pointlessness that entails (no tests except to look at staining. Said I couldn't have aqueous deficiency because I'm young and male etc).

I asked for an Ikervis prescription, and was told that it was something they'd only prescribe as a last resort (FFS). Strongly argued my case and he did then agree to write one. Probably just to get rid of me.

Great that you got it - it is really sad that we have to flight for it in such way.
Doctors statement only shows they know nothing about dry eye - can we trust them?

[MGD1701]

I asked for an Ikervis prescription, and was told that it was something they'd only prescribe as a last resort (FFS).

It is such a joke that Ikervis as a last resort.
Why most people have to visit many doctors and still suffer? This is the main reason. Doctors do not intervene early enough.

I watched a lecture recently, some opinion leaders in USA discussing some cases.
One case: patient with very red eyes (rosacea), no pain. Osmolarity were 325 or so etc.
These doctors ALL said we need to catch/treat this patient earlier, with Restasis, xiidra etc.

[quattroboy]

Ikervis is a minimum three months taking six to be fully effective. Even 9 months.

I think it's helping me now. Three months in.

Ikervis only actually helps a small number of people, I've read around 15% of AD based dry eye.

Again NHS view of dry eye is tragic. Just leave people to suffer.

[ebi1368]

Well poking the eye with the sharp corner of a rolled up tissue and watching your reaction. Mr. Walker could poke my right eye all day long!

Going for a confocal microscopy on the 18th, for a second opinion.

I had an appointment with my doctor today. She used this device with long string to poke my eyes. I could easily feel the string. She said I don’t have nerve sensation problem.

What device mr walker used?

[quattroboy]

I had an appointment with my doctor today. She used this device with long string to poke my eyes. I could easily feel the string. She said I don’t have nerve sensation problem.

What device mr walker used?

No fancy devices just the corner of the tissue.

I've seen the string approach on youtube.

[epicjinx]

@quattroboy I am sorry to hear your story....I don't know for sure what is the cause of my dry eyes. The opticians I saw at the beginning told me I had MGD, but the hot compresses was told to do do did not have any effect so I am not sure this is correct. The general consensus amongst the doctors I have seen at Moorfields is that I have evaporative dry eye due to poor quality of tears which is causing an unstable tear film. I had puncal plugs put in but my eyes because very itchy, a new sensation. Blepharatis has been ruled out. I am at my wits end.

You mention very itchy eyes? I would check for allergies could be possible. They check your eye lids on the inside to see about this. I hope this helps!