A Pharmacist's Guide to OTC Therapy: Ocular Care Products

Good general health and proper nutrition are very important for overall eye health. Age-related macular degeneration (AMD) is the leading cause of blindness in the United States. Risk factors associated with developing AMD include the following¹:

• Age?the risk increases for individuals over age 55
• Gender?due to hormonal changes after menopause, women have a greater risk of developing AMD. The highest incidence is among Caucasian women over 60 years of age.
• A familial history of AMD
• Smoking
• Excess exposure to sunlight
• Diet?research shows that a diet deficient in certain vitamins and minerals can increase the likelihood of developing AMD
• Individuals with light-colored irises
• A history of hypertension

The Age-Related Eye Diseases Study (AREDS), a 10-year analysis conducted by the National Institutes of Health, provided valuable information regarding antioxidant therapy and AMD. The study found that high levels of antioxidants and mineral therapy can slow the progression of moderate-to-advanced AMD. The researchers concluded that patients aged 55 or older with moderate or advanced AMD, or vision loss due to AMD in 1 eye, and without contraindications (eg, smoking), would benefit from taking antioxidants and zinc.² The recommended daily doses of these antioxidants were as follows^1,2:

• Vitamin C: 500 mg
• Vitamin E: 400 international units
• Beta carotene: 15 mg
• Zinc oxide: 80 mg
• Cupric acid: 2 mg

The results also suggest that lutein and zeaxanthin supplementation may have a protective role in AMD. Lutein and zeaxanthin are natural carotenoid pigments present in the macula at birth. These 2 supplements were not part of the AREDS analysis, but studies are ongoing to confirm their beneficial effects with regard to AMD.

A variety of formulations of nonprescription ophthalmic vitamin supplements are available on the market today to meet specific patient needs (Table). Some types are available without beta carotene, because beta carotene supplementation has been shown to increase the risk of lung cancer among smokers. Pharmacists can play a vital role in patient care by providing adequate counseling to individuals regarding the proper use of these products.

Ms. Terrie is a clinical pharmacy writer based in the northern Virginia area.

For a list of references, send a stamped, self-addressed envelope to: References Department, Attn. A. Stahl, Pharmacy Times, 241 Forsgate Drive, Jamesburg, NJ 08831; or send an e-mail request to: astahl@ascendmedia.com.