Comparing the Effects of THERA°PEARL Eye Mask (Bausch & Lomb Inc., New York, USA) With the Use of Blephasteam® (Spectrum Thea Pharmaceuticals LTD, Macclesfield, UK).
Phase: PHASE4
Conditions: Dry Eye Syndromes, Meibomian Gland Dysfunction
Sponsor: Oslo University Hospital

 
1
Comparing the Effects of THERA°PEARL Eye Mask (Bausch & Lomb Inc., New York, 
USA) With the Use of Blephasteam® (Spectrum Thea Pharmaceuticals LTD, Macclesfield, 
UK). 
Table of Contents 
Project group ........................................................................................................................ 1 
Background .......................................................................................................................... 2 
Study Description ................................................................................................................. 6 
Data Management and Statistical Analysis Plan .................................................................. 8 
Project Feasibility and the Research Group   ..................................................................... 9 
References ............................................................................................................................ 12 
 
 
Project group  
Tor Paaske Utheim1,2, Øygunn Aass Utheim1,2,3, Darlene A. Dartt4, Xiangjun Chen1,5, 
Aleksandar Stojanovic1,5,6, Neil Lagali7 , Jon Roger Eidet1,2, Jonatan Olafsson1, Reza 
Badian1, Sten Ræder 1,5  
1Tørreøyneklinikken, Norway  2Department of Medical Biochemistry, Oslo University 
Hospital, Norway  3Department of Ophthalmology, Oslo University Hospital, 
Norway  4Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical 
School, Boston, US 5SynsLaser Kirurgi, Norway  6 Department of Ophthalmology, Nordland 
University Hospital, University of Bergen, Norway 7 Linköping University, Department of 
Clinical and Experimental Medicine Ophthalmology  SE-581 85 Linköping, 
Sweden  8Innlandet Hospital Trust, Norway  
 
ID: 2014/1983 
Date of document: 11th of October, 2017 
 

 
2
 
 
 
 
 
Background   
Dry Eye Disease and Meibomian Gland Dysfunction  
Dry eye disease (DED) affects up to 20% of the population in North America.1 Clinically there is 
a plethora of irritation symptoms associated with DED, which includes ocular burning, foreign 
body sensation, soreness, stinging, scratchiness, photophobia and blurred vision. In 1995, the 
National Eye Institute workshops (in USA), defined dry eye as “a disorder of the tear film due to 
tear deficiency or excessive evaporation that causes damage to the interpalpebral ocular surface 
and is associated with symptoms of discomfort”.2 Recent studies point to the importance of the 
meibomian glands of the eyelids to avoid DED. Meibomian glands are located in the upper and 
lower eyelids and produce an oily substance that helps stop the water in the tears from 
evaporating, thus helping to prevent dry eyes. Meibomian gland dysfunction (MGD) is defined as 
“a chronic, diffuse abnormality of the meibomian glands, commonly characterized by terminal 
duct obstruction and/or qualitative/quantitative changes in the glandular secretion. It may result in 
changes of the tear film, symptoms of eye irritation, clinically apparent inflammation, and ocular 
surface disease.”3 The term “posterior blepharitis” is often used synonymously with MGD, 
however, in its early stages, MGD is not always associated with inflammation of the eyelid. The 
symptoms of MGD are a consequence of a reduced quantity and/or quality of meibum that is 
supplied to the ocular surface. The terminal ends of the ducts of the meibomian glands can 
become blocked with keratinized cells. Importantly, such obstruction of the duct can lead to 
ductal dilatation and loss of secretory cells in the acini of the gland.4 Blocked terminal ducts 
reduce the quantity of meibum produced by the gland, and are also, most likely, responsible for 
affecting its lipid composition deleteriously. In MGD, there is a clear tendency for more branched 
chain fatty acids and cholesterol in the meibum, which result in a more waxy and viscous 

 
3
character.  
Fig 1. Meibomian glands are the oil- producing glands located in both the upper and lower 
eyelids. The glands normally slowly release oil into the tear film. This oil helps to stop the water 
in the tears from evaporating, thus helping to prevent dry eyes.  
(picture: http://contactlens.org.nz)  
 
