Optimel - Australia's new dry eye treatment.

[hankm9]

Here is the link: http://www.melcare.com/optimel.html

[hankm9]

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[Spoon]

best of luck. Is there any other active ingredient?? if not, since it's 98% manuka honey by weight (980mg/g) one might as well buy a high quality jar of 'Leptospermum' manuka honey if this stuff is expensive or hard to find

[neilw]

hankm9

Can you let us know the contact details of the pharmacist?

Thanks
Neil

[hankm9]

Order online from here:

http://jubelee.webs.com

Or if you want Australian Stocklist here is the link:

http://bit.ly/11IkpJc

[DCRdryeye]

best of luck. Is there any other active ingredient?? if not, since it's 98% manuka honey by weight (980mg/g) one might as well buy a high quality jar of 'Leptospermum' manuka honey if this stuff is expensive or hard to find

Yes, sounds logical. But no-one wants to risk their eyes unless it's been specially tested and formulated safe to use on the eyes. Have you heard about the benefits of Manuka honey? For one thing, it's a rather thick which means it won't evaporate too quickly and rather than just lubricating the eye it's "treating" it via it's anti-bacterial and anti-inflammatory actions. Nature comes to the rescue - got to love it !!!

[neilw]

I spoke by phone to the CEO of the company (Anthony Maloney) and he told me that Optimel has been approved by the TGA (Australia's version of the FDA) and has undergone clinical studies. Optimel is not exclusively for dry eye use. I believe it is to be used where there is a bacterial issue with the eye, but don't quote me.

It seems some honeys have very powerful anti-bacterial properties. The use of certain honeys in fighting antibiotic resistant infections in hospitals is being studied with some success.

Anthony Maloney told that his company had been working with a team of ophthalmologists for the past 10 years in the development of these drops. He also sent me links to a couple of clinical studies, only the first of which is to do with dry eye.


• http://www.ncbi.nlm.nih.gov/pubmed/17133045 Effect of antibacterial honey on the ocular flora in tear deficiency and meibomian gland disease.
• http://www.ncbi.nlm.nih.gov/pubmed/22508360 Honey prophylaxis reduces the risk of endophthalmitis during perioperative period of eye surgery.

[hankm9]

Title: Antibacterial medical honey: sweet success in ocular surface disease management.
Dr Julie Albietz BAppSc(Hons) PhD GradCertOcTher
Dr Lee Lenton MBBS FRANZCO FRACS
Introduction
Dry eye, tear film and ocular surface conditions are prevalent and often poorly responsive to conventional treatments. They can be recalcitrant and a potentially vision threatening concern to patients and eyecare practitioners.1
Given this unmet need, the release of a novel certified ophthalmic product for dry eye and ocular surface disease is a welcomed. Optimel Antibacterial Manuka Eye Drops (Melcare Biomedical Pty Ltd) is a low cost, over-the-counter, sterile, non-preserved, non-cytotoxic, multidose, high efficacy antibacterial honey product.

Optimel is prepared for medical use to a rigorous set of systems and standards from a unique proprietary mix of honeys from the Australian and New Zealand Leptospermum species (commonly known as Manuka, Tea Tree or Jelly Bush), selected for their highest and most consistent level of antibacterial activity, including against antibiotic resistant strains, and other exceptional physicochemical properties.2-6 Optimel has a three month shelf life after opening and is an excellent adjunctive treatment for chronic dry eye, meibomitis and recurrent corneal erosion.

This brief review aims to give clinicians a background in the ophthalmic applications of medical grade antibacterial honeys, their unique properties and our decade of clinical experience with this unique and impressive natural product.

For thousands of years, the amazing wound healing and antimicrobial properties of raw honey have been documented. Natural unprocessed honeys from various floral sources and geographical locations have been used since ancient times to effectively treat a range of ailments including skin wounds, sore throats, gastrointestinal disorders and external eye infections.7,8 Aristotle (350 B.C.) wrote of honey being salve for wounds and sore eyes.9 Celsus1 in the first century A.D. applied a dressing of honey-soaked linen to prevent symblepharon.10 The ancient Maya civilisations used honey in the treatment of cataracts.11 Honey continues to be used in traditional management of ocular surface infections and inflammation in parts of Africia,13 the Middle East,13 and Pakastin,14 and in Indian Ayurvedic medicine.15

In more recent times use of honey in Russian,16,17 Egyptian18 and Lebanese19 ophthalmology for the management blepharitis, conjunctivitis and infectious and non-infectious keratitis and bullous keratopathy has been reviewed.

