Eyeworld

EW INTERNATIONAL 60 July 2015 by Matt Young and Gloria D. Gamat EyeWorld Contributing Writers New research probes whether East can meet West to advance treatment options E xperts from Asia are ex- ploring the potential of combining alternative Asian medicine to complement western medicine in the treatment of dry eye syndrome. Ophthalmologists in Singa- pore are working with Traditional Chinese Medicine (TCM) experts to evaluate the use of TCM protocols in dry eye patients. Further, Korean researchers have sufficient reason to believe that Korean red ginseng (KRG) supple- mentation may provide an addition- al treatment option for dry eye and for patients with glaucoma using anti-glaucoma eye drops. Evaluation of TCM against dry eye In Singapore, herbal medicine and acupuncture are the most popular TCM modalities in treating dry eye syndrome. In a randomized clinical trial conducted by clinician scientists at the Singapore Eye Research Institute (SERI) in collaboration with TCM experts at the Singapore Chung Hwa Medical Institution (SCHMI), quali- fied patients are being grouped into 3 treatment categories (eye drop, eye drop and acupuncture, eye drop and herbal mixture). Patients are being treated for a period not exceeding 1 month, and western medical science protocols are used to evaluate treatment results. "A standard question is adminis- tered for severity of dry eye symp- toms," said Louis Tong, MD, PhD, principal clinician scientist and head of the Ocular Surface Research Group at SERI. "Tear function, sta- bility and evaporation rates will be measured, while tear osmolarity and cytokine levels will also be evaluat- ed." From the perspective of TCM, dry eye patients may fall under 8 different types of pattern differenti- ations, according to Pat Lim, MD, PhD, TCM ophthalmologist at ICU Eye Care and SCHMI, Singapore. However, out of the 8 types, only 1 was chosen as the TCM inclusion criteria—"lung-kidney yin defi- ciency"—the most common TCM criteria in Singapore. "The patient selection criteria are based on established TCM study protocols," Dr. Lim said. "Mainly aged between 40 and 85, with the chief complaint of dry eye, [these patients] do not have major system diseases, autoimmune diseases or other eye diseases, and at the same time satisfy the TCM criteria as 'lung-kidney yin deficiency' patients." "In mainstream medicine, it has been shown that dry eye has an immune basis and various auto- immune diseases such as Sjogren's syndrome and other rheumatic conditions are also associated with dry eye," Dr. Tong said. Furthermore, Dr. Lim explained, TCM sees the eye as a whole body structure and not just an eye alone. The powers of Asian medicine against dry eye syndrome I t is easy to dismiss traditional medicine as unscientific, but it is important to keep an open mind to the potentially useful things we can learn from folk remedies. Presented here is an objective look at how traditional Chinese medicine can be used to treat dry eye syndrome. As the world becomes a smaller, we will increasingly be exposed to alternative thinking about how to approach common problems. Korean red ginseng might just prove to be the next big thing. John A. Vukich, MD, international editor International outlook In a randomized clinical trial conducted at Singapore Eye Research Institute, qualified patients are being grouped into 3 categories for dry eye treatment: eye drop, eye drop and acupuncture, eye drop and herbal mixture.

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