 
Systematic studies of the epidemiology of MGD have been hampered by difficulties in definition 
and lack of standardized tools for clinical assessment. Moreover, the specialized tests required to 
identify MGD in an early stage are not appropriate for use in population- based epidemiological 
studies.5 However, some trends are clear, i.e., Asian populations appear to have a much higher 
prevalence of MGD than do Caucasians.5 A number of factors have been identified that coexist 
with MGD. Although causal links have not been proven, plausible mechanisms exist for 
connecting them with the pathophysiology of 
MGD, i.e., anterior blepharitis, contact lens 
use, Demodex mite infestation, and DED.5 In 
addition, hormonal conditions, including 
menopause and androgen deficiency, rosacea, 
psoriasis, atopy, and hypertension may 
contribute to the illness.5 In 
Tørreøyneklinikken (TØK), we have access 
to state-of-the-art equipment to diagnose various subgroups of DED. This gives us an opportunity 
to assess the relative importance of MGD in our cohort of DED patients. Our studies so far reveal 
that about 80 % of our patients have DED caused by MGD. The large number of patients 
suffering from MGD has encouraged us to compare various treatment options to optimize future 
treatment of the disease.  
The Significance of Studying Dry Dye Disease   
The prevalence of DED in the Norwegian population is unknown, but based on epidemiological 
studies abroad, probably about 1 million Norwegians suffer from DED in one form or another. 
Age is an important risk factor for DED. Therefore, the prevalence of DED is expected to 
increase in the years to come as population ageing is unprecedented, without parallel in human 
history.6 Thus, research on DED is important for a large proportion of our population. Sadly, it 
has been an underprioritzed field of research in the Nordic Region in sharp contrast to many other 

 
4
countries. For example, at the Department of Ophthalmology, Harvard Medical School, DED is a 
highly prioritized field with several research groups working on improved treatment modalities. 
Research on DED holds the prospect to significantly improve quality of life for hundreds of 
thousand people in Norway. In addition, research on DED is critical to maximize the clinical 
outcome of some of the most severe forms of visual impairment that necessitate ocular surface 
stem cell treatment and/or corneal transplantations. Without an adequate tear film, these 
transplants will inevitably fail. Therefore, research on DED has the potential to help patients with 
the most severe visual impairments, either directly (in the event of keratinizing DED) or 
indirectly by enhancing the clinical results of other surgical procedures. In the light of DED being 
both a widespread disease and having huge implications for maximizing outcome of several 
diseases and treatments in ophthalmology, several members of our research group has taken 
measures to contribute to lessening DED in the Norwegian population. One example is the 
establishment of the Norwegian Dry Eye Clinic, which is the first specialized clinic for DED in 
Scandinavia.  
Treatment Options for Meibomian Gland Dysfunction   
There are several treatment options for MGD, but yet no consensus on the best approach. Lid 
scrubs using for example mild shampoo, eyelid massage and warm compresses of the eyelids, 
belong to the basic therapy. In addition, a large number of medications have been suggested over 
the past years for more severe forms of MGD. Comparative studies between possible treatment 
strategies are warranted to be able to conclude on the best available options.  
Basic Therapy   
Good eyelid hygiene, warming and massage are considered an effective mainstream therapy for 
MGD and blepharitis, in spite of the lack of standardization of the technique as well as the 
uncertainty about patient compliance. Studies comparing different methods of mainstream 4 
therapy, such as eyelid warming, would allow evidence-based recommendations. The diversity of 
recommendations for such basic treatment is exemplified by the advice given in two leading 
textbooks of ophthalmology:  
• “Warm wet face cloth for 5 minutes once or twice a day, and massage upper and lower lid 
(Moorfields Manual)”  
• “Warm compresses for 15 minutes four times per day, and clean with wet cotton bud and 
mild (baby) shampoo (Will ́s Eye Manual)”.  
Recent advances   
Recently, there have been two alternatives to the conventional, but somewhat unstandardized 

