By Dr. Mila Ioussifova, OD, FAAO
Nutrition plays a major role in all health outcomes, including the eyes. It is well established that nutrition and lifestyle can cause or prevent non-communicable diseases, such as diabetes and hypertension, which continue to grow in the U.S. and worldwide. We know these conditions can have serious ocular complications, and of course, we have learned about the role of nutrition in other ocular conditions, such as age-related macular degeneration (AMD). To my surprise, my patients with diabetes and hypertension are not always educated on what to eat and what lifestyle modifications to make to manage their disease.
This is where my passion for nutrition and nutritional education started. I wanted to give my patients the tools they could use to prevent and even reverse chronic conditions. I am fascinated with epigenetics, where our food and lifestyle choices can turn our genes on or off for a particular disease. When patients nervously tell us that they have a family history of eye disease, or their DNA testing showed a mutation in the macular degeneration gene, we can educate them and give them the tools on how to prevent the disease process from ever turning on.
So, I started to educate myself on nutrition, as my passion for wellness and preventative health for my patients grew stronger over the years. I’ve completed graduate-level nutrition courses in the Human Nutrition and Functional Medicine program at the University of Western States, and I am currently completing 1,000 hours of supervised clinical nutritional training, which is required to become a Certified Nutrition Specialist (CNS).
Holistic Eye Care
I am often told by my patients that I am their only health care provider who talks to them about nutrition and preventative health. I even hear this from my diabetic patients, which is surprising and shocking. People are looking for holistic providers, and as independent optometrists, we are the best providers for this, as many of us already offer nutraceuticals in our offices for conditions such as dry eye disease and AMD.
Because of my interest in this area, my established patients expect that I will be talking about nutrition during their eye exams, and new patients are pleasantly surprised to get an eye exam with an integrative or functional medicine approach. This dedication to my patients’ overall health and wellness shows them a different level of care that I think helps our practice stand out from others.
When patients suffering from dry eye disease come to me and I spend a significant amount of time assessing their nutritional intake, gut health, stress management, and sleep habits, it is often an eye-opening experience for them. Patients are surprised that their nutrition and lifestyle can affect their eyes. I love hearing that while treating their dry eye, patients start to see improvements in other areas, such as better sleep, more energy, and less anxiety.
Integrating Nutrition into Your Practice
While each patient is different and has different needs for both their eye care and overall health and wellness, there are some things we do in our office with each of our patients to get the ball rolling with nutrition.
From a diagnostic standpoint, we use a BioPhotonic scanner to measure carotenoid levels and the omega index, which gives us omega-3 levels in the patient’s blood. I also order blood tests to measure micronutrient levels and stool tests to assess the gut microbiome. This allows me to recommend personalized nutrition advice and supplements.
When it comes to supplements, we offer them for ocular conditions, but I will also often prescribe or recommend other nutraceuticals based on the patient’s specific imbalances or deficiencies. Instead of stocking every supplement, we utilize an online supplement pharmacy called Fullscript that we’ve found to be convenient for patients and for us.
Getting Started with Nutrition
We have good evidence of the benefits of nutraceuticals for managing AMD and dry eye diseases. That’s a good place to start. We also know that omega-3s and carotenoids are good for our entire body – not just the eyes. We should feel good about offering patients supplements benefiting them systemically.
I truly believe all providers should have nutritional education, but unfortunately, we don’t get much training on it. It is up to us to learn and share as much as possible with our patients on the importance of nutrition and lifestyle for the eye and overall health. The area of integrative and functional medicine is rapidly growing, and if you have a passion for it, this is a good time to start learning about nutrition. Your passion and knowledge will have a long-lasting and possibly life-changing impact on your patients.