Raconteur

Eye Health 2019

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R A C O N T E U R . N E T 7 antioxidant multivitamin supplement may slow down the progression of AMD." Dr Blakeney says: "As much as we all want to know the outcome, these studies are very difficult to conduct." They require thou- sands of people to make up a sample for observations over multiple years. Then there are many other risk factors, like what did they eat or drink during that time? Also, with older people, it's harder to narrow down all the influences due to their longevity. People who take vitamins tend to be wealthier, healthier and better educated, and this can skew the results of some research as cause and effect get tangled in a web of circumstances. What's more, several studies include dis - claimers, such as: "Although generally As much as we all want to know the outcome, these studies are very difficult to conduct Commercial feature four-year study by Ulster University has revealed that children in the UK are becoming short-sighted at a younger age, which is believed to result from a combination of environmental and genetic factors. A report by the College of Optometrists, released earlier this year, predicted Specsavers has a team of mobile opti- cians that provide free NHS-funded eye tests and high standards of care from the comfort of your own home. They can test your vision and check for other eye conditions such as cataracts and glaucoma. "This is an excellent service designed for some of the most vulnerable people in society," says Dr Nigel Best, Specsavers' clinical spokesman. "For those eligible, it is a free and convenient service, but research shows the public is not fully aware of the availability of domiciliary sight tests. "Two thirds of of those entitled don't know they can have their eyes examined in their home.* We want to ensure that those people who cannot get out to visit our stores take advan- tage of this service so we can look after their eye health." *Based on fi ndings published in NHS domiciliary eye tests: assessing the need among the UK population, produced as part of the Specsavers-RNIB partnership. that by 2050 almost half the world's population – fi ve billion people – will have myopia, with an estimated nearly one billion at high risk of sight-threatening conditions as a result. "In the UK, the prevalence of myopia in children aged between 10 and 16 has more than doubled over Lifestyle factors and short-sight The world is in the grip of a myopia epidemic that has far-reaching impacts on both eyesight and eye health A This is much more than a requirement for more people to wear glasses; this has real eye health implications Domiciliary eyecare "As an industry, we need to be advis- ing parents, particularly those who are short-sighted themselves, that their children are at risk of developing myopia and one of the most important things they can do to reduce the risk is to encourage their children to spend more time outdoors." The College of Optometrists believes that other intervention strategies may become available that could slow down the progression of myopia, and Specsavers is closely following ongoing research into the use of atropine and specially designed contact lenses. "The research is important and we need to raise awareness about the issue and the benefi t of sunlight for children," says Dr Best. "This is about much more than wearing glasses. The eyeball can become bigger and bigger through myopia, even- tually stretching to the point where it becomes vulnerable to retinal detachment and other sight-threatening conditions. "We want to stop the UK following some countries where 80 to 90 per cent of chil- dren wear glasses and where highly myopic prescriptions of minus seven are common. "Myopia is a growing concern and Specsavers is committed to raising aware- ness and advising parents what steps they can take to reduce the likelihood of it affecting their children." For more information please visit specsavers.co.uk the last 50 years, and children are becoming myopic at a younger age," it says. Dr Nigel Best, Specsavers' clinical spokesman, comments: "We are in the midst of a worldwide myopia epidemic; in some parts of south east Asia, more than 90 per cent of young people are short-sighted. This is much more than a requirement for more people to wear glasses; this has real eye health implications." Being short-sighted is a known risk factor for major ocular health disorders and, at high levels, can increase the likelihood of retinal tearing, glaucoma and cataracts, research has shown. Myopia, which is often hereditary, occurs when the length of the eyeball increases too quickly resulting in blurred distance vision. "Scientists are working hard to fi nd what is driving this increase in myopia," adds Dr Best. "With children spending more time than previous generations on phones, tablets and gaming, it would be tempting to blame it on screen use. However, a direct link between myopia progression and screen use has not yet been established. "What we do know is that sunlight would appear to provide a protective mechanism against myopia progres- sion. So, although there is no strong evi- dence of a direct link between screen time and myopia, you do wonder whether the increase in short-sightedness could in part be as a result of chil- dren spending less time outdoors than previous generations. "There is growing recognition glob- ally of the value of a daily dose of natural light in slowing myopia progression and some schools are intentionally incorporating outdoor