A Horse Is a Horse, of Course

HOT TOPIC

Could Melatonin Ward Off AMD?

The commonly used sleep supplement melatonin has been linked to a reduced risk of developing age-related macular degeneration (AMD) and slowing its progression, according to new research published in JAMA Ophthalmology.

The study’s researchers speculate that the drug may reduce oxidative stress within the eye and subsequently, the overexpression of vascular endothelial growth factor. They examined how patients at risk for developing AMD could potentially benefit from melatonin supplementation.

While assessing the data from 121,523 electronic health records, the researchers selected 4,848 patients to represent the melatonin group; the remaining ~116,600 patients served as the study’s control group. When comparing the two testing groups, the researchers found that melatonin reduced the risk of AMD by more than half. The testing population was comprised of patients 50 years of age or older and did not account for smoking or other supplements that could play a risk of AMD development or progression. Also noteworthy was the fact that the patients in the melatonin group provided their history of melatonin use before the study was conducted and were not monitored during the observation period. (Read more here.)

My Two Cents

I’m definitely on Team Melatonin. Found in our Dry Eye Drink PM, I believe that melatonin’s likely reduction in oxidative stress positively affects my patient's dry eye symptoms. Unsurprisingly, melatonin would also help the back of the eye. However, its potential benefit blows even me away. “When comparing the two testing groups, the researchers found that melatonin reduced the risk of AMD by more than half.” It makes me consider recommending this supplementation to my patients at risk of AMD. The researchers concluded, "Given the convenient availability in oral form and generally benign safety profile of melatonin, confirmation of this study’s results in future clinical trials and longitudinal studies could contribute to advancing the current treatment options for age-related macular degeneration.”

OUTSIDE THE LANE

The Cost of Beauty

A model in Thailand has lost an eye after a botched eyelash appointment.

Bai Fern, a 40-year-old bar hostess and model, recently got her eyelash extensions done at a local beauty clinic. During the appointment, she complained of a stinging sensation in her eyes. According to Ms. Fern, 1 week later, she developed a severe infection after some of the eyelash adhesive ended up in her left eye. She said the beauty staff told her to just sit in front of a fan to ease the stinging. The symptoms became worse days later, so she took some “antiinflammatory medication.” Two days later, she knew something was wrong and went to the doctor because her iris had changed color. The following day, Ms. Fern went to several hospitals until she found one that accepted her insurance. She recalls, “The doctor asked if I was ready. At that time, I was shocked. What did he mean? But eventually, I understood that he meant the removal of my eye.”

My Two Cents

That’s about as bad as it can get from eyelash extensions. I knew infections like this could happen, but this is the first one I’m aware of that resulted in enucleation. Speaking of which, it seems as though most patients who have these extensions benefit from daily hypochlorous acid, and I have made it a habit of recommending it to each patient I see. Finally, it seems as though Demodex mites are prevalent in patients who wear extensions, so keep Xdemvy (Tarsus Pharmaceuticals) and lid wipes in mind.

CAN YOU RELATE

I recently spent the weekend in Saratoga Springs, New York, for the Belmont Stakes race weekend. (For those unaware, the Belmont Stakes is one of three American horse races that comprise the triple crown—along with the Kentucky Derby and the Preakness Stakes). It typically takes place in Belmont Park in Elmont, New York. Due to ongoing construction, the Belmont moved to Saratoga Springs for the next 2 to 3 years.

One of my best friends from undergraduate school has a house there, and I was lucky enough to spend time with him, taking in the sights and revelry of the track. A couple of things jumped into my mind during the races.

First off, this would be a fantastic place to advertise. Some quick marketing quips I came up with were, “Gallop to Great Vision—Book Your Eye Exam Today!” and, “Bet on Clear Vision. We’re the Odds-On Favorite for Local Eye Care.” “From the Paddock to the Track, Keep Your Eyes on the Prize With Us!”

Second, Saratoga Springs is a beautiful town. What a great place to practice and live!

Third, are there horse optometrists? After a deep dive—no, that doesn’t appear to be a profession. There are horse ophthalmologists who perform cataract surgery, but no horse optometrists.

During this deep dive, however, I discovered a reasonably prevalent issue in the horse community that is summed up quite simply in the following headline: “Training Problem or Dental Problem?” A group in the veterinary dental community is trying to spread the word that the condition of a horse’s teeth affects how it eats and its on-track performance. This is yet another thing that sounds familiar to us in optometry. How many nurses/PCPs/etc think that a child’s bad behavior or poor performance on schoolwork is due to attention deficit disorder, when the child actually has an uncorrected refractive error? Too many of those nurses/PCPs/etc, it’s hard to imagine that the eyes could cause bad behavior, though to us, it’s ordinary senses. The same problems we encounter regarding assumptions about how the senses can affect the mental status and quality of life affect not only humans and their eyes, but also horses and their teeth!

Also, let’s say there were horse optometrists. I wonder what diameter soft contact lens an average horse would require …