 
5
basic treatment. Blephasteam® (Thea, France), which is eyelid-warming goggles (patented 
medical device) is one such option. The goggles are designed to deliver standardized conditions 
of moist heat therapy for 10 minutes in order to melt meibomian secretion. This dual action 
(moist and heat) unblocks the meibomian glands. The principal effect of this device is to improve 
the thickness and quality of the lipid layer of the tear film, thus enhancing tear function. 
THERA°PEARL Eye Mask (Bausch & Lomb Inc., New York, USA), is another mask with 
similar functions. It is heated in a microwave and placed on the eyelids to meld the meibomian 
secretion.  
Additional Therapy (a Selection)   
Antibiotics. A number of topical and systemic antibiotics with effect against lid-related bacteria 
are available. Solid evidence, however, based on randomized controlled clinical trials is lacking. 
This makes guidance of antimicrobial management of MGD difficult. Tetracyclines are widely 
used in several ocular surface diseases, including ocular rosacea, corneal angiogenesis 
blepharitis, recurrent erosions, and DED. These components may be helpful for blocking the 
vicious-circle characteristics of dry eye disease and severe MGD through 1) anti- inflammatory 
and anti-apoptotic properties and 2) by counteracting the free fatty acid accumulation known to 
be responsible for development of MGD. Despite several studies on oral tetracyclines in the 
treatment of MGD, additional comparative studies against other therapies are needed.7 
Interestingly, one such recent study demonstrated better effects of using a macrolide 
(azithromycin) compared to applying a tetracycline (doxycycline) for the treatment of MGD.8  
Immunosuppressive medication. Most studies involving topical cyclosporine are small in sample 
size.9-11 Interpretation of some of the studies is somewhat challenging due to the influence of a 
reduced Schirmer score or the presence of ocular rosacea. A recent, randomized double-masked 
study on the use of topical cyclosporine confirms its potential role in the treatment of MGD.12 
However, there are no comparative studies of a combined approach using the presumptive best 
choice of antibiotics and cyclosporine compared with antibiotics alone.  
Ocular protection: In addition to providing the ocular surface with moist, ocular protection in the 
forms of drops has proved advantageous. Sodium hyaluronate and disaccharides have been 
included in eye drops with the aim of increasing ocular protection. Sodium hyaluronate 
containing solutions have been demonstrated to result in improvement in dry eye in patients 
compared to other lubricant solutions in several studies.13,14 Naturally occurring disaccharides, 
which are a major component in Thealoz, are used with the purpose of protecting the cells of the 
cornea and conjunctiva as well as to give resistance to dryness. Thealoz has proved successful in 
clinical studies.15,16   

 
6
Study Description  
Aims: To compare the effects of THERA°PEARL Eye Mask with the use of Blephasteam®.  
Study Design   
All the studies will be conducted based on written consent of the patients. Moreover, they will be 
performed in accordance with the tenets of the Helsinki Declaration and after approval from the 
Regional Ethics Committee as well as. If the patients encounter any problems during the study, 
they will be examined, irrespective of the planned follow-ups. The patients are free to quit the 
study at any time for any reason.  
To answer our aim, we have, in brief, chosen the following study design:   
1) THERA°PEARL Eye Mask versus treatment with Blephasteam®. In both groups, 60 patients 
with MGD are enrolled. We aim to make the two groups comparable as to the severity of the 
disease, age, and gender. The patients will be examined before the treatment and after 3 months, 
and 6 months. Treatment for both groups will be according to the manufacturer. All the analyses 
mentioned in the section analyses are planned to be included at every examination. Inclusion 
criteria: Meibomian gland dysfunction and candidate for eyelid heat therapy. Diagnosis of at least 
mild severity will be based upon recommendation by the diagnostic subcommittee of the 
International Workshop on Meibomian Gland Dysfunction, as seen in Table 1. 
Ocular Surface Disease Index (OSDI) 
>12 
Quality or expressibility score 
≤20 years old: >1 
>20 years old: ≥1 
Non-invasive tear film break-up time 
(NITBUT) 
<10 s in at least one eye 
Schirmer-1 test 
>5 mm after 5 min in at least one eye 
 
Exclusion criteria: Glaucoma, ocular allergy, autoimmune disease, contact lens-wear during 
study, current punctal plugging, pregnant/lactating, candidate for topical anti-inflammatory 
therapy, or cicatricial MGD.   
Analyses   
McMonnies Dry Eye Questionnaire. The McMonnies Dry Eye Questionnaire has been considered 
to be the "gold standard" for examining dry eye symptoms. The validity of the theory behind the 
questions and the questionnaire's usefulness in clinical settings has been demonstrated in 
numerous research articles.17 In addition, Ocular Surface Disease Index [OSDI] will be applied.18 

