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Randomised assessor-masked trial evaluating topical manuka honey (Optimel) in treatment of meibomian gland dysfunction
  1. Anita Lai-Wah Li,
  2. Sophia Ling Li,
  3. Ka Wai Kam,
  4. Alvin Lerrmann Young
  1. Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Professor Alvin Lerrmann Young, Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong; dr.a.l.young{at}


Purpose To evaluate the effects of manuka honey eye-drops in the treatment of meibomian gland dysfunction.

Methods This is an assessor-masked (single-blind), randomised controlled trial comparing conventional treatment group with interventional group using Optimel 16% manuka honey topical eye-drops. 59 patients were recruited to the study and randomised into two groups: one given regular lubricants and the other given Optimel 16% manuka honey eye-drops. The Standard Patient Evaluation of Eye Dryness (SPEED) score was measured at baseline and on follow-up. 4 patients were lost to follow-up. Multiple ocular surface parameters were graded from slit lamp examination by a masked assessor. Results were compared from baseline to follow-up date 3 weeks later.

Results Patients in the conventional treatment group demonstrated minimal difference in SPEED score at 3-week follow-up (mean difference 1.087, p=0.183), which was not statistically significant. However, measurements of tear film break-up time, corneal surface stain (Oxford), lid margin, conjunctival redness, as well as meibum quality and expressibility showed significant improvements at 3 weeks (p<0.01). Patients in the manuka honey eye-drops group showed significant difference after 3 weeks in SPEED score (mean difference 2.53, p=0.006), as well as in lid margin redness, conjunctival redness, corneal surface stain (Oxford), and meibum quality and expressibility (p=0.000).

Conclusions Optimel 16% manuka honey eye-drops showed significant improvement in symptoms and objective signs in meibomian gland dysfunction and are an effective alternative treatment for meibomian gland dysfunction.

Trial registration number NCT04457648.

  • cornea
  • evaporative dry eye disease
  • meibomian gland dysfunction
  • manuka honey eye drops
  • ocular surface

Data availability statement

Data are available upon reasonable request.

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  • Contributors AL-WL conceived and planned the study. SLL helped carry out the study. AL-WL wrote the manuscript. KWK and ALY supervised the study and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Both Melcare or Alcon did not influence the study design, data collection, data analysis or the decision to publish.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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