New blog to address AMD prevention

Blue light is the hot “new” topic in eye care, and I get to blog about it, cool!

To be clear, blue light is just the tip of the iceberg of a much broader field that includes visual performance, age-related macular degeneration and general well-being. I have developed a great passion for discussing these topics with colleagues and patients alike.

Before we jump in, please indulge me to present a little of my history in practice. I am just an everyday, in-the-trenches practitioner like many of you reading this, so if you have been in practice awhile, you may relate.

I started my practice in 1993 in Sun City, Ariz., a retirement area. Old folks get AMD, hence the “age” part of age-related macular degeneration. So, as a new grad, with a new practice started cold, I watched many of my patients progress to legal blindness. I found this depressing on several fronts.

As a disease, we learned little about AMD in optometry school outside of basic dry/wet and to prescribe low vision aids when needed. I would send patients with choroidal neovascularization to retina, where laser treatment would ensure a permanent scotoma, and the patient would return, asking why I sent them to another doctor that blinded them.

I recall patients asking what they could do to prevent their AMD from getting worse – Should they take the new “eye vitamins”? Ocuvite was launched by Storz in April 1990, and by June it was at 200% of forecasted sales. Clearly patients were clamoring for something, anything that could help them maintain their vision.

The release of the Age-Related Eye Disease Study (AREDS) results in 2001 provided some clarity; at least I knew which patients to give all of those vitamin samples to. However, I now had to tell many with early AMD that the AREDS formula was not shown to help them.

A bright spot was the introduction of anti-VEGF agents mid-decade, with Lucentis (ranibizumab, Genentech) being approved in 2006, and off-label Avastin (bevacizumab, Genentech) use following soon after.

Then in 2007 I was introduced to measuring macular pigment and using supplements to build it. That was my personal epiphany: prevention! Since that time my interest has grown exponentially in strategies to prevent AMD and help those with AMD maintain their vision.

This is a big topic with many moving parts. Nutrition, light protection, genetic testing, in-office monitoring and home monitoring programs are a few of the areas I now address every day in clinic and will present in this blog. In talking with colleagues I have come to realize that implementing AMD prevention and monitoring tactics is of great service to our patients and can certainly help our practices to thrive in an ever-changing marketplace. However, while knowledge and resources for this are growing, we have a long way to go. In fact, as I am writing this just after attending Vision Expo West, one of the presenters there mentioned that only one optometry school is teaching curricula regarding ocular nutrition and AMD prevention.

So in closing this first installment, I would like to leave you with two questions. Which type of light do you feel is more dangerous to your patients, UV light or visible light including blue light? What factors shape your answer? We will dive into this topic next time. Thanks for reading!

Reference:

Team effort launches Ocuvite [press release]. Lederle Update. June 1990. http://www.mediniche.com/press.html.

Disclosures: Morgan is an advisory board member for Arctic Dx, MacuHealth LLC, and Signet Armorlite.