Honey is a supersaturated solution of sugars with an acidic pH, high osmolarity and low water content. These characteristics inhibit the growth of microorganisms.20 Additional antimicrobial activity is generated on dilution by the activation of bee-derived glucose oxidase to produce hydrogen peroxide.20 In addition to the presence of these well-characterized major antibacterial factors in honey, methylglyoxal 21,22 and cationic antimicrobial peptide bee defensin-123 also act as antibacterial substances. However, the concentration of these two distinct factors varies depending on the floral source and geographical origin of the honey. Moreover, honey contains a wide range of phytochemicals including the polyphenols (e.g. flavonoids and phenolic acids). Manuka honey has significantly higher levels of antibacterial activity against S. aureus and higher levels of polyphenols and antioxidant activity than other honeys and is effective against antibiotic resistant bacterial pathogens including MRSA, VRE and Pseudomonas aeruginosa. 2-6 Synergistic effects of Manuka honey with antibiotics improves its in vitro activity against antibiotic resistant bacterial strains.24,25 Manuka honey also demonstrates in vitro anti-viral activity.26
Leptospermum sp. honeys are light- and heat-stable and have a long shelf life. Activity is not influenced by the final sterilizing procedure of gamma-irradiation.
Antibacterial honey is not an antibiotic as it does not have ‘a fast onset of activity’ defined as a reduction of bacteria (more than five log steps) and fungi in 1–10 min.

Recent animal models of ocular surface injury, inflammation and infection treated with honey have produced encouraging results. In animal models of S. aureus and P. aeruginosa bacterial conjunctivitis, honey reduces redness, swelling and the time taken to eradicate bacterial pathogens and is as effective as topical antibiotics.27,28 In a rabbit model of P.aeruginosa induced microbial keratitis, there were no significant differences in clinical signs between honey treated and ciprofloxacin treated eyes.29 In a model of corneal abrasion and endotoxin-induced P.aeruginosa keratitis, the anti-angiogenic and anti-inflammatory properties of honey were demonstrated.30 The anti-inflammatory and antioxidant effects of pure raw Malaysia Tualang honey in an alkali induced corneal burn model were clinically and histopathologically equivalent to conventional therapy.31

Our decade of clinical experience with medical grade Australian and NZ Leptospermum sp. antibacterial honeys involves the treatment of many hundreds of patients for the following external eye conditions: bacterial conjunctivitis, anterior blepharitis, angular blepharoconjunctivitis, indolent herpetic keratitis, recurrent corneal erosion, post-viral dry eye, post- lasik dry eye, aqueous tear deficiency, meibomian gland dysfunction , Thygeson’s superficial punctuate keratitis, superior limbic keratoconjunctivitis, glaucoma medicamentosa, and post-operative corneal odema. Improvements in symptoms and clinical signs were noted in the majority of cases and will be detailed in future publications. We have not experienced any adverse events from the use of antibacterial honey, although some temporary stinging, redness and epiphora occurs due to its low pH which is minimised by eye closure.

We have published some of the results of a prospective open –label clinical study that assessed the effect of pure medical grade antibacterial honey on the ocular flora in patients with dry eye caused by aqueous tear deficiency and/or meibomian gland disease and poorly controlled by conventional treatrments.31 Bacteria isolated from the eyelid margin and conjunctiva fornix were identified and quantified before after initiation of treatment with topical application of antibacterial MedihoneyTM honey thrice daily. Use of antibacterial honey significantly reduced total bacterial colony forming units for the eyelids and the conjunctiva of dry eye subjects from baseline at month 1 and 3. At month 3, the total CFUs for all dry eye subgroups were not significantly different from those of the non-dry eye group.
Our clinical findings are supported by two recent clinical trials. A 25% honey solution eradicated the bacterial flora in the conjunctival sac after one week in the perioperative period in patients scheduled for cataract surgery or vitrectomy. The capacity of honey solution to eradicate ocular pathogens was not significantly different to that of 0.3% topical ofloxacin. 33 A 20% honey solution applied topically tid for 3 weeks effective than artificial tears in controlling dry eye symptoms and signs including corneal erosions.34
Conclusions

The recent addition to the dry eye and ocular surface disease product range of a certified high efficacy ophthalmic antibacterial honey offers opportunities to both patients and eyecare practitioners. Many in vitro studies and animal studies confirm the antibacterial properties and the positive effects on ocular surface wound healing in a range of acute and chronic ocular surface conditions of medical grade Australian and NZ honeys. Use of any medical device must be based on clinical justification
and available evidence about product safety and effectiveness. Currently there is insufficient evidence to guide clinical practice and further research is needed to clarify the role of antibacterial honey as a primary or adjunctive treatment for acute and chronic dry eye and ocular surface diseases.
We look forward to advances made by others in understanding the mechanisms of action of antibacterial honeys and continuing our own clinical research with this unique local product and in sharing its impressive effects with others eyecare practitioners.
Financial disclosure: Clinical research has been partially supported by Medihoney Pty Ltd and Melcare Pty Ltd.

