Article Date: 5/1/2013

Gearing Up For Sunwear Season
visioncare

Gearing Up For Sunwear Season

Educating your patients leads to more sunwear purchases.

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PETER G. SHAW-MCMINN, O.D., RIVERSIDE, CALIE

In a survey conducted among roughly 110,000 American adults, 2.4 million pairs of sunglasses were sold in optical chains and independent practices, says the Vision Council. This is compared with 35.4 million sunglasses sold in drug/grocery/mass/warehouse club stores.1 A separate survey indicates that 16.1% of Americans wear sunglasses due to health concerns, compared with 63.8% who wear sunglasses to protect from glare and 11.7% who wear sunglasses for style reasons.2 Our patients are not as educated as they should be regarding the effect of the sun’s UV rays on ocular health, and the potential exists to increase our sunwear sales