Dry eye patients find relief at the tips of their fingers


Posted: Wednesday, January 10, 2018


Dr Shafi Balal demonstrating the fingerprick technique at the XXXIV congress of the ESCRS


A new approach for treating dry eye syndrome and persistent epithelial defects in which patients apply a pricked and bleeding finger tip to their eye appears to be safe and effective, according to the findings of a study presented by Shafi Balal MD at the XXXIV congress of the ESCRS.

“ Our small study suggests fingerprick autologous blood (FAB) is an effective alternative low-cost, readily accessible treatment for DES, and also for persistent epithelial defects,” said Shafi Balal MD, Moorfields Eye Hospital, London, UK.

He noted that the treatment appears to work by the same mechanisms as other blood-derived products, such as autologous serum, platelet-derived plasma which have shown promising results in clinical trials. However, those treatments have not been widely adopted owing to the expense and time-consuming nature of production.

In contrast, FAB involves almost no expense and simply requires patient s to wash their hand, sterilise their finger with alcohol and prick their finger- in the same way diabetic patients do to test their blood sugar levels-and then apply a drop of blood directly from their fingertip to their lower fornix.

Dr Balal’s study involving 12 patients with dry eye syndrome and three patients with persistent epithelial defects underwent FAB treatment four times daily for eight weeks and then were followed for a further four weeks.

They found that after eight weeks treatment the patients’ mean Oxford corneal staining grade improved from 3.67 to 2.33 (p<0.0001), tear break-up time increased from 5.24 seconds to 7.71 seconds and OCI score improved from 53.17 to 27 (p<0.001). There were also improvements in mean visual acuity and Schirmer’s scores, but they did not reach statistical significance. There were no complications .

Four weeks after treatment cessation mean Oxford Staining grade, OCI and tear break up time all worsened. However, persistent epithelial defects had resolved after one month of treatmen, Dr Balal said.

ESCRS Posters

  • Poster: Analysis of postoperative alignment error of toric intraocular lenses by ray-tracing aberrometry and slit lamp, and its correlation with visual outcome

  • Poster: Efficacy and safety of lifitegrast ophthalmic solution 5.0% in three randomized controlled trials for dry eye disease

  • Poster: Analysis of a large series of MICS toric lenses: what amount of astigmatism correction for the best vision?

  • Poster: Toric trifocal IOL as best option to achieve emmetropia and near vision after cataract surgery: 3 years clinical results and patient satisfaction

  • Poster: Results of toric intraocular lens implantation using surgical guidance and AS-OCT orientation

  • Poster: Intense pulse light in dry eye challenging cases: long-term results

  • Poster: New customised toric IOL using Barrett calculator achieved the best significant rotational stability, accuracy and patient satisfaction as compared to conventional toric IOL

  • Poster: Evaluation of the rotational stability of toric IOL: importance of head positioning and cyclotorsion