[hankm9]

References

1. Sullivan DA, Hammitt KM, Schaumberg DA et.al. Report of the TFOS/ARVO Symposium on global treatments for dry eye disease: an unmet need. Ocul Surf. 2012;10(2):108-16.
2. Irish J, Blair S, Carter D. The antibacterial activity of honey derived from Australian flora. PLoS One. 2011;6(3):e18229.
3. Blair SE, Cokcetin NN, Harry EJ, Carter DA. The unusual antibacterial activity of medical-grade Leptospermum honey: antibacterial spectrum, resistance and transcriptome analysis. Eur J Clin Microbiol Infect Dis 2009; 28:1199–1208.
4. George NM, Cutting KF. Antibacterial honey (Medihoney™): in vitro activity against clinical isolates of MRSA, VRE and other multiresistant gram-negative organisms including Pseudomonas aeruginosa. 2007; Wounds 19: 231–236.
5. Schneider M, Coyle S, Warnock M et al. Anti-Microbial Activity and Composition of Manuka and Portobello Honey. Phytother Res. 2012 Sep 18. doi: 10.1002/ptr.4844. [Epub ahead of print].
6. Alzahrani HA, Alsabehi R, Boukraâ L et al. Antibacterial and antioxidant potency of floral honeys from different botanical and geographical origins. Molecules. 2012 Sep 4;17(9):10540-9. doi: 10.3390/molecules170910540.
7. Forrest RD Early history of wound treatment Journal of the Royal Society of Medicine 1982;75:198-205.
8. Zumla, A; Lulat, A. Honey a remedy rediscovered. Journal of the Royal Society of Medicine 1989;82: 384-385.
9. Aristotle (350 BC) Volume IV. Historic; animallum. In Smith, J A; Ross, W D (eds) works of Aristotle. Oxford University; Oxford, UK (translated by D'A W Thompson, 1910).
10. Arrington, G. E. A History of Ophthalmology, MD Publications. New York, 1959.
11. Jones, R. Honey and healing through the ages, In Munn, P; Jones, R (eds) Honey and healing, IBRA International Bee Research Association; Cardiff, Great Britain; 2001:1-4.
12. Meda, A. Lamien CE, Milogo J. et al Therapeutic uses of honey and honeybee larvae in central Burkina Faso. Journal of Ethnopharmacology. 2004; 95 (1): 103–107.
13. Shenoy R, Bialasiewicz A, Khandekar R et al. Traditional Medicine in Oman: Its Role in Ophthalmology. Middle East Afr J Ophthalmol. 2009; 16(2): 92–96.
14. Iqbal A., Orakzai O.K. and Ayaz M. Home remedies and traditional eye medicines used for the treatment of common eye ailments in District Swabi. Journal of Postgraduate Medical Institute 2012 26:432-438.
15. Bhardwaj A, Tanwar M. Effect of Rasanjana Madhu Ashchyotana in Netra Abhishyanda (Mucopurulent Conjunctivitis). Ayu. 2011; 32(3): 365–369.
16. Mozherenkov VP, Miniaeva TG. The use of products from bee raising in ophthalmology and otorhinolaryngology (Russian). Med Sestra. 1991;50: 47–51.
17. Popescu MP, Palos E, Popescu F. Efficacy of combined biological therapy with bee products in localized palpebral and conjunctival eye lesions with reference to the clinico-functional changes. (Russian). Rev Oftalmol. 1985;29:53–61.
18. Emarah, MH. A clinical study of the topical use of bee honey in the treatment of some ocular diseases. Bulletin of Islamic Medicine 2001: 2 (5): 422-425.
19. Mansour AM (2002): Epithelial corneal oedema treated with honey. Clin Experiment Ophthalmol 30: 149-150.
20. Cooper RA, Molan PC, Harding KG. The sensitivity to honey of gram-positive cocci of clinical significance isolated from wounds.J Appl Microbiol 2002;93:857–63.
21. Adams CJ, Boult CH, Deadman BJ, et al. 2008. Isolation by HPLC and characterisation of the bioactive fraction of New Zealand manuka (Leptospermum scoparium) honey. Carbohydr Res 343: 651–659.
22. Mavric E, Wittmann S, Barth G, Henle T. 2008. Identification and quantification of methylglyoxal as the dominant antibacterial constituent of Manuka (Leptospermum scoparium) honeys from New Zealand. Mol Nutr Food Res 52: 483–489.
23. Kwakman PH, Zaat SA. Antibacterial components of honey. IUBMB Life. 2012;64(1):48-55.
24. Jenkins R, Cooper R.Improving antibiotic activity against wound pathogens with manuka honey in vitro.PLoS One. 2012;7(9):e45600. doi: 10.1371/journal.pone.0045600. Epub 2012 Sep 26.
25. Müller P, Alber DG, Turnbull L,et al.Synergism between Medihoney and Rifampicin against Methicillin-Resistant Staphylococcus aureus (MRSA). PLoS One. 2013;8(2):e57679. doi: 10.1371/journal.pone.0057679. Epub 2013 Feb 28.
26. Shahzad A and Cohrs RJ. In vitro antiviral activity of honey against varicella zoster virus (VZV): A translational medicine study for potential remedy for shingles. Transl Biomed. 2012; 3(2): 2. doi: 10.3823/434
27. Al-Waili NS. Investigating the antimicrobial activity of natural honey and its effects on the pathogenic bacterial infections of surgical wounds and conjunctiva. 2004; J Med Food 7: 210–222.
28. Ilechie AA, Kwapong PK, Mate-Kole E et al. The efficacy of stingless bee honey for the treatment of bacteria-induced conjunctivitis in guinea pigs. Journal of Experimental Pharmacology 2012:4 63–68
29. Nejabat, M., Astaneh, A., Eghtedari, M. et al. Effect of honey in Pseudomonas aeruginosa induced stromal keratitis in rabbits. J. Appl. Anim. Res. 2009; 35: 101–104.
30. Uwaydat, S; Jha P; Tytarenko, R et al. The Use of Topical Honey in the Treatment of Corneal Abrasions and Endotoxin-Induced Keratitis in an Animal Model. Current eye research 2011;36 (9): 787-796.
31. Bashkaran K, Zunaina E, Bakiah S. et al. Anti-inflammatory and antioxidant effects of Tualang honey in alkali injury on the eyes of rabbits: experimental animal study. BMC Complement Altern Med. 2011; Oct 9;11:90.
32. Albietz JM, Lenton LM. Cornea. Effect of antibacterial honey on the ocular flora in tear deficiency and meibomian gland disease.2006;25(9):1012-9.
33. Cernak M, Majtanova N, Cernak A, Majtan J. Honey prophylaxis reduces the risk of endophthalmitis during perioperative period of eye surgery. Phytother Res. 2012;26(4):613-6.
34. Jankauskiene J, Jarushaitiene D, Cheksteryte V, Rachys J. 2007.Using 20% honey solution eye drops in patients with dry eye syndrome. J Apic Res 2007;46: 232–235.

