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Optometry Has a Significant Opportunity to Impact AMD-associated Vision Loss

Pamela Lowe, OD, FAAO, of Niles, Illinois, sees that her patients are aging along with her. “As a baby boomer, I began paying more attention to diseases of aging such as age-related macular degeneration (AMD), type 2 diabetes, hypertension and other chronic diseases. As a primary care practitioner, I realize the importance of talking to my patients about these conditions,” she says.

“I decided to create a center of excellence dedicated to the prevention of AMD. I tell patients how nutrition, diet and exercise can help protect their macular health and vision. The literature suggests if we identify people at the front end of this disease process and teach them how to improve their nutritional status, we can help many patients preserve their vision,” she says.

AMD is one of optometry’s big opportunities, she says. The prevalence of AMD, affecting an estimated 9.2 million people in the U.S., is higher than the prevalence of diabetic retinopathy and glaucoma combined. “We can turn this ship around. We have tests such as macular pigment optical density (MPOD) measurement and dark adaptation to identify at-risk patients earlier; then we are wellpositioned to implement proactive measures.”

In her goal to be proactive, Dr. Lowe brought the QuantifEye® Macular Pigment Optical Density instrument into her practice about 10 years ago to measure the thickness or density of her patients’ protective macular pigment. Over the years, she has expanded her pool of candidates for this quick and non-invasive test. “I find that young women in particular don’t eat well, and most are not thinking about their health 30 to 40 years down-stream. Females have twice the risk of developing AMD.”

Dr. Lowe says the MPOD test is very easy to explain. “I tell them, ‘We have this amazing technology that lets us understand an important AMD risk factor from a prevention perspective. Insurance doesn’t pay for screening tests such as this; however, it’s cost-effective and important.’” Macular pigments serve two important and protective roles; they filter high-energy visible blue light and provide localized antioxidant protection in retinal tissue.

The MPOD test determines the quantity of blue light transmission to retinal tissues based upon the thickness or density of zeaxanthin and lutein in the axon of one’s photoreceptors. “We want to identify patients with suboptimal MPOD protection of lower than 0.50 and eliminate this AMD risk factor,” Dr. Lowe says. For these patients, she also prescribes an ocular nutraceutical or eye vitamin brand, available in her office. “I’ve done my due diligence and understand the science, and I’ve seen consistent results in increasing MPOD with the EyePromise® brand.”

Talking about vitamins and vitamin supplements isn’t new to Dr. Lowe, but selling them was, so taking that step was initially a difficult decision. “I’m used to writing scripts. It’s medical, and the patient takes the prescription to a pharmacist and I’m not selling
anything. I had to focus on the idea that I was providing patients what I thought was best.” She knows it’s more convenient for her patients too. “The choice of vitamin formulations available at a pharmacy or health store is overwhelming. After I talk about the EyePromise formula being unique vs. retail store brands in several ways, my patients ask where they can find the product. When I say, ‘We have it right here in the practice,’ they love that.”

She adds, “If I have a vegan or vegetarian patient who doesn’t want fish oil in an eye vitamin, there’s an EyePromise lutein and zeaxanthin formula without fish oil. I also recommend the EZ Tears dry eye and DVS diabetes formulations. EyePromise has all the eye vitamin choices necessary to meet my patients’ needs.”

Many of her patients also enroll in the EyePromise autoship program so that their eye vitamins are shipped directly to their homes. “That’s a convenience for my patients. It supports compliance, and it’s a practice management benefit for my staff,” she says. When Dr. Lowe encounters a patient with a very high risk of developing AMD, she also encourages genetic testing. This test helps Dr. Lowe further refine her eye vitamin prescription. “A recent publication suggests a small percentage of AMD patients fare worse after taking
an AREDS formula with a high dosage of zinc. More research is needed, but this author concluded some subjects shouldn’t consume higher dosages of zinc. EyePromise offers an AREDS 2 formula without zinc for those better suited for zinc-free prescriptive supplementation,” Dr. Lowe says.

“In my practice, we say prescribe vs. recommend when we talk to patients about eye vitamins. It makes a difference in patient adoption and compliance. As an example, when patients come to the front desk in our practice, a staff member might say, ‘I see Dr. Lowe prescribed EyePromise Diabetes Vision Support for you.’ This approach has contributed to higher adoption, referrals and satisfied patients. The word gets out when you discuss diet, nutrition, exercise and wellness, and we find that many people are eager to learn about preventive measures. They truly feel and appreciate your concern.”

Disclosure: Dr. Lowe is a member of ZeaVision’s Speaker’s Bureau.

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