nutrition

From the Inside Out

Explaining UV protection and antioxidants to patients.

KIMBERLY K. REED, O.D., F.A.A.O.

UV-blocking sunglasses are not the only protection we can offer patients from the sun’s harmful rays. We can also shield the lens and macula from the “inside out.” Specifically, we can prescribe the antioxidants lutein, zeaxanthin, astaxanthin and green tea to patients who have a low macular pigment optical density (MPOD).

Here, I discuss how to educate these patients on this topic:

1 Explain MPOD.

Use this patient scrip

“Everyone’s eyes contain macular pigments. These pigments are believed to limit the oxygen depletion the sun’s rays cause. This is important because our retinas consume a high amount of oxygen. In fact, the outer segments of the retina’s photoreceptor, which responds to light, is comprised in large part of polyunsaturated acids, and these acids are vulnerable to oxygen depletion. With regard to glaucoma, this depletion of oxygen is thought to contribute to the development of optic nerve damage.”

This script works to illustrate to the patient the significance of macular pigment optical density (MPOD). This, in turn, makes them more receptive to what you’ll discuss next.

2 Discuss measurement findings.

Tell low MPOD patients:

“Some patients are at an increased risk of oxygen depletion, and, therefore, damage to their retinas, because they have a reduced macular pigment optical density. The MPOD measurement we conducted on you reveals you fall in this category.”

This script works to explain the significance of a low MPOD measurement.

3 Explain antioxidant benefits.

Finally, tell these patients:

“Dietary or supplemental intake of lutein and zeaxanthin, which are antioxidants, “darken” the macula, or cause an increased MPOD. In addition, astaxanthin, another antioxidant, is capable of reducing inflammation that is caused by UV light, and it holds strong promise for offering additional UV protection to the skin. Finally, green tea is a rich source of polyphenols that serve as antioxidants and also have a protective effect for the skin. I’d like you to start _______, in addition to wearing a pair of UV-blocking sunglasses. By following my recommendations, we, as a team, can best protect your eyes from the sun.”

Educate patients that antioxidants, such as lutein, shown here, aids in protecting their eyes from the sun.

Intake levels

The tricky part is determining what intake levels to recommend. Commonly available “blends” or “mixtures” of macular health formulas usually contain lutein and zeaxanthin; some contain green tea extract and/or astaxanthin. Recommend reputable products in their labeled intake suggestion, and avoid vague references — don’t leave it up to your patient to find and interpret a good product. OM

DR. REED IS AN ASSOCIATE PROFESSOR AT THE NOVA SOUTHEASTERN UNIVERSITY COLLEGE OF OPTOMETRY IN FORT LAUDERDALE, FLA., A DIRECTOR OF THE OCULAR NUTRITION SOCIETY AND AUTHOR OF NUMEROUS ARTICLES ON OCULAR NUTRITION, DISEASE AND PHARMACOLOGY. SHE IS ALSO A FREQUENT CONTINUING EDUCATION LECTURER. E-MAIL DR. REED AT KIMREED@NOVA.EDU, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT.COM.