Foto: Lars Eivind Bones / Dagbladet

Dry eyes: Rune’s solution

When Rune failed to take an important step in the treatment of dry eyes, he had to take the solution into his own hands.

Up to half of all adult Norwegians suffer from dry eyes. Rune was severely affected, but found a treatment method that has given him a new quality of life.

Rune Ødegård’s (60) eyes were becoming increasingly troubled. Irritation, a feeling of sandpaper and dryness were just some of the symptoms. He went to the optician several times and received eye drops, went to an optometrist, as well as a trip to a public eye specialist – but to no avail.

Over time, he gradually became more sensitive to light and also began to have trouble concentrating when using his sharp vision.

SEVERELY TROUBLED: At one point, Rune was so bothered that he had to drive with one eye closed at a time.

The ailments he had suffered since 2013 ended with a 100% sick leave in 2016. He couldn’t look at a screen for more than ten minutes at a time without his eyes hurting. The correct diagnosis didn’t come until the following year: dry eyes.

One eye on the road

– “At one point it was so bad that I no longer dared to drive. I sat and closed every other eye while driving,” he says.

One December day in 2016, Rune is once again on his way to the doctor. He is sitting behind the wheel with one eye closed. To his right is a large field. Suddenly, a hunting dog with an orange coat runs into the road, right in front of the car. Rune slams on the brakes and stops right in front of the dog.

– When I got to the doctor, I said: Now you’re taking that certificate away from me,” says Rune.

FOLK DISEASE: According to ophthalmologist Sten Ræder, the most common cause of dry eyes is aging.

What is dry eye?

“Dry eye is a common eye disease,” says ophthalmologist and researcher Sten Ræder. He is the founder and CEO of the Eye Health Clinic and the Dry Eye Clinic.

Usually, dry eyes are treated with artificial tear fluid, eyelid treatment and medication, says the ophthalmologist – but in Rune’s case, it took even more.

Despite the condition being called dry eye, the most common symptom is watery eyes.

– This paradox is due to the fact that many people have inflamed eyes due to dryness. “When the eyes become inflamed, the body tries to correct this by, among other things, producing more tear fluid, which in turn causes watery eyes,” explains Ræder.

EYE DOCTOR: Sten Ræder is an ophthalmologist and general manager of the Dry Eye Clinic and the Eye Health Clinic.

The causes of dry eyes are primarily related to ageing. In particular, the hormonal changes that occur as you get older. The body gradually produces less estrogen and testosterone, which means that the glands that produce water and fat in the eyes are weakened.

– It is particularly the decreased production of lipids that causes dry eyes. The sebaceous glands in the eyelid secrete oil that forms a membrane over the tear fluid – which means that the tears do not evaporate as quickly. Without the lipids, the tear fluid evaporates quickly – leaving the eyes dry, according to the ophthalmologist.

“Some medications can also cause dry eyes, such as beta-blockers for high blood pressure, antihistamines for allergy and isotretinoin for acne,” he adds.

When Rune came to see Ræder at the Dry Eye Clinic, he was told that he had lost around 75 percent of the sebaceous glands in his eyelids, his tear production was very low and he had suffered nerve damage in his cornea.

– “If I had come to Sten earlier, it probably wouldn’t have been so bad,” says Rune.

Scleral lenses

After examination and treatment at Ræder, Rune was referred to Erik Robertstad, general manager at Interoptik Holt in Tønsberg, for a fitting of what are called scleral lenses. Scleral lenses are large lenses that lie like a shield over the surface of the eye.

OPTICIAN: Erik Robertstad

– The lenses come in different sizes – how big you need is situation-specific and is an assessment based on each individual case. The lenses are made exactly to the patient’s eye shape,” Robertstad explains and continues:

– When you have dry eyes for a long time, nerve damage can occur. This can make the cornea more sensitive – and it takes less time before you are bothered.

“Scleral lenses relieve the cornea from dryness, not to mention irritation from the friction caused by blinking,” he adds.

– The lens is attached to the white of the eye, creating a cavity over the cornea. This cavity is filled with sterile saline to provide the cornea with a moist environment,” he explains.

