Herbal Tea for Presbyopia Treatment?

HOT TOPIC

Drink Away Dry Eye, Presbyopia, and More?

A study in Medicina found that presbyopia, dry eye symptoms, and IOP improved in patients who drank cassia tea. For the unaware, cassia, or senna, tea is a traditional herbal tea made from the seeds of Senna obtusifolia. It’s a popular drink in Asian cultures, particularly valued for its eye health and digestion benefits.

This large study of 425 eyes from 425 participants who were an average of 52.5 years of age showed that those who consumed 10 g of cassia brewed in 500 cc of water daily achieved the benefits listed above when compared with the control group, which consumed 500 cc of plain water along with 1,000 mg of vitamin C each day. After 4 months of the treatment, participants noted increased tear volume, reduced IOP, and pupil constriction, yielding better near vision. The antioxidant activity of cassia tea was “found to surpass that of anthocyanins, wolfberry, and vitamin C.”

The study concluded that regularly drinking cassia tea improves dry eye symptoms, reduces IOP, regulates pupil size, and enhances near vision due to its excellent antioxidant and pharmacological properties.

My Two Cents

This is … a lot to take in. Maybe cassia tea is some super potion we’ve just never heard of. Admittedly, the results are so good they’re suspicious. Perhaps this is “big tea” making a marketing ploy to get us to start recommending more tea for our patients, or more likely it’s another example of natural products that may yield the answers to some of our most common problems. A fitting statement to be made because I happen to be writing this on Earth Day!

OUTSIDE THE LANE

Controlled Blood Pressure May Reduce Risk of Dementia, Study Finds

A recent study published in Nature Medicine highlights a significant link between “intensive” blood pressure control and reduced dementia risk, offering insights relevant to optometrists who may observe related ocular signs.

The large-scale, randomized trial involved 33,995 rural Chinese adults 40 years of age and older with uncontrolled hypertension who were divided into two groups: one receiving usual care and the other managed by trained nonphysician community health care providers prescribing titrated antihypertensive medications to achieve blood pressure below 130 mm Hg/80 mm Hg.

After 4 years, the intensive control group showed a 15% lower risk of dementia and a 16% reduction in cognitive impairment compared with the usual care group. This suggests that aggressive hypertension management could be a primary preventive strategy for dementia. Optometrists should know that hypertension can manifest in the eyes as hypertensive retinopathy, with signs such as retinal hemorrhages or narrowed arterioles, which may correlate with risks of cognitive decline. This study underscores the importance of addressing cardiovascular risk factors, including blood pressure, to enhance overall brain health and quality of life. While limitations include a lack of baseline cognitive assessments, the findings advocate for interdisciplinary collaboration so optometrists can play a role in identifying hypertension-related ocular changes and referring patients for comprehensive care. Encouraging lifestyle modifications and medication adherence in patients with hypertensive ocular signs could further support dementia prevention efforts.

My Two Cents

If you haven’t seen the trend in my newsletters thus far, I’m about tying eye care into the general health care system. We are truly frontline health care providers! How often have you seen a patient who hasn’t been to a doctor in years? These patients usually show up in their 40s with issues reading or even later when nothing seems to work for them. We have the tools to get these patients into the health care system! If you see something out of the ordinary saysomething! Don’t be afraid to bill medical for your medical expertise.

CAN YOU RELATE

Every week, there seems to be an update about a new test we need to use or a new protocol we should follow, either to ensure the best care possible for our patients or the care insurance requires to achieve that juicy $40 exam reimbursement from vision plans.

One of the more interesting things I’ve stumbled across recently is that the American Academy of Ophthalmology’s (AAO’s) 2024 Preferred Practice Patterns (PPP) Guideline for diabetic retinopathy management has officially included electroretinography (ERG) in its recommendations. Additionally, the AAO’s Dry Eye Syndrome PPP has been updated to include Miebo (Bausch + Lomb). As members of the eye care community, paying attention to these guidelines is incredibly important, as they give us a good framework for what we should consider when caring for our patients. Check out the AAO’s website if you like to nerd out like I do. The guidelines are pretty incredible.

Not to be outdone, our American Optometric Association also has its own clinical practice guidelines! You can find those here.

Briefly returning to the topic of ERG, LKC Technologies has a pretty nifty ERG device that is not nearly as cumbersome as older versions. After reading the AAO’s Diabetic Retinopathy PPP, we’ll be looking to incorporate this technology into our patient visits.

Now, I might sound like a broken record, but we must intertwine ourselves in the health care system, and being familiar with these PPPs is a great start. Our patients are more than just a set of eyes—there’s a whole body attached to them. Just today, I saw a patient who I had referred out to oculoplastics due to a new (and extremely subtle) ptosis that didn’t sit right with me. I called in a consult with the oculoplastics team, which led to an MRI, that led to the discovery of not one, but four brain aneurysms! My gut feeling may have saved my patient’s life. She came in for a glasses exam because her prescription had expired and instead left with the directive that her eyelid needed a closer look.