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An uncomfortable truth

Dry eye may be the condition that poses a treatment conundrum, but optometrists are well placed to provide invaluable eye care support and evidence-based advice to patients, reiterates Henrietta Alderman

Henrietta Alderman

Dry eye is a challenging disease with many causes – age, environment, behaviour, other diseases – and there are several potential treatments.

It is already very common, affecting up to 33% of the population, depending on how it is defined. However many people have it, there will almost certainly be more in the future, as the condition is associated with age, screen use, and co-existing clinical conditions, all of which are on the increase.

As we know, the condition is uncomfortable rather than sight-threatening, but the discomfort can be extreme, and the condition cannot be cured in some cases. Patients may need to carry on using eye drops for many years. And for a small group it is considerably more serious.

"We were very concerned to see a recent NHS England public consultation document with proposals to no longer issue prescriptions for some over the counter products"

Patient support

We were very concerned to see a recent NHS England public consultation document with proposals to no longer issue prescriptions for some over the counter products. Dry eye was one of 25 conditions that were seen as appropriate for self-care and therefore patients would be expected to purchase treatment products themselves.

The AOP argued that this proposal would disproportionately affect those living with a disability and the elderly, pointing out that disposable income in these groups is lower than in the general population. Some 14% of pensioners fall within the absolute low-income category and, given the increased prevalence of dry eye related conditions within this age group, we argued that there is a real risk of disadvantaging this group. The consultation closed on 14 March and we are yet to hear what effect our representations had.

The recent reports of the US Dream study have underlined how important it is to keep up with developments in research. The study – a controlled trial over three years in which patients were given either omega 3 oil or an identical-looking capsule containing olive oil – showed that omega 3 was no more effective than the placebo.

This was covered in the popular media, and busy AOP members who have signed up to our Eyes in the news service through our online community forum will have been among the first to hear about it.

The findings about omega 3 go against the popular understanding of its value – and popular understanding is very hard to undermine, however strong the facts!

Optometrists, as trusted professionals, are in a strong position to pass on factual evidence-based health information to patients, and the AOP is here to provide support in that work, through our downloadable patient leaflets, our OT coverage and our CET.