Living light

Rune received scleral lenses just before Christmas in 2018 – but struggled terribly to get them into the eye.

– “Robertstad got me all sorts of tools, but they were so small and fragile. I sat over the mirror with my fingers in my face – my wife even had to help – but I couldn’t do it,” he explains.

THE DIAGNOSIS: Rune had lost around 75 percent of the sebaceous glands in his eyelids, tear production was very low and he had suffered corneal nerve damage.

One Christmas, an angry, frustrated and red-eyed Rune sat at the living room table, staring at the Christmas tree. His wife started lighting the candles on the tree. An idea suddenly popped into his head.

He took a new Christmas tree candle and burned it down a little before blowing it out. He then removed the wick and washed the tip of the candle. Then he placed the lens in the small bowl that had formed on top of the candle, and filled the lens with saline solution. He had thus created a small tool that gave him a clear view of the eye, and the lenses went on at the first attempt.

– It’s worth mentioning that I’ve been declared severely disabled, but it’s still bubbling and boiling between my ears,” he adds.

Bubbling and boiling eventually became an idea – and with NOK 320,000 in funding from Forregion1 Vestfold, the idea became a prototype. The prototype was tested and further developed. After good feedback, Rune made another prototype, this time of a stand, so you can have both hands free to keep your eye open.

– Both the stand and the lens tool work well for both hard and soft lenses. The stand is an extra helping hand for those who need it when fitting lenses,” says Rune

THE PRODUCT: Here Rune shows off the lens tool he has called “Easy On Off”

Today, it is currently at the prototype stage, but the hope is that it will soon be a ready-to-sell product.

– “I’ve slowly started selling the lens tool, and the machine that will be able to mass produce the stand has just been completed,” he adds.

Rune emphasizes that he has only had the ideas and thoughts about the design of the tool. “It’s his many good helpers along the way who have done the work that was needed – and should be given credit for it being as good as it is,” he says.

Well received

“The lenses are hard and larger than normal lenses, which makes it a little more challenging to put them on,” explains Robertstad. In addition, you need to balance the lens so that you don’t lose the saline solution or get any air bubbles.

HANDS FREE: Rune demonstrates how the tool frees both hands.

– You need to keep both your head and the lens horizontal. Then you have to hold your eye open with one hand while balancing and bringing the lens up with the other. Many people find this frustrating and difficult to achieve,” he adds.

Robertstad applauds Rune’s invention. According to him, for some people this will be a tool that can help them see well and, not least, function well in life.

– “We already have tools to handle this type of lens, but he has developed what already exists and created something that is simply better – and easier to use,” he adds.

He has contributed professionally – by answering Rune’s hundreds of questions – but has no financial ties to the product, only a clinical interest.

– “Something worth mentioning is that a colleague and I took Rune’s tools down to France with us – to an optometrist conference. There they were very well received. So now it’s spread to a selection of professionals around Europe – and the feedback so far has been very good,” says Robertstad.

THE PROFESSIONAL ENVIRONMENT: Sten Ræder says that the professional community has taken notice of the tool.

Sten Ræder also praises Rune for his innovation:

– The professional community has opened its eyes to this – and it’s great that he as a patient, who has the problem himself, sees a solution that people in the professional community have not seen.

Restless

Rune had to put his 28-year career as an accountant on the shelf. The illness means that many hours in front of the computer are out of the question.

He started working in the forest on his own initiative. He had no experience or knowledge, but restless as he was, he couldn’t just sit at home. A former auditing client gave him both a job and training in forestry, for which he is very grateful. This eventually led to him receiving training in chainsaws and forest clearing from NAV.

Today, he clears forest for Sandefjord municipality. He is paid for the area he clears – so he can take as many breaks as he needs, which he is also grateful for:

– All credit to Sandefjord municipality for taking responsibility and making things easier for me as a disabled person. Nevertheless, I have to say that I sometimes miss being an accountant. What I don’t miss is a hundred hours of overtime a month – after ten minutes of fine focus, my eyes are completely exhausted, so that’s out of the question now,” says Rune.

First published in Dagbladet : 2023 | By : Sondre Opedal | Photo : Lars Eivind Bones

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