Got a Corneal Wound? Breast Milk Could Help

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Tropicamide 1% Could Be Used for Cycloplegic Refraction, Study Finds

A recent meta-analysis published in Optometry and Vision Science compared the efficacy of tropicamide 1% with that of cyclopentolate 1% for cycloplegic refraction. The analysis included 17 full-text reviews and four randomized controlled trials with 171 participants (including infants, children, and adults). Using these data, the study found no statistically significant differences in mean spherical equivalent refractive error values between the two groups (mean difference of -0.05), with no heterogeneity observed.

These results remained consistent even when focusing solely on children. The researchers concluded that tropicamide 1% could be a worthy substitute for cyclopentolate 1%, offering comparable effectiveness in determining refractive error in patients. Despite the relative limitations due to having “only” four trials, this study provides compelling evidence that supports the use of tropicamide 1% in patients without strabismus across various age groups.

My Two Cents

As we all know, tropicamide’s shorter action duration and less intense dilation make it a better alternative (at least in my clinic) than cyclopentolate for cycloplegic refraction, thereby reducing post-cycloplegia vision issues in our patients. I would be extremely curious to see how the compounded 1% tropicamide/2.5% phenylephrine (Imprimis) we use in clinic compares with both standard 1% tropicamide and 1% cyclopentolate in future trials. Here’s a senior project idea for optometry students looking to get a poster published at a significant meeting.

OUTSIDE THE LANE

Breast Milk to Treat Corneal Wounds?

Researchers at the University of Colorado School of Medicine are investigating the potential healing properties of human breast milk to treat corneal wounds. The school's recent study was inspired by various anecdotal reports from local mothers who used breast milk to treat their children’s eye injuries and infections, ranging from “pink eye” to chemical burns to blocked tear ducts.

Emily McCourt, MD, and Mark Petrash, PhD, led the research, which found that human breast milk significantly enhanced corneal healing compared with saline and prescription medications in animal models. The study measured the re-epithelialization of the cornea and higher levels of Ki67, a cell proliferation marker, in eyes treated with breast milk. Their findings strongly suggest that breast milk contains various bioactive molecules that promote healing, although the exact components responsible remain unknown. The researchers believe that breast milk could eventually be developed into an eye drop similar to available serum tears regularly used for severe dry eye disease and other inflammatory eye diseases.

My Two Cents

The human body is incredible. This isn’t the first time I’ve heard about the potential healing properties of breast milk, but I’ve always assumed mothers used their breast milk on their children. This study implies that it could potentially help heal anyone’s cornea.

CAN YOU RELATE

In today’s social media landscape, we are constantly surrounded by advertising in every conceivable way—banner ads, Google ads, targeted Facebook ads, and the ever-present social media “influencers” pushing products they get kickbacks on. Maybe I’m showing my age, but it’s borderline out of control!

On the topic of influencers, I know not everyone’s a fan, but I like and support a lot of them. Heck, many of my friends here in Louisiana are influencers in food and fashion. Not only that, but in my opinion, some of the best people in eye care are highly successful influencers who do things the right way. I’m looking at you, Joseph Allen, OD, FAAO, Dipl ABO, (@DoctorEyeHealth on Youtube, Eye Care Insiders on Eyetube, and other various media outlets), Nadia Afkhami, OD, (@eyeamdrnadia on Instagram), Jennifer Tsai, OD, (@drjenandjuice on Instagram), and countless others in the eye care space!

Jolene Kohne

However, one disturbing trend I’ve noticed is that various companies use influencers to poo-poo all over optometry. It’s no surprise that our friends at 1-800 Contacts have used social media to spread their message of skirting us as eye care practitioners. Influencer “Shawty.Got.Lowe” writes in her TikTok post, “Anyone else hate going to the eye doctor? Because same. That’s why I use @1-800 Contacts.” She describes how she can get an exam and her contact lenses without going to a doctor’s office. We also can’t forget the 1-800 Contacts TV spot ad that starts “Hold on! Are you still purchasing your lenses from your optometrist? What are you doing?!?!”

My personal favorite is related to a somewhat new company called “Cornea Care.” A Facebook post from “influencer” Jolene Kohne on starts off saying, “Things that an eye doctor would never tell you because they’d lose money.” She goes on to say, “If you have dry eyes or you’re strained from looking at a computer screen or a phone screen all day, you don’t need drops with chemicals that you can’t pronounce in them. Get you a self-heating eye compress… .” Ms. Kohne essentially claims that we, as eye care practitioners, withhold valuable medical information from our patients so they either purchase eye drops or get prescription medications, thereby insinuating that we’re a bunch of unethical crooks. That’s a lot to unpack, and it’s shameful to insinuate that eye doctors are criminals. I’m not sure what we’ve done as a profession to be the target of these ads, but as of this writing, this particular post has been seen by ~160,000 unique users. That’s a lot of people wrongfully being told that eye doctors are not to be trusted.

Keep an eye out for these attack ads, and feel free to share them with me via email. Let’s put these people on blast for their unethical and simply wrong portrayal of eye care professionals.