 
7
Slit lamp examination. The cornea will be evaluated for the presence of active inflammation or 
structural change. The iris and anterior chamber will be assessed for sign of inflammation, 
whereas the eyelids will be evaluated for sign of Meibomian gland dysfunction with grading of 
the quality, expressibility, and volume of gland secretion, according to the Bron/Foulks scoring 
system.19  
Tear film quantity and quality. RTVue (Optovue Inc, Fremont, CA) 
(http://www.optovue.com/wp-content/uploads/RTVue-Single-Sheet-Brochure_RevF.pdf) is the 
most comprehensive High Definition Ocular Coherence Tomography (OCT) system available 
today.20 The Cornea Anterior Module unit for the RTVue system provides a rapid, non-contact, 
non-invasive method for producing high-quality images (5 micrometer resolution) that enable 
measurements of the tear meniscus. The overall tear volume can quite well be predicted by 
measuring the tear meniscus size21,22 as the meniscus contains 75% to 90% of the tear volume23. 
Its size is related to the tear secretion rate23 and the tear stability.24 In addition, the Schirmer test, 
a traditional tear production measurement, will be applied with and without anesthesia. TBUT 
(fluoresceinn break-up time) will be used to test the quality of the tear film. TBUT will be 
measured after instilling 5 uL of a 2% sodium fluorescein solution. The average of three 
consecutive break-up times manually determined with a stopwatch will be calculated. Corneal 
staining will be evaluated under cobalt blue illumination 2.5 to 3.0 minutes after fluorescein 
instillation. The staining amplitude will be measured according to the National Eye Institute 
(NEI)/Industry Workshop scale.2 Likewise, conjunctival staining will be investigated 2.5 to 3.0 
minutes after 10 uL of a 1% sodium lissamine green dye is instilled. Conjunctival staining 
amplitude will be assessed in accordance with the NEI/Industry Workshop scale.2 
Tear film osmolarity. TearLab TM Osmolarity system (TearLab, San Diego, CA) will be used. It 
requires a very small volume of tears (50nL), which will be collected at the inferior lateral 
meniscus.  
Luminex. A multiplex Luminex® bead-based assay will be used to analyze ten cytokines 
(interleukin 1α [IL-1α], IL-1β, IL-1ra, IL-4, IL-6, IL-8, IL-10, IL-13, monocyte chemotactic 
protein-1 [MCP-1], and tumor necrosis factor-α [TNF-α]) and five metalloproteinases (MMPs) 
(MMP-1, MMP-2, MMP-7, MMP-9, and MMP-10). The Luminex bead-based assay is based on 
the principle of flow cytometry. The system allows us to simultaneously measure numerous 
analytes in a single microplate well, using very small sample volumes25 while for many cytokines 
achieving excellent correlations to individual Enzyme-linked immunosorbent  
assay (ELISA).26 Recently, Luminex has been used to measure the cytokine content in tear 

 
8
samples collected with capillary tubes27,28
 
or Schirmer strips.29 The analyses will be performed at 
the Department of Medical Biochemistry, Oslo University Norway. The content of cytokines and 
MMPs will guide us in the evaluation of the effectiveness the treatment. Moreover, it will shed 
light on the pathological mechanisms. As the important role of inflammation in DED has gained 
considerable scientific support recent years, a Luminex based approach seems pertinent in a 
clinical setting.  
Confocal microscopy. Heidelberg Retina Tomograph with Rostock corneal module 
(http://www.heidelbergengineering.com/products/hrt-glaucoma-module/cornea-module/) is 
considered a state-of-the art diagnostic tool to evaluate the cornea at high magnification. In the 
present proposal, the density of presumed inflammatory cells in the central and peripheral cornea, 
subbasal nerve fibers, and epithelial wing cells will be investigated. Two independent 
investigators will evaluate the confocal pictures, and inter-observer variability will be measured 
to further assess the robustness of the method.  
Keratograph 5M. Keratograph 5M (Oculus, Germany) technology will be used to enable 
meibography, which is a novel in vivo technique that provides photographic documentation of the 
meibomian gland, including the ducts and acini, under specialized illumination. In vivo confocal 
microscopy has the advantage of very high resolution, but at the expense of the overview. Both 
detailed analyses of selected glands and an overview of the general health of all the glands in the 
eyelids are important to be able to decide upon the best treatment strategies.  
Integrative approach. The Dry Eye WorkShop (DEWS) severity scale30 will be used as it 
integrates the values derived from the following analyses in one singel score: tear osmolarity, 
Schirmer tests, TBUT, corneal staining, meibomian score, conjunctival staining, and OSDI.  
Data Management and Statistical Analysis Plan 
All data will be stored in a special electronic medical record system built for management of dry 
eye disease. The extraction of the patient data from the system database will be carried out 
according to guidelines by the Regional Ethical Committee and the Norwegian Data Protection 
Agency. The dataset will be de-identified prior to any statistical analyses. 
 
