Hot Topic A new look at old problems
Vitamins Vision
Can selling supplements really help preserve your patients' vision and boost your bottom line?
By Erinn Morgan Illustration by Jon Krause
Selling supplements to your patients can be a boon to their health—and to your business. At Gailmard Eye Center in Munster, Ind., Neil Gailmard, OD, MBA, FAAO, says he resisted selling nutritional supplements in his practice for many years because he was concerned that the image was not professional.
Today, Gailmard Eye Center boasts $100,000 in gross annual revenues on nutritional supplement sales and AMD testing fees. “I've seen the devastating impact AMD has on vision, and I want to do more than just diagnose the disease and assess the damage,” says Gailmard. “I want my practice to play an active role in educating patients about the risk factors and helping them to prevent the disease.”
NEW PERSPECTIVES
ECPs are embracing this change of focus, and today there is an increase in the number of proactive practitioners offering eye health supplements to their patients. At the same time, the eye health supplement market is booming because of positive results in research efforts such as the National Eye Institute's AREDS study and an aging population that is concerned about their eyes.
In 2008, the total U.S. eye health ingredients market was worth $138 million, according to a research report by Frost and Sullivan. The compound annual growth rate from 2008 to 2015 for the total market is estimated to be 5.3 percent.
“More people are becoming aware of the relationship between proper nutrition and their eye health,” says Chris Barber, president of ZeaVision LLC, a maker of eye health supplements. “Numerous scientific studies have demonstrated a relationship between eye health issues such as cataracts, age-related macular degeneration, and poor visual function with low dietary intake of ingredients such as zeaxanthin, lutein, and omega-3 fatty acids.”
| THE POWER OF Paprika |
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| While the eyecare world waits for the results of AREDS2, three groundbreaking studies have recently come out to confirm that zeaxanthin reduces the risk for Age-Related Macular Degeneration (AMD) and assists in the treatment of advanced AMD as well. A 2011 study from the Erasmus Medical Center Rotterdam in the Netherlands demonstrated that certain nutrients such as zeaxanthin reduced the risk of early AMD. In addition, the Beijing Tongren Eye Center in China recently published data showing a direct correlation between higher blood serum levels of zeaxanthin and a 96 percent reduction of developing AMD. The third and most recent study, conducted in the U.S. at the Retina Center of St. Louis, showed that an additional 20 milligrams per day of Zeaxanthin given to patients undergoing therapy for advanced or wet AMD significantly reduced the number of invasive treatment cycles they required. Naturally occurring in the macula as the primary protective carotenoid, zeaxanthin is difficult to replenish through today's average daily diet—one would have to eat approximately 20 ears of corn to get a recommended dosage of eight to 10mg of natural dietary zeaxanthin per day. This is where eye health supplements come into play. Products such as ZeaVision's EyePromise supplement includes patented formulas that contain the proper daily dose of zeaxanthin available derived naturally from paprika peppers. |
| An Inside Look At AREDS |
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| The statistics on vision impairment paint a stark picture. More than 10 million Americans suffer from early signs of age-related macular degeneration, and almost a half million have significant visual loss from late-stage AMD. The most common surgical procedure in the U.S., cataract extractions, account for more than two million procedures a year. The life-impacting natures of both cataracts and AMD have caused patients and their practitioners to search for ways to prevent or delay these eye health issues. A large body of research unveiled within the last decade has made it clear that nutrition is one of the most promising ways to help protect the eyes from these diseases. “Nutritional supplements are extremely valuable because they can literally prevent or slow progression of one the leading causes of blindness in the United States,” says Neil Gailmard, OD, MBA, FAAO, of Gailmard Eye Center in Munster, Ind. “As the baby boomer population ages and lives longer, AMD is a serious threat to vision. There are many scientific studies that support the effectiveness of nutritional supplements and specifically, zeaxanthin.” The Age-Related Eye Disease Study (AREDS) from the National Eye Institute, released its results in 2001 and is still a leading information source today. Conducted over seven years with over 4,700 participants, AREDS was a major clinical trial that was designed to evaluate the effect of high doses of antioxidants and zinc on the progression of AMD and cataracts. Scientists found that people at high risk of developing advanced stages of AMD actually lowered their risk by 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene, and zinc. The same nutrients had no significant effect on the development or progression of cataracts in this study, but other studies have shown the benefits of nutrients on cataracts. The AREDS study also revealed that even those high-risk-for-AMD people taking a multivitamin regularly lowered their risk by adding in the AREDS formulation. It contained 500 milligrams of vitamin C, 400 international units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide, and two milligrams of copper as cupric oxide (copper was added to prevent copper deficiency, which may be associated with high levels of zinc supplementation). Reaching for the next level of knowledge, the AREDS2 study strives to determine whether a modified combination of vitamins, minerals, and fish oil can further slow the progression of vision loss from AMD. The test formulation includes the original AREDS formulation plus lutein, zeaxanthin, and omega-3 fatty acids derived from fish oils. This study was launched in 2006 and results are expected in 2013. Because of the depth of research clearly showing the eye health benefits of certain nutrients, there has been a marked growth in the number of eye health supplements containing the AREDS formula (or some variation of it) on the market. With this has come a growing acceptance by ECPs of selling supplements as a patient service, one that also increases their bottom line. In large-scale research project, the Nurses Health Study, the need for cataract surgery was lower among women who used vitamin C supplements for 10 years or longer. Also, the Longitudinal Study of Cataract showed that vitamin E supplement use for at least a year was associated with a reduced risk of nuclear cataracts becoming more severe. |
At The Low Vision Institute in Ft. Lauderdale, Fla., supplements have been part of the practice for 25 years. “I've always believed very strongly in them,” says director Marc Jay Gannon, OD, FAAO, who currently offers a macular formula created by the International Academy of Low Vision. “But our knowledge of their benefits has really increased in the past three to five years, so we've been bringing in supplements in a much more comprehensive way.” Nearly 90 percent of Gannon's low vision patients are on some kind of eye health supplement.
