Are autologous serum drops reimbursed?

Preparation is carried out by a hospital pharmacy or an authorised establishment; funding arrangements depend on the route and the indication, and are explained when the treatment is prescribed.

How long must they be used?

Several weeks at least, often several months. The effect is judged on closure of the epithelium and on comfort, not over a few days.

Is there a risk of rejection?

No: it is your own serum. The main risk is contamination of the bottle, hence strict storage rules.

Autologous serum eye drops, explained

You have been prescribed eye drops made from your own blood, and the prescription often surprises more than the treatment itself. The idea is simple: to replace a tear film that no longer nourishes the surface of the eye.

Why blood in an eye drop

Tears are not salt water. They contain growth factors, vitamin A, fibronectin, immunoglobulins and substance P — a combination that maintains the epithelium continuously. In severe dry eye that nourishing function disappears, and artificial tears, which only wet the surface, do not replace it.

Serum — the liquid part of blood, free of cells and fibrin — has a composition remarkably close to that of tears for most of these constituents. Hence the long-standing idea of diluting and instilling it.

Who it is for

Severe dry eye, particularly in Sjögren syndrome.
Persistent epithelial defects — a surface ulcer that will not close despite proper treatment.
Neurotrophic keratitis, where the cornea has lost its sensitivity and its nerve support.
Graft-versus-host disease after bone marrow transplantation.
Certain burns and complicated surgical courses.

It is not a treatment for ordinary dryness: it comes after preservative-free artificial tears, lid treatment and, where appropriate, punctal occlusion.

How it is prepared

Blood is drawn — the equivalent of a few tubes, more if several months' supply is wanted. The blood is allowed to clot, centrifuged, and the serum is collected and diluted, most often to between 20 and 50 %, in saline. The product is divided into small bottles and frozen.

Preparation is carried out by a hospital pharmacy or an authorised establishment: it is not a retail pharmacy product, which explains the lead times and the particular supply route.

Day to day

Bottles are kept in the freezer; the one in use is kept refrigerated, generally for a week.
The usual frequency is four to eight instillations a day, sometimes more at the start.
The treatment is judged over several weeks, not a few days.
There is no risk of rejection or allergy, since it is your own serum. The main risk is contamination of the bottle: the storage and hygiene rules are not negotiable.

A variant exists when blood cannot be drawn or the patient's serum is of poor quality: umbilical cord serum, allogeneic, richer in growth factors, but of more restricted access.

When to seek care without delay. Report promptly any pain, redness or fall in vision occurring during treatment: these are not expected and call for the eye — and the storage of the bottles — to be checked.

Frequently asked questions

Are autologous serum drops reimbursed?: Preparation is carried out by a hospital pharmacy or an authorised establishment; funding arrangements depend on the route and the indication, and are explained when the treatment is prescribed.
How long must they be used?: Several weeks at least, often several months. The effect is judged on closure of the epithelium and on comfort, not over a few days.
Is there a risk of rejection?: No: it is your own serum. The main risk is contamination of the bottle, hence strict storage rules.