Dry Eyes 101

Do you have dry eyes? How to find out if you are suffering from dry eyes? And how to manage it? 

Read this informative piece. Click here. 

Eye-drops for kids with severe myopia

The Straits Times

Dec 18, 2013

By Salma Khalik

CHILDREN who suffer from rapidly deteriorating myopia can now turn to a new treatment offered by the Singapore National Eye Centre (SNEC). Its low-dose atropine eye-drops, which cost less than $20 for a month’s supply, can slow down short-sightedness by as much as 60 per cent, said Professor Donald Tan, the SNEC’s medical director. “It would be fantastic if a child who would normally end up with myopia of 800 degrees is able to keep it to 400 degrees or less,” he added.

The SNEC will provide the drops to as many children here as possible. But if its paediatric clinics cannot cope with the expected high demand, Prof Tan said the centre will open more clinics.

About one in six children here suffer from severe myopia of 600 degrees of more by the time they are in their late teens. This puts them at risk of getting cataract at an early age as well as other eye problems like macular degeneration and retinal detachment.

SNEC’s five-year trial of 400 children, which began in 2006, found that the daily use of low-dose atropine showed no noticeable side effects. Instead the drops, which retard the elongation of the eyeballs which leads to myopia, proved a success in slowing down the condition. For some children, it even arrested the short-sightedness from getting any worse. 

Prof Tan’s wish is to see the drug became widely accessible, but there are regulatory hurdles to overcome. The SNEC tried to interest pharmaceutical companies to produce the eye-drop, but with no success. Prof Tan said this is because the company would need to carry out expensive trials to get regulatory approval. 

But because it is an old drug that is no longer under patent, once a company has obtained approval, others could simply produce and sell similar eye-drops. SNEC finally decided to pay a company to make the eye-drops. But until large-scale trials are conducted to meet regulatory demands, these drops can be dispensed only by SNEC’s pharmacy, and all patients have to be logged.

Prof Tan hopes to be able to conduct trials that will satisfy health regulators within a few years – together with eye centres in other Asian countries facing a high incidence of myopia, such as China. When that happens, the eye- drops can then be dispensed by any doctor. Until then, SNEC will be the only place supplying these eye-drops to patients in general to prevent worsening of myopia.

About 85 per cent of teens here are myopic, with the condition generally starting when a child is five or six years old. 

Usually, the fastest deterioration occurs between the ages of seven and nine years. Prof Tan stressed that while the drops can slow the progression of myopia, they cannot cure it.

Parents can call 6227-7266 for an appointment, or e-mail appointments@snec.com.sg

Those who want subsidised treatments need a referral from a polyclinic. Parents should bring along proof of their child’s deteriorating myopia, such as the need for a new pair of spectacles every few months.

salma@sph.com.sg

More eye drops possibilities?

Another study is experimenting with the possibility of using eye drops to treat macular degeneration. It is a far superior method compared to the discomfort and pain of injection - the current predominant way of delivery. This advantage is summed up in the first sentence of this Huffington Post article: "A drop a day might soon keep blindness away." 

In short, it is easy, convenient and likely to be cheaper compared to injections. Good news all round for patients. Click here to read this latest eye drops experiment by Tufts University in Massachusetts. 

There are previous attempts at devising an eye drop solution to treatment. Remember the shark eye drops story which we posted here in June this year? Or even this project from Texas, first reported on in 2008? 

In any case, the move away from injections to eye drops is an exciting one. Not only could it be a further form of treatment for macular degeneration, but it could also be a far more economical and comfortable one for all of us. 

Shark eye drops to treat MD?

As unbelievable as it may sound, scientists have found that sharks could help to treat macular degeneration. Yes, sharks! 

Experts have been keen to find out why sharks rarely develop illnesses. They found that sharks have squalamine, a compound produced by sharks to stop them getting infections. 

Squalamine is extracted from the liver of sharks and can prevent the abnormal growth of blood vessels. It reduces the growth of unwanted blood vessels by a third. 

Now, scientists have synthesised squalamine into a chemical and made eye drops out of it. Trials are underway in US. 

Read this Daily Mail article and this Medical Daily story for more. Check out this video by Ohr Phamaceutical, manufacturer of this new eye drop, too! 

Fighting myopia, 1 eye drop a night

Nov 11, 2012
The Straits Times

By Alphonsus Chern
Photojournalist

Singapore researchers have found a way to put the brakes on myopia in children, and even improve the eyesight of a lucky few. Doctors say a simple eye drop could be the best solution to fighting short-sightedness, which afflicts eight in 10 people here by the time they are adults.

"We think we have found the answer to reducing the progression of myopia in children," said Professor Donald Tan, chairman of the Singapore Eye Research Institute (Seri), who led the latest study.

"There is reasonable evidence that reducing near-work activities such as reading and playing computer games may slow it down, but not by such a huge margin as the eye drops."

Seri has tried battling myopia on several fronts - using computer software to exercise the brain and an eye gel, for example - but nothing has proven as successful as the latest eye drops. They contain a very dilute solution of the chemical atropine, which has been proven to slow myopia, but can cause problems such as glare and the loss of near vision in higher concentrations.

"We were extremely pleased to find that the children had almost no side effects and the drug was absolutely safe," said Prof Tan of the latest study.

Singapore is the myopia capital of the world, where 7 per cent of five-year-olds are short-sighted and more than 60 per cent are myopic by the time they are in Primary 6. High myopia rates mean more individuals have severe myopia, said Dr Audrey Chia, an adjunct clinician investigator at Seri, adding that they are also at risk of developing potentially blinding eye conditions such as retinal holes, retinal detachment and even glaucoma.

With the new eye drops, myopia in an average child increased at only half the usual rate, so a child who might have had a short-sightedness level of 1,000 degrees in one eye might have a level of just 500, she added. Such eye drops generally do not work on adults as their myopia, if any, would be fully developed.

Myopia occurs when the eyeball grows longer than normal, making it unable to focus on distant objects, and atropine works by slowing this growth. Seri's study was the first in the world to fine-tune the dosage. At a 0.01 per cent concentration - 100 times lower than previously used - the solution worked well with no side effects.

"We feel we have finally arrived at an ideal therapy in 0.01 per cent atropine eye drops," said Prof Tan. "No other approach seems to be as effective and safe."

The five-year trial that ended last year involved 400 children, aged six to 12, who applied a single drop every night.

Anglo-Chinese School (Independent) student Nikhil Daniel Angappan was 10 when he joined the study. At the time, he was moderately short-sighted, with 225 degrees in the left eye and 250 degrees in the right. Now 16, his short-sightedness has stopped at 150 degrees in his left eye and 175 degrees in his right.

"This really was a fantastic programme," said Nikhil, who likes to play rugby. "There was a reduction in myopia and I was still able to have an active lifestyle."

The eye drops are expected to be available to all children here by the middle of next year.At the same time, a further study involving up to 600 children will begin, said Prof Tan. This will fulfil drug registration requirements and test the new eye drop's performance in a real world setting.

Eye drops for AMD

Doctors in Texas are testing two new eye drops to treat wet and dry age-related macular degeneration (AMD). Data from clinical trials will reveal whether the drops are effective within two years.

The wet AMD drops - called TG100801 - is designed to block new blood vessel growth and leakiness and reduce inflammation.

The dry AMD drops, known as Hydergine, is like an antioxidant or an "eye vitamin". The drops are used four times a day.

The drops are not available to the public yet. But doctors in the study say they're hopeful. Click here to read more and here to watch a video of a patient who is trying out the drops.