“We are seeing much more acceptance of supplements today. The times are changing and more and more doctors are getting involved,” says Rodney Horton, OD, president of MedOp Inc., a supplement supplier. “This is a great change because more people are going to get optimal treatment.
We also see doctors picking up the products and selling them in their offices and making money.”
With solid research, noteworthy market growth, and patient benefits in the mix, it might just be the right time to consider adding supplements.
GETTING STARTED
Practitioners accustomed to selling supplements suggest looking to the products that work for their peers, as well as some of their own market research, when determining the supplements that are right for their practice.
“Examine the labels for the exact ingredients,” says Rodney Horton, OD, president of MedOp Inc., a supplement supplier that now includes the AREDS2 study formulation in its eye health supplements.
ECPs can look for supplements that contain the proven AREDS formula, even if contained within a multivitamin formulation. They can also look for eye health supplements that contain the right amounts of the appropriate nutrients.
| Label Conscious | ||||||||||||||||||||||||||||
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| Want to know what to look for when comparing the ingredient lists of eye health supplements? This rundown of some of the more accepted formulations' daily doses will help get you started. AREDS Formula
AREDS2 Formula The AREDS formulation PLUS: - Lutein - Zeaxanthin - Omega-3 fatty acids derived from fish oils Nutrient Wish List from the Low Vision Institute “This is a great dose for someone who has AMD or a risk of it,” says Marc Jay Gannon, OD, FAAO, director of the Low Vision Institute in Ft. Lauderdale, Florida.
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“These supplements have to have a significant amount of the appropriate ingredients to become functional,” says Gannon, who adds that many over-the-counter supplements sold at drug stores and mass merchants claim eye health benefits but, in most cases, do not have the ingredient makeup to make an impact.
Noting that some big-name over-the-counter options touting eye health benefits have less than a quarter of a milligram of certain ingredients such as lutein, Gannon adds, “It needs to have at least six milligrams to have a clinical impact, but it's preferable for it have 12 to 20 milligrams. Be sure to read the labels before you buy.”
PROPER PRESENTATION
Once ECPs have pinned down the proper supplements for their practice, the next step is bringing them into the office in a professional manner. Gailmard's practice stocks supplements in the office and sells them through the practice website.
“We house them in the therapy room with the occupational therapist where they are sitting on a shelf and visible,” says the Low Vision Institute's Gannon. “After the exam, we educate patients about the benefits of eye health supplements.”
At Behavioral/Holistic Optometry in New Paltz, N.Y., Marc Grossman, OD, discusses the benefits of eye health supplements with every patient with an eye disease or a family history of eye disease. “I also discuss it with everyone over 50 years old in terms of prevention,” says Grossman, who is also the co-author of the book Natural Eye Care—An Encyclopedia.
HEALTHY EYECARE
Eyecare professionals can also go above and beyond the supplement business with a more comprehensive approach to providing a front against eye diseases. “We now have what we call the Center for Macular Health in my practice,” says Gailmard. “We start with testing for macular pigment levels with the QuantifEye instrument at age 21. This is not a test to determine if macular degeneration exists, it is a test for a major risk factor for developing AMD.”
Based on the test data gathered and known risk factors determined from the exam, Gailmard prescribes nutritional supplements, discusses the importance of UV protection in eyewear, and advises patients about lifestyle choices such as smoking.
Patients look to the ECP to filter through the eye health supplements on the market for the options that are the most impactful. “Most patients know that taking nutritional supplements are an important factor for eye health, but they are confused about which ones to take,” says Gailmard. “They want advice from their eyecare professional.” EB
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