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Dr. Jeffrey Fardink shares the latest in eye care news and trends. Learn about Omega-3s on Diabetic Retinopathy, Smart Contact Lenses, Corneal Endothelial Cell Therapy, and more.
Table of Contents
Eye Care News: Omega-3s and Diabetic Retinopathy: Fact or Fiction?
Dr. Darryl Glover:
Ooh, I like that. Well, let’s make that happen, man. So, tell me about Omega-3s and diabetic retinopathy. Is there a connection? What’s the latest eye care news?
Dr. Jeffrey Fardink:
Maybe not much, or I’m not sure. This new significant study was part of the ASCEND study—I love these acronyms. It stands for ‘A Study of Cardiovascular Events in Diabetes.’ It was published in the Journal of Ophthalmology. This six-and-a-half-year study attempted to link Omega-3 supplementation with improved outcomes in diabetic patients. However, they found no statistically significant benefit. In the study, 15 percent of patients in the Omega-3 group and 14 percent in the placebo group developed diabetic retinopathy.
Some might question the type and amount of Omega-3s used. They were given 380 milligrams of DHA and EPA, which is quite low compared to what many major brands recommend. So, while there’s still hope that higher doses of Omega-3s might be beneficial, the lower dose in this study didn’t prevent diabetic retinopathy.
Dr. Darryl Glover:
Interesting. What do you usually tell your patients about dosage? How much do you typically recommend?
Dr. Jeffrey Fardink:
It really depends on what we’re treating, such as dry eye or other conditions. Different manufacturers have different guidelines. The most critical factor is the quality of EPA and DHA. Not all Omega-3s are the same. The re-esterified form of the molecule is crucial—it’s a purer version of Omega-3 fatty acids and more easily absorbed by our bodies. So, ensuring the right type of DHA and EPA, and then the correct dosage, is vital. I generally recommend at least a thousand milligrams of each for daily use. The dose in the study we discussed seems very small to me.
Eye Care News: Quality Over Quantity – The Secret to Effective Omega-3 Supplements
Dr. Darryl Glover:
Yeah, I usually suggest between one to two thousand milligrams. But I should probably focus more on quality, like you mentioned. So, for 2024, I plan to research and find the best option. What are you prescribing for dry eyes in terms of a quality supplement?
Dr. Jeffrey Fardink:
My go-to is PRN, Physician Recommended Nutraceuticals. They offer really high-quality Omega-3s. Nordic Naturals is another good choice. The key is the re-esterified form. These are the brands that do it best.
Dr. Darryl Glover:
I’ve heard about Nordic Naturals. Patients seem to prefer their taste over other options. That’s a common feedback from my colleagues.
Dr. Jeffrey Fardink:
Exactly. The re-esterified form also means less of that fishy aftertaste. So, you don’t get that with the higher quality ones. It’s worth investing in for that reason alone. Plus, because it’s better absorbed, you tend to see fewer digestive side effects compared to other forms.
Eye Care News: Mysteries of Nature – Unveiling the Color-Changing Eyes of Reindeer
Dr. Darryl Glover:
Interesting. Let’s switch gears a bit. The next topic we have is ‘not your typical reindeer.’ What does that mean? Share with me, Dr. Fardink the latest in eye care news.
Dr. Jeffrey Fardink:
In the news recently, there’s been a story about reindeer eyes that’s been circulating in popular media outlets, like The Guardian. However, I think these articles might be misrepresenting the facts. They talk about reindeer eyes changing color, but that’s not exactly accurate. It’s not the iris of the reindeer that changes throughout the year, but rather the tapetum lucidum. This is a structure in the retina, that humans, unusually for mammals, don’t possess. It’s a reflective layer beneath the retina. You know how deer or cat eyes glow when caught in headlights at night? That’s the tapetum lucidum. It reflects light back through the retina, giving animals better night vision by essentially allowing them to ‘see’ the light twice.
Dr. Darryl Glover:
Wow, that’s fascinating. I wonder why nobody has utilized this concept in anti-reflective coatings or contact lenses. Maybe it’s already been developed but not yet introduced to the market.