All data will be checked for normality to determine the appropriate parametric or non-parametric 
test. To test for differences among groups, relevant Chi square test, one-way analysis of variance 
(ANOVA) and Kruskal–Wallis equality- of-populations rank test will be used. Where there is 
difference among groups, relevant Student’s t test or Wilcoxon rank sum test will be performed. 
Chi square test will be used to evaluate the differences in the primary and secondary outcomes 
between groups. Logistic regression will be used to adjust for baseline differences. Statistically 
significant difference is based on 0.05 level of significance. All analyses will be performed with 
SPSS software, version 24 (IBM Corp., NY, USA). 

 
9
 
Missing data will be handled with last observation carried forward.  
 
Zero-hypotheses: Blephasteam® (Spectrum Thea Pharmaceuticals LTD, Macclesfield, UK) and 
THERA°PEARL Eye Mask (Bausch & Lomb Inc., New York, USA) differ by a clinically 
relevant amount. Type I error rate of 0.05 and power (type II error rate) 0.20. There are many 
parameters that will be measured in the study, the primary being tear film break-up time 
(TFBUT).  
 
Originality and Scientific/Clinical Value   
Originality: The study design is novel and may give useful information that can guide both 
general practitioners and ophthalmologists in their treatment of one of the largest patient groups 
in ophthalmology.  
Presentation/Publication   
The results will be presented at two international congresses, and two manuscripts will be 
submitted to a peer-reviewed journal of ophthalmology with high impact factor.  
Project Feasibility and the Research Group   
Tørreøyneklinikken (TØK) is the first private clinic in the Nordic region with DED as primary 
focus. Moreover, it is the first in Norway to employ osmolarity measurements, meibomography 
(Keratograph), LipiView (Tear Science), and in vivo confocal microscopy (Heidelberg) for 
setting the diagnosis as well as evaluating the effects of the treatment. All patients in TØK will be 
asked to enroll in research projects/systematic quality assessments. In this way, TØK will 
eventually be able to document the effectiveness of a variety of treatments modalities applied to 
different subgroups of the disease. For the present proposal, we have a broad team to carry out all 
the clinical examinations and analyze the clinical and the laboratory data. We also have the 
advantage of collaborating with Darlene A. Dartt and Neil Lagali. Dartt is a Senior Scientist and 
Harold F. Johnson Research Scholar at Schepens Eye Research Institute, Massachusetts Eye and 
Ear (SERI/MEE), Harvard Medical School and Professor at Department of Ophthalmology, 
Harvard Medical School. She is regarded as one of the world`s leading experts in the field. Dartt 
was the Director of Research at the institute for nine years and has trained five of the members of 
the research group (Øygunn Aass Utheim, Xiangjun Chen, Sten Ræder, Jon Roger Eidet and Tor 
Paaske Utheim) at SERI/MEE, Harvard Medical School. Lagali is a world-class scientist on the 
use of IVCM with numerous publications in this field. Tor Paaske Utheim is the recipient of 14 
national and international awards and honors and is currently the youngest Adjunct Clinical 
Associate at SERI/MEE, Harvard Medical School. Sten Ræder is CEO of the TØK and recipient 

