A couple of weeks ago, I mentioned how the treatment of life-affecting floaters was now achievable by improvements in the outcomes of vitrectomy. What I did not mention was that the surgeon, Kam Ballagan, gave short shrift to the usefulness of nutritional supplements aimed at reducing floaters.
The association between eye health and nutrition is a useful one and ECPs can offer helpful advice, but it is a fraught relationship. Much of the evidence of benefit is inconclusive, often diluted by the impact of the many other variables that can skew results of studies and are difficult to control for when investigating the long-term impact of diet on specific diseases.
The AREDS2 study is a good example. Having something positive to say to longstanding AMD patients is important, but too often the outcomes of the study are misquoted, the component nutrients described wrongly, and benefits explained to people who do not match the sub-group showing the effect in the original paper.
The Cochrane Database is helpful. Omega-3 for dry eye? ‘There was a beneficial effect on dry eye symptoms when omega-3 supplements were combined with standard dry eye treatments compared to standard treatment alone, and when long-chain omega-3 supplements were compared with omega-6 supplements.’1
During another recent webinar, I was interested to hear renowned ophthalmologist Ramon Malhotra describe a newly published review of oral nicotinamide.2 Available from most health food shops, this is ‘a cheap and well-tolerated treatment option for patients at high risk of developing future non-melanoma skin cancers (NMSCs).’ Basal cell carcinoma is one such NMSC, and one which many of our older, paler patients are at risk of.
So, keep up-to-date and in proportion. To quote an aside from the great Professor Alan Bird overheard some years ago; nutritional interventions are of most benefit to ‘the worried well.’
- Do you have an idea for a clinical feature? Email the clinical editor bill.harvey@markallengroup.com.
- For details of how to submit a case study and earn an interactive CPD point for each of the domains, go to the CPD area of opticianonline.net.