Optimel is a honey based eye product derived from Manuka Honey. It comes in two forms, an ointment and drops. It is well tolerated, stable and has a long shelf life.
It works based on the antibacterial properties of honey which have been known about and used for centuries.
In patients with dry eye we often see “foam” in the tear film. This is thought to be due to an overgrowth of bacteria on the lid margins. The bacteria eat the oil that comes out of the meibomian glands. They don’t like to eat it raw so they partially digest it by secreting enzymes to break down the oil into a soapy substance. Having this soapy foam in the tear film disrupt the tear film making it break down more quickly which leads to the symptoms of dry eye. So removing this overgrowth of bacteria is an important part of managing dry eye.
A second issue with the overgrowth of bacteria is that they are thought to contribute to the thickening of oil that we so often see in the meibomian glands of patients with dry eye. They do this my secreting enzymes that change the composition of the oil in the glands to increase it’s melting point. This is the reason for the use of hot packs in meibomian gland dysfunction. The problem with the thickened oil is that it does not do it’s job properly in the tear film and this leads to a reduced tear break up time and to the symptoms of dry eye.
The medical grade Manuka honey Optimel is also thought to have some anti-inflammatory properties. This is useful because inflamed eyes and inflamed eyelids are often found with dry eye.
The experience of patients who have used it is that it stings a bit, especially the ointment. This can be reduced by eye closure. Some patients also try and make their own concoction from supermarket bought honey but this is definitely not advised.
The research evidence for its use is limited but the early results are encouraging. There are currently more studies underway by Dr Julie Albietz from the Queensland University of Technology and we await the results with interest.
Is this a first line treatment for us? No. There are other ways to reduce the bacterial load such as antibiotics, eyelid cleaning with Blephex and eye lid hygiene. It is an option for some patients, especially those who prefer more natural therapies.