Product profile

Meena Puar discusses the importance of supplementation for total eye health – and how to educate patients about their benefits

Feast your eyes

GUIDANCE FOR TOTAL EYE HEALTH

As clinicians, we never cease doing the best we can to help patients, and so when new innovations and technologies emerge we find ourselves wanting to increase our knowledge and develop our skillsets. Recent examples include optical coherence tomography (OCT) and myopia management. Another topic which has seen a rise in PubMed publications in recent years is nutritional supplementation and eyecare.

Age-related macular degeneration (AMD) is the leading cause of visual impairment, with numbers predicted to increase from 196 million to 288 million by 20501,2. With a large ageing population, it is important to stop this tidal wave of age-related eye conditions and reduce the burden on NHS resources and ophthalmology departments. This is where the conversation around nutrition and eyecare is paramount.

KNOWLEDGE IS POWER Simply eating a good diet is not enough for good eye health – and this is where your recommendation can be very powerful3 (Figure 1). Surveys have shown that only four per cent of people eat enough of the recommended foods to support their eye health4. As eyecare practitioners (ECPs) we have a duty of care at the very least to provide our patients with information so that they can make an informed choice.

Evidence suggests that certain nutrients can benefit our eye health (Figure 2). For a number of reasons (including cost, dietary habits and lifestyle) it can be difficult for patients to get these by diet alone. Figure 3 illustrates how much a patient would need to eat daily to get the same nutritional value from just one Nutrof Total capsule. Recommending a supplement like Nutrof Total can safeguard intake of these specific nutrients.

WHEN TO RECOMMEND SUPPLEMENTS We are all living longer and know that as we age, waste disposal in the retina slows down. Certain lifestyle choices can also impact this system negatively, including: • Cigarette smoking • Exposure to excessive light • High blood pressure • Fatty diets

Figure 1. Practitioner recommendation can be extremely powerful Figure 2. Certain nutrients can benefit eye health

Patients may be aware of how the above affects other aspects of health, but it is our duty to advise patients on maintaining the health of their eyes and vision. This may include offering services such as OCT to screen for conditions, and providing advice on supplements to support eyes nutritionally. Asking open questions about nutrition, diet, lifestyle, risk factors such as family history of AMD and smoking, is a great starting point when doing history and symptoms. It can also be helpful to incorporate a nutritionalbased questionnaire as a screening and grading evaluation (Figure 4).

As ECPs, we are continually measuring changes and offering advice accordingly. We can now utilise imagery from OCTs, together

Figure 4. A nutritional-based questionnaire can be very helpful

with an understanding of the patient’s history and symptoms, to recommend a nutritional supplement when we see changes in the macula.

The ideal patients to discuss nutritional supplementation with are: • Patients who don’t appear to get enough nutrients from their diet • Those presenting with risk factors such as a family history of eye disease, smokers, obese patients • Those with age-related changes affecting the eyes, i.e. presbyopes • Multivitamin users; data suggests that most consumers look for vitamins D, C and omega 3 for overall wellness.

Components of Nutrof Total have been shown to maintain normal vision and protect cells involved in key visual pathways from oxidative stress

KEY CONSIDERATIONS AND TIPS It is always important to match your supplement choice to the needs of the individual patient.

In the UK, 30 per cent of people aged 65 and over are vitamin D deficient and our average lutein and zeaxanthin intake is 1-3mg a day. We also know that 40 per cent of patients struggle to swallow tablets. Here we should look for a supplement containing vitamin D, 10 and 2mg of lutein and zeaxanthin, and an easy-to-swallow capsule rather than a tablet.

Nutrof Total (Figure 5) is a unique once daily capsule delivering ingredients known to support eye health. These are: lutein and zeaxanthin, vitamin D, omega 3, resveratrol plus essential vitamins and minerals. Each softgel capsule contains a premium formula specially developed to help make sure patients’ eyes have the correct nutritional intake.

With pharmaceutical grade ingredients, the capsules are individually blister-packed to ensure the highest quality – from the first capsule to the last. Nutrof Total provides a total formulation in line with a wealth of scientific research into nutrition and normal vision – providing additional clinically supported ingredients to standard formulas. Most recently, it has been adapted to include the powerful antioxidant resveratrol and highly sought-after vitamin D – following research showing their benefits to eye health (Figure 6).

Quick nutritional eye health tips: • Approach the discussion as you would agerelated changes and/or the importance of

OCT-recommend lifestyle changes • Introduce the idea of: ‘sunglasses protect from the outside, nutritional supplementation protects from the inside’ • Ask whether your patients take any multivitamins • Break the price down; Nutrof Total costs 50p per day • Recommend with confidence

IN SUMMARY Utilising existing tools such as OCT, taking a good history and symptoms or using nutritional questionnaires, can help us as clinicians confidently recommend products such as Nutrof Total where appropriate as part of the eye examination. It can be difficult to get enough nutrients for good eye health from diet alone – and this is where Nutrof Total can help ensure patients are getting the needed nutrients to support their eye health. With our ageing population, and everincreasing numbers of age-related eye conditions, the time to educate patients and encourage maintenance of eye health is now. The fact that 60 per cent of people take some form of vitamin and mineral supplement reminds us that eye health supplements are not the reserve of patients who already have a problem.

For helpful patient leaflets, eye health posters and to find out how Nutrof Total can help your patients, contact your Thea area sales manager, call 01782 381698 or email

marc.smith@theapharma.com

Figure 5. A unique once-a-day capsule

Meena Puar BSc (Hons) MCOptom, FBCLA is sales and education lead for Théa UK.

REFERENCES 1. Keenan TD et al. Study the past if you would define the future (Confucius). B. J.

Ophthalmol. 2020 104;(4):449-450. 2. Wong,WL et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and metaanalysis. The Lancet Global Health 2;(2): e106-e116. 3. 20:20 Vision Report 2015. The influence of diet and lifestyle on eye health. 4. de Koning-Backus et al. Intake of vegetables, fruit, and fish is beneficial for age-related macular degeneration. Am. J.

Ophthalmol. 2019 198:70-79.