playtime into their school day for this reason. Truth behind eye health vitamins The vitamins and supplements market can be a crowded and confusing place for patients in search of products to aid eye health here are many claims about food. According to one, Royal Air Force pilots ate blueberry jam during the Second World War, which supposedly improved their vision on night flights. But a counter view says the pilots were testing new and improved radar equipment during this time. It's the latter that explains their success, but our enthusiasm for promising nutrients continues. Walk into any health food shop and you will find eye health vitamins that prom - ise to "protect your cells" with ingredients such as "special berries native to Northern Europe". Are such vitamins an essential part of eyecare or are they simply a mar- keting ploy? Ageing populations and hea lthier life- styles have spurred sa les of vitamin sup - plements over the last decade. More than ha lf of A mericans reg ularly ta ke vita- mins or minera l supplements, according to a 2013 Ga llup poll. A mong those aged over 65, consumption is the highest at 68 per cent. The upshot is a thriving consumer mar- ket. In 2018, revenues from vitamin and nutritional supplements reached $31 bil- lion in the United States, according to research company Statista. In the UK, sales of supplements reached a record £442 mil- lion in 2018, according to Mintel. And it's an upward trend. Do optometrists ever recommend eye health vitamins? "It's common practice to recommend supplements for people who have age-related macular degenera- tion (AMD)," says Roshni Kanabar, clinical adviser at the UK's Association of Optom- etrists. She says they are not typically rec- ommended for cataracts. AMD is caused by damage to the macular region of the eye, which is the part of the retina that provides detailed and central vision. There are two main types of AMD: dry and wet. Ms Kanabar explains that the common treatment for wet AMD consists of eye injections, while there is no effective treatment for the dry AMD, but supple - ments are often recommended. This recommendation is largely based on two inf luential American studies. In 2001, a large-scale study called Age-Re- lated Eye Disease Study (AREDS) found that people who already have A MD low- ered the risk of a more advanced stage by 25 per cent when they took a combination of vitamin C, vitamin E, beta-carotene and zinc. In 2013, there was a follow-up AREDS2 study. This time, the researchers made two changes: they added omega-3 fatty acids to the equation, but found this had no effect on the formulation. And they swapped beta-carotene for the antiox - idants lutein and zea xanthin, which appeared to be a safe and effective alter- native. The motivation for this second change was that prior studies found E ye hea lt h v it a m i n s do not , t herefore, help w it h prevent ion for t he genera l p opu lat ion, s ay s Su s a n Bla keney, cl i n i- c a l adv i s er at t he L ondon-ba s e d C ol le ge of O ptomet r i s t s . The two AREDS studies had a robust sample size and were sponsored by the US National Eye Institute. But later stud- ies have failed to reproduce the same ben- efits, which is how scientists test whether research results are reliable. According to a 2017 Cochrane Review: "Supplements containing lutein and zeax- anthin are heavily marketed for people with age-related macular degeneration, but our review shows they may have little or no effect on the progression of AMD." Another one was more positive, it concluded: "taking an regarded as safe, vitamin supplements may have harmful effects." With all vita- mins, the wrong combination or a high dosage can cause side effects. Many robust studies have shown that vitamin-rich foods, such as vegetables and fruit, improve our health. But that doesn't necessarily mean we can condense the benefits of broccoli into a green pill. "It's not what people want to hear, but the main thing to protect their eye sight is to stop smoking," says Dr Bla keney. "We know it increases the risk of A M D signif icantly. "It helps to have a hea lthy diet, main - tain a hea lthy weight and protect your- self from sunshine by wearing sunglasses or a hat with a brim. "It's wor th having reg ular check-ups. They won't prevent you from having eye disease, but spotting conditions early can help keep you hea lthier for longer. Even though there is no good evidence that the genera l population should be ta king eye hea lth vitamins, it's wor th asking your optometrist if you fa ll within the par t of the population which could benef it from them." Ms Kanabar at the Association of Optom - etrists emphasises that smoking can increase the risk of AMD four-fold. "It's not too late to stop," she says. "If a person stops smoking, the risk level goes down and, after five years, it's almost the same as that of a non-smoker." But does eating carrots improve your eye- sight? "Yes, carrots are beneficial," says Ms Kanabar, "but so are other vegetables." S U P P L E M E N T S T Marina Gerner $2.9bn projected sales value of eye health supplements in 2024 beta-carotene posed an increased risk of lung cancer if it is taken by smokers. Cr ucia l ly, t he s t udy note s t hat for p e o - ple w it hout a ny A M D, "t he nut r ient s d id not prov ide a n appa rent b enef it ". 30% US revenue share of the global eye health supplements market by 2024 6% compound annual growth rate in Europe's eye health supplements market Persistence Market Research 2019

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