Do Your Patients Take Supplements?

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Novel Platform the Next Advancement in OCT Technology?

The DREAM OCT platform (Intalight) was recently granted CE mark approval by the European Union and represents a significant advancement in OCT for ophthalmic care. This system is designed to meet the needs of retina specialists and comprehensive eye care practitioners. DREAM stands for Deep imaging depth, Rapid sweeping speed, Extensive scan range, Accurate results, and Multimodal imaging capabilities. The DREAM OCT platform features an ultrawide single scan that produces a 130˚ OCT angiography (OCT-A) image, which enables detailed visualization of the retina, choroid, and a significant portion of the vitreous space through its 12-mm super-depth swept-source technology.

According to Intalight Chairman and Founder Shawn Peng, this approval enables European ophthalmologists to use state-of-the-art technology for improved patient outcomes. More than 160 peer-reviewed studies have already used DREAM OCT findings, underscoring its reliability and research potential. Intalight’s CEO, Bing Li, emphasized that the platform addresses clinicians’ demands for speed, accuracy, and depth, outperforming existing solutions for challenging clinical and research applications. Joe Garibaldi, chief commercial officer, expressed excitement about the platform’s European launch and its anticipated availability in the United States. The DREAM OCT’s multimodal capabilities and high-quality imaging make it an indispensable tool for daily clinical practice and advancing retinal research, offering optometrists a robust solution to improve diagnostic precision and patient care.

Intalight. Corneal flap thickness measurements after LASIK.

My Two Cents

This isn’t the type of news that typically makes the newsletter; however, you should take a peek at this video that shows just how incredible the images from the DREAM OCT are. I’m not sure exactly how far out the technology is from the US or Canadian market, but when it becomes available, I’ll certainly take a closer look at it. The images are astonishing! This could be the next advancement in OCT technology, which has already been growing by leaps and bounds with the (relatively) recent mainstream adoption of OCT-A.

OUTSIDE THE LANE

Supplement-Related Liver Dysfunction on the Rise

The increasing use of dietary and herbal supplements by US adults (and teens) poses significant risks for drug-induced liver injury (DILI), also known as toxic hepatitis, which can affect systemic health and potentially affect ocular conditions managed by optometrists.

A recent NBC News article highlights a dramatic rise in supplement-related liver damage, with cases requiring liver transplants increasing eightfold from 1995 to 2020. Approximately 20% of DILI cases are linked to supplements, contributing to an estimated 44,000 annual liver damage cases and 2,700 deaths in the United States. Turmeric, a commonly used supplement, alongside other botanicals such as green tea extract, ashwagandha, and black cohosh, is notably associated with liver toxicity.

Unlike pharmaceuticals, supplements are not rigorously regulated by the FDA, leading to frequent mislabeling—51% of 272 supplements studied did not match their labels—complicating toxicity assessments. For optometrists, this is critical, as liver dysfunction can result in ocular symptoms such as jaundice, which may present as scleral icterus, or exacerbate conditions such as dry eye or uveitis due to systemic inflammation. Patients often self-prescribe supplements without medical oversight, increasing risks, especially in those with genetic predispositions to slower toxin metabolism. The Drug-Induced Liver Injury Network emphasizes the need for heightened awareness, noting that supplement-related liver damage can mimic other liver diseases, necessitating thorough diagnostic workups to rule out viral hepatitis or autoimmune conditions.

My Two Cents

I’m guilty of this. I’m constantly researching and even trying supplements myself if the science suggests they might help me on my ongoing journey to better health. As optometrists, we need to be aware that our patients may be self-medicating with supplements that can have huge effects on both their systemic and ocular health. Whenever a patient can pinpoint a relatively specific period of time during which they began to experience ocular issues, one of the first things I ask is whether they started taking any new medications or supplements around that same time. The number of times a patient has told me they started a new dietary or herbal supplement right around the time their eyes became dry, itchy, blurry, or problematic is too numerous to count.

CAN YOU RELATE

Last weekend was Memorial Day weekend, which is a time each year dedicated to honoring the brave men and women who have made the ultimate sacrifice in service to our country. Something you may not realize is that this federal holiday, rooted in the aftermath of the Civil War, was initially known as Decoration Day and serves as a time to pay tribute to fallen military personnel by reflecting on their courage and selflessness. Families, communities, and organizations around our country often gather to commemorate the day through ceremonies, parades, and the respectful adornment of graves with flowers, flags, and wreaths, symbolizing gratitude and remembrance.

Not only this, but the extended weekend also marks the unofficial start of summer as people come together to celebrate the freedoms secured by those who gave their lives. Many families have their own Memorial Day traditions, and mine is a trip to the beaches of Orange Beach, Alabama. The long weekend serves as my shift into “summer mode,” and whenever I head out of town, my dog Buddy stays at a locally owned franchise called Camp Bow Wow. It truly feels like I’m dropping my doodle off at his second home. He loves it, and the staff genuinely seem to love him. My friends and family who don’t have dogs don’t understand how I can pay such a hefty price to have Buddy spend the night somewhere. Of course, the boarding fee is just the tip of the iceberg. When I drop Buddy off, I can check the box that tells the staff to indulge him in water day and/or the one that indicates I’d like them to play games with him or give him cuddle time or provide him with special snacks. Each one of these costs extra in the form of an upcharge. This also shocks my friends and family. But again, they just don’t get it. This is my dog we’re talking about it, so of course he deserves the best.

Buddy at camp. Shown: $5 pup cup. Not shown: $10 water day upcharge.

Talking about all this makes me think of the importance of valuing our eyes and vision. Glasses come in varying levels of quality, and you get what you pay for. Those upcharges we throw at patients include anti-glare, transitions, progressives, thinner lenses, and anti-scratch coatings, which might blow the mind of a non-spectacle wearer, but they’re worth the money! It’s something many patients understand the importance of, but by the end of the spectacle-buying process, after electing to have all the bells and whistles, it could end up costing hundreds of dollars.

I could drop Buddy off at a shed out in the country where he’s locked up 23 hours a day with no stimulation for much less money, but I choose not to because I’m that type of consumer. Here’s hoping we all attract more patients who value their eyes and the incredible services we provide and are willing to spend a little more money because of it!

QUOTE OF THE WEEK

“It is not the employer who pays the wages. Employers only handle the money. It is the customer who pays the wages.”

— Henry Ford