LASIK Nerve damage and human NGF

[quattroboy]

Many of you know my background already, so I won't repeat myself here in detail.

I'm now 12 months post LASIK with dry eyes. The LASIK was carried out on top of existing dry eyes, unfortunately, I wasn't aware because I was symptom-free.

I've been trying to get better ever since. Like all of you, the impact on my life has been massive and taken a real toll on my mental health.

Up to now, I've tried:

1. Plugs - really helped, used to have all four but down to one in each eye now.
2. Ikervis - again I feel this has helped, I'm now nearly 6 months.
3. Gland probing, again this cleared man blocked glands.
4. Followed a strict Demodex lid hygiene routine for my blepharitis.
5. Blephex to clear my lids and lashes (now done twice)
6. Lippiflow in May, properly wasted because I should have got the glands probed first.
7. The usual supplements and eating a piece of oily fish per day.
8. OTC drops as required.

I would say I'm 75% improved but still get plenty of gritty foreign body sensations in my eyes, certainly around the inner and outer corners.

All of the above have simply tinkered around the outside of the problem, they not really dealt with the real issue, the damage to my nerves.

In October I had a confocal microscopy which proved my nerve lengths and densities were greatly reduced.

As many of you may have read in my past posts I've had a long-term desire to pursue AMT but have hit plenty of residence in the UK about using it to fix nerve issues. Also, serum drops are really difficult to get in the UK with many going to Spain to obtain PRP drops.

Well, there is a new player in town for human nerve growth factor, Oxervate, which takes a different approach and has only just been licensed. I'll let you google it.

Problem is availability it's incredibly expensive. As a result unavailable in the UK on the NHS and nearly £15k privately for an eight-week course.

So today Mr.Walker (https://www.thebestsense.com/) and I created our own version using internationally sourced recombinant human nerve growth factor derived in the same way as Oxervate and mixed with Minins eye drops.

We have mixed enough for 30 days use, five times a day. We've created three times stronger mix then Oxervate.

The hope is this will deal with the root cause of my LASIK damage and restore the nerve function in my eyes and improve my corneal sensitivity.

Researching the clinical studies suggest this is the correct course of action.

Of course, I will try and keep you updated with my progress.

[Guest]

quattroboy do you have any idea why autologous serum costs so much in the UK? I'm trying to find who to complain to. I'm disabled so have gone to Spain but its frankly ridiculous I have to resort to this. The only option I have found in the UK is to pay £1000 for two months of serum!! Keen to hear how the oxervate goes. I looked into it but the cost is just too high and the NHS in general look at me with blank eyes like I'm crazy when I explain to them I have corneal neuropathy. Apparently they can't understand that messing with the most highly innervated part of the human body might lead to nerve issues!!

[Guest]

I’m happy you found someone willing to compunded this for you. I hope this helps your condition and ultimately makes you feel better. Keep us posted I’m super curious about this.

[quattroboy]

quattroboy do you have any idea why autologous serum costs so much in the UK? I'm trying to find who to complain to. I'm disabled so have gone to Spain but its frankly ridiculous I have to resort to this. The only option I have found in the UK is to pay £1000 for two months of serum!! Keen to hear how the oxervate goes. I looked into it but the cost is just too high and the NHS in general look at me with blank eyes like I'm crazy when I explain to them I have corneal neuropathy. Apparently they can't understand that messing with the most highly innervated part of the human body might lead to nerve issues!!

Unfortunately I don't know why it's so expensive but I suspect it's because there is only one supplier the national blood service. This makes the whole process complex and convoluted.

There are consultants who understand the condition but few and far between.

Mr Hau at moorfields might be a start.

[quattroboy]

I’m happy you found someone willing to compunded this for you. I hope this helps your condition and ultimately makes you feel better. Keep us posted I’m super curious about this.

Me too.

Of course there are no guarantees with any of this but given the following findings from my confocal microscopy imaging:

Right eye fibre density (no/mmsq) - 12.5, branch density (no/mmsq) - 20.8, Fibres length - 11.5 (mm/mmsq)
Left eye fibre density (no/mmsq) - 12.5, branch density (no/mmsq) - 16.7, Fibres length - 7.7 (mm/mmsq)

I'll let you guess which is the dryer eye of the two!

Promoting healthy nerve growth has got to help. All the finding point to NGF being a key component in this.

I've long believed this has been the missing part of my treatment.

[Guest]

Me too.

Of course there are no guarantees with any of this but given the following findings from my confocal microscopy imaging:

Right eye fibre density (no/mmsq) - 12.5, branch density (no/mmsq) - 20.8, Fibres length - 11.5 (mm/mmsq)
Left eye fibre density (no/mmsq) - 12.5, branch density (no/mmsq) - 16.7, Fibres length - 7.7 (mm/mmsq)

I'll let you guess which is the dryer eye of the two!

Promoting healthy nerve growth has got to help. All the finding point to NGF being a key component in this.

I've long believed this has been the missing part of my treatment.

If you can get a centrifuge and start spinning your own drops, why the hell not. I did it lol. But this is great man, very happy for you. I think if you take a multi faceted approach you can attain this hard.

Moisture chambers, NGF, serum, diet, supplements, etc. I think you can have a great outcome. Keeping blood sugar low, preventing evaporation and keeping the eye saturated in growth factors is the ticket!

[quattroboy]

Just quick update.

I've been using the drops now for just over a week, five times a day at three-hour intervals.

I've noticed today the dull ache has subsided a little.

In terms of my dry eye symptoms, I've not noticed any improvements but I wouldn't expect to see any this early on.

It's hard to say whether the foreign body sensations I'm still feeling are from my normal-dry eye or from the drops. I know another one of the side effects was foreign body sensations.

[Guest]

Please keep letting us know of progress

[quattroboy]

Update
I visited my UK consultant today who mixed the drops for me.
Positives
- he couldn't see any dry spots in my eye.
- the tear break up times were touching 13 seconds, previously they'd been around 3 in left and 6 in right. Of course many believe this to be a subjective measure.
- my tear film is stable with a waxy shine to it.
- my Lacrimal glands looked fuller and healthier, where before they looked flat and concaved. Still looked smaller than average.
- the tear lake in my right eye looked ok, but my left properly half what it should be. This is with lower plugs fitted.

Negatives
- a number of glands on my top lids have reblocked and look slightly angry. I did have them probed in November so this is frustrating.

I'm still struggling with general foreign body sensations and scratchy eye's, but not pain.

Going forward I've still got s week's worth of drops left so finish those and continue to monitor progress. Properly go for another convocal to check nerves in a couple of months.

In the meantime carry on with blepharitis routine but adding low dose Doxy to try and stop then glands reblocking.

Also I'm going to give Salagan a go. See if it can help me produce more tears and get those Lacrimal glands working better. Side effects could be interesting.