Dr. Jeffrey Fardink:
It’s possible, but there are likely downsides. Humans probably evolved without a tapetum lucidum for a reason. Perhaps our higher resolution vision benefits from not having this layer, as it might make vision blurrier or hazier. There’s a trade-off in sharpness. But most mammals do have it, and in reindeers, it changes color with the seasons. In summer, their eyes reflect a golden color, similar to a cat’s. But in winter, the tapetum lucidum reflects a light blue color, which is quite remarkable.
Eye Care News: Exploring the Potential of Smart Contact Lenses
Dr. Jeffrey Fardink:
I always enjoy discussing new developments in our field, especially those to improve patients’ vision. I want to talk about a smart contact lens currently being developed by Azalea, named the Alma lens. Over the years, I’ve seen various soft lenses incorporating bits of technology, but this one is particularly fascinating. It features an embedded diaphragm, liquid crystal technology, a microchip, an RF antenna, and a medical-grade micro battery with configurable light control.
Dr. Darryl Glover:
All of that in a single contact lens?
Dr. Jeffrey Fardink:
Yes, all-in-one contact lens. Unlike other smart lenses I’ve seen, which focus on measuring blood glucose or projecting a smart display onto the retina, this lens aims to improve vision for people with presbyopia, especially those with ectatic corneas like keratoconus or pellucid marginal degeneration. It’s exciting to think about having such advanced electronic lenses to aid our keratoconus patients in the future.
Eye Care News: Corneal Endothelial Cell Therapy
Dr. Darryl Glover:
What we have up next is corneal endothelial cell therapy. What is this about my man?
Dr. Jeffrey Fardink:
I’m super excited about this. Let’s discuss my favorite structure of the eye: the cornea. Specifically, the endothelium. Patients with Fuchs dystrophy face challenges keeping their corneas clear due to unhealthy endothelial cells as they age. Not long ago, the only solution was penetrating keratoplasty, a full-thickness cornea transplant, which isn’t ideal due to its complexity and post-operative maintenance. Nowadays, we have Descemet’s Stripping Endothelial Keratoplasty (DSEK), which transplants only the endothelial layer. However, this still requires donor tissue, and one donor cornea can only treat one eye, posing a challenge in countries with limited donor tissue.
That’s why endothelial cell therapy is so promising. It started from a patient with a failed DSEK, where the transplanted cells migrated to her cornea and functioned well. This led to the idea of injecting endothelial cells directly into the anterior chamber. It’s remarkable – one donor cornea can provide cells for about 100 patients. The procedure involves injecting endothelial cells with a collagenase inhibitor into the anterior chamber and having the patient lay face-down for a few hours. There have been successful pilot studies in El Salvador and Japan. It’s a revolutionary treatment for Fuchs dystrophy and similar endothelial issues.
Eye Care News: Revolutionizing Glaucoma Treatment – The Rise of SLT
Dr. Darryl Glover:
Incredible! Well, next, let’s discuss SLT, selective laser trabeculoplasty. It’s a hot topic, especially with the expanding scope of optometry practice.
Dr. Jeffrey Fardink:
Exactly. It was a great article in the Review of Optometry. Selective laser trabeculoplasty is increasingly important for optometrists, as we might be performing this surgical procedure more often. It’s surprising how many patients are now receiving SLT as a first-line treatment for glaucoma, even bypassing medication therapy.
Dr. Jeffrey Fardink:
Yeah, the convenience of SLT is a significant advantage, especially considering the challenges of compliance with glaucoma drops. Patients often struggle with the discomfort from the drops and don’t immediately perceive their benefits, making adherence difficult.
Dr. Darryl Glover:
Absolutely, the convenience factor is crucial. People want simplicity and minimal hassle in their lives. Having more optometrists capable of performing SLT could greatly impact patient compliance and overall eye health. I’m excited about this shift. Let’s delve a bit deeper into the article’s details.
Dr. Jeffrey Fardink:
Definitely, I recommend everyone read the article in the Review of Optometry. It breaks down SLT into ten crucial vital points for us to understand. The article discusses the effectiveness of SLT and its duration. The efficacy of SLT varies; for some patients, it can remain effective for up to six years, but for others, it may only last between one and a half to two years.
