CLINICAL

  NUTRITION

GO BEYOND THE EYE

CONSIDER TAKING A HOLISTIC APPROACH TO DRY EYE DISEASE

LAURIE CAPOGNA, O.D.

EARLIER THIS year, as I was in the process of growing my new clinic, Eye Wellness, I was diagnosed with breast cancer. The diagnosis didn’t come as a complete surprise, as I was aware I carried the BRCA2 mutation and had been deep in the throes of figuring out my preventive plans.

With the breast cancer at an early stage and the presence of that genetic mutation, my medical team and I decided on a bilateral mastectomy, and I began diligently researching how to change my diet and environment to reduce the risk of a cancer recurrence. During this time, I had a revelation: I could apply a holistic approach to the management of dry eye disease (DED) too. So, I created the Eye Wellness Holistic Dry Eye Program in my practice.

Here, I discuss what this program is comprised of and its benefits.

PATIENT INTERVIEWS

Once I have diagnosed a patient as having DED, my staff provides a questionnaire regarding the patient’s lifestyle to determine any contributing factors (digital display use, diet, etc.).

SERVICES/PRODUCTS

My practice offers in-office eyelid treatments (warm compresses for 15 minutes) with the patient reclined and enjoying spa music. We also perform manual meibomian gland expression and provide an array of holistic DED treatments, such as lid hygiene products, humidifiers and high-quality omega-3 supplements. Further, we provide referrals to dieticians and naturopaths, who create personalized anti-inflammatory diets that take into consideration the patient’s overall health and food sensitivities.

DRY EYE JOURNAL

To help patients consistently follow their DED treatment plans, we provide a DED journal, which we ask they bring to every subsequent visit. The journal includes:

• A welcome letter that outlines the program’s goals, such as educating the patient about the underlying causes of his or her DED and developing a treatment plan that includes dietary changes, environmental adaptations and appropriate eye care to help conquer DED symptoms.

• A DED information sheet that explains the causes, etiology and treatments for DED in a simple manner. For example, we outline the Top 5 causes of DED: environment, medications, lid conditions, such as blepharitis, nutritional deficiencies and underlying systemic conditions.

• A daily checklist for eye drops and ointments, warm compresses and lid care treatments.

• Recipes for “dry eye smoothies” that contain anti-inflammatory ingredients, such as leafy greens, turmeric and green tea.

• Daily tracking for omega-3 supplements and “dry eye smoothies.”

BENEFITS

Every O.D. knows the most likely reason DED treatments aren’t successful is poor patient compliance. Engaging patients through the Eye Wellness Holistic Dry Eye Program has improved patient compliance and, thus, reduced their symptoms. As for me, I will continue to implement in my practice the lessons I learn from my personal health journey. OM

DR.CAPOGNA Runs Eye Wellness and operates a low vision clinic. In addition, she is a member of the Ocular Nutrition Society and co-author of “Eyefoods: A Food Plan for Healthy Eyes and Eyefoods for Kids: A Tasty Guide to Nutrition and Eye Health.” E-mail lcapogna@cogeco.ca, or send comments to optometricmanagement@gmail.com.