[MlleCoconut]

Hello hankm9,
Do you have any update for us

[patrick]

Hi all,


This sure does sound promising!
I did some research on the internet and of course read all the pubmed articles. To me it seems that all the properties the manufacturer claims this makula honey based eyedrop has is indeed evidence based.

Especially with mgd it is very important to try to avoid bacterial colonisation in the eyelids and for that the chronic use of an anti bacterial or anti biotic is recommended. Since this eye drop is all natural i think one can use it indefinitely in contrary to anti biotics and such.

To my surprise it is already available here in the netherlands! Although it is not very cheap.
I really want to give these drops a try and today i'm gonna order it.
I think initially i want to do a six weeks trial to see what it does. I'll report my findings here on the boards of course.

Btw. I found an older post here on the dry eye zone (2010) of someone who reported having great success with makula honey as an ointment.

Patrick..

[jstrmereel]

I'm interested in this too. Please keep us updated.

I feel like treating my dry eye has come down to trying random things to see what sticks!

[patrick]

What a bummer.
It is available in the netherlands,but i tried to order it and i received an e-mail the next day in which the distributor tells me that this is not an otc eye drop at the moment. I need a doctors prescription. Which always is such a hassle here.
However,this eye drop will become otc by early 2014 the distributor says.
Well,i don't feel like waiting that long so i guess i have to pursue this prescription.

Patrick..

[hankm9]

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[why]

I think this great there are new options such as these coming through.

Ive also read other threads about honey drops or smearing honey on the lid margins...

I tried a little manuka honey on one eye (left lid margins) that is particularly troubling...wasnt expecting much..but it stopped the itching burning.. it seemed to me that the (left) eye was feeling better than the right ..(after application)...and was holding the tear for longer (less evaporation occurring ?)

If I wear goggles..normally the left goggle mists up and the right does not (evaporation?)....but when the honey is applied the misting does not occur.

I have ATD and MGD ...

Perhaps it helps in multiple ways...

Its viscous...perhaps acts like the oil that is lacking with MGD..helping to keep on the eye the aqueaous tear.

It stings...perhaps stimulating the lacrimal gland (at least after initial contact)

And other stuff we dont really understand.???

Youtube vid - how to apply Optimel