In the 1980s, Professor Peter Molan of Waikato University, having heard Māori legends about the medicinal properties of mānuka, established a Honey Research Unit and developed methods to evaluate the antibacterial activity of mānuka honey, a feature that was termed the unique manuka factor (UMF).

Prof Molan and his colleagues isolated high levels of a strongly antibacterial and anti-inflammatory organic compound called methylglyoxal (MGO) which is unique to manuka honey, and demonstrated its effectiveness in wound healing. Manuka-infused bandages have since become popular and effective in treating burns victims and previously non-healing chronic ulcerations.

In 2012, a collaboration began between Auckland company, Manuka Health, and the University of Auckland’s Department of Ophthalmology to investigate potential ocular applications of high UMF mānuka honey. It quickly became apparent that blepharitis, with its underlying chronic bacterial and inflammatory associations, could be considered a target for a manuka honey-based therapy.

With similarities to gut health, ocular surface health requires the ocular surface microbiome to be kept in balance. A well-known trigger for blepharitis is an overpopulation of gram-positive Staphylococcus spp., leading to inflammatory eyelid disease and ocular surface sequelae. In the background, Manuka Health had been working on improving the bioavailability of their honey product with the development of a complexed honey-based formulation (Manuka Honey with Cyclopower) which comprised freeze-dried manuka honey solids encased in alpha-cyclodextrin, a type of soluble fibre which allows for a more sustained release of MGO. Independently, this led to the commercialisation of a new Manuka Health oral supplement that offers more effective delivery of the active components of manuka honey to the bacteria resident in the gut.   

Over the last five years, our team, working across three Auckland University departments - ophthalmology, molecular medicine and pathology and optometry - has developed an exciting manuka honey-based eyelid cream for overnight application, in the hope of better managing blepharitis. Extensive in vitro and in vivo studies have been performed to establish the optimal dosage for targeted bactericidal effectiveness, while ocular surface inflammatory modulation, tear film and ocular surface integrity and toxicology have been monitored, to produce a safe and effective formulation which aims to modulate the levels of both gram-positive bacteria and tissue inflammation. Clinical efficacy trials are now in progress and, depending on the outcomes, there’s the possibility that we might see this novel and uniquely New Zealand-based treatment for blepharitis, on shelves in our stores in the not too distant future.      

About the author

Grant Watters is an optometrist, specialising in complex contact lens fitting and management, orthokeratology and keratoconus, and a lecturer and researcher with Auckland University.