 
10 
of several awards, including three innovation prizes. Jon Roger Eidet is Director of Research at 
TØK and is also recipient of several awards/honors. Xiangjun Chen and Alexandar Stojanovic 
have numerous publications relating to the ocular surface. They have both been involved in 
research on dry eye disease since TØK was established in 2012.  
How the Present Project Complies with the Guidelines (§ 3 b) given by ExtraStiftelsen  
1) The ability of the project to spark new actions based on the defined project aims –  As the 
number of DED patients in the population is almost unlimited and the issues reported very 
diverse and complex, the project appears ideal for sparking new actions. With regard to 
aniridia, Norway is currently in a very favourable situation to spark new actions as both the 
Head of the Scientific Committee in Aniridia Europa and its president are from Norway. Our 
ambition is to apply for EU funding after the completion of the present project to build on our 
results and the expertise in the reseach group.   
2) The ability of the project to solve hitherto unsolved issues in health and rehabilitation in 
society – The research group thinks the present projects holds great promise to solve hitherto 
unsolved issues for the following reasons: 1) the aims of the projects are clearly defined, 2) 
the available literature studied in great detail, 3) all planned methods are very well known to 
the project group, and 4) several scientists in the research group has an exceptional strong 
track record of supervision of PhD candidates and scientific achievements, please see the 
section Project Feasibility and the Research Group. 5) The project leader is currently 
Heading the Scientific Committee in Aniridia Europe. This should make it relatively easy to 
implement important results from the project on a European scale and ensure almost 
immediate translation of our findings.   
3) The extent of the health problem in society, and whether many are or can be affected – 
Aniridi is a rare disease, but is regarded an excellent model for the study of stem cell 
deficiency of the ocular surface. This is of particular interest to many scientists in the group, 
in which three of the members have a PhD on the topic. The importance of the tear film in 
stem cell deficiency of the ocular surface can not be underestimated. Therefore, the combined 
study of DED and aniridia is of utmost importance in patients with aniridia.  
4) The severity and complexity of the health problem – Both aniridia and DED are considered 
very complex health problems. Anirida can arise from X mutations and presents considerable 
phenotypic variations. Despite decades of intense research, mechanisms involved in DED are 
still poorly understood. Aniridia is a severe disease. DED, however, comes in all grades of 
severity. The most severe form results in ocular perforation and therefore blindness. Of note 
such serious consequences of DED are very rare. That said, a minimal moisture of the ocular 

 
11 
surface is a requisite for maintaining the integrity of the eye as the ocular surface depends on 
water and nutrition from the tear film to maintain their normal function.  
5) Projects involving children, adolescence and elderly – By including two populations – a 
congenital disease and a general elderly population – in the project we hope to comply with § 
3 b by ExtraStiftelsen.   
6) Projects with patient contribution and administration – The project puts emphasis on patient 
information and involvement. These two factors are the most important measures to avoid 
exacerbation of DED. Unfortunately, there is little general knowledge of DED in the 
population. By applying for funding to carry out a PhD project on DED in a general 
population and in ocular disease (aniridia), we hope increase the awareness of DED and 
possible measures to lessen symptoms/avoid exacerbation. This is particularly important in 
DED as many patients enter a vicious circle without proper diagnosis and guidance. In TØK a 
novel software (ADEMS – A Dry Eye Management System) was developed in 2012 that 
increase patient contribution and awareness of DED. The further development of the program 
has so far been supported by the Norwegian Research Council, pharmaceutical industry and 
eye clinics. An improved version will be launched prior to the initiation of the present project 
(given it is funded). This program will allow even higher degree of patient involvement and 
education.  
7) Projects that spark collaboration between voluntary organization and between voluntary 
organizations and various academic environments - The project leader is consultant at the 
Norwegian Association for the Blind and Partially Sighted and the Head of the Scientific 
Committee for Aniridia Norway. Thus, the project leader is well connected to two 
organizations and has an excellent collaboration with both. The present project is, therefore, 
very likely to boost collaboration between at least two voluntary organizations associated to 
ExtraStiftelsen. The project is also quite extraordinary be including no less than eleven 
affiliations, including both dentistry and medicine and three international partners, including 
Harvard Medical School. With regard to medicine, the project group includes expertise not 
only in ophthalmology, but also medical biochemistry, the latter is of vital importance in dry 
eye disease as the not only the amount, but also the content of the tear film is of a critical 
factor in the development and exacerbation of DED. The present project, which is based on a 
substantial element of previous innovation (ADEMS), is likely to increase interfacultary, 
interdisciplinary and international collaboration. The research group`s ADEMS is now not 
only a software that is in use in Norway, but also abroad.  
8) Good plans for information related to the project and dissemination of the results of the 
projects - Several of the members of the research group has received substantial publicity 
based on previous scientific work, in particular the project leader with dissemination of the 

 
12 
scientific results in television (EuroNews, NRK Dagsrevyen, Schrødingers Katt), and 
newspapers (The Journal of the Norwegian Medical Association, “Everything about vision ” 
(Norwegian journal about vision – circulation up to 700.000), Aftenposten, Ullevål-Nytt 
(newspaper for Oslo University Hospital, Ullevål, etc) and webpages (tidsskriftet.no, 
forskning.no, EuroNews.com, nrk.no, helse-sorost.no, oslo-universitetssykehus.no, 
medinnova.no, blindeforbundet.no, abcnyheter.no, etc). Based on this track record with 
regard to publicity, it is likely that the research group will succeed in ensuring broad 
dissemination of the results while acknowledging the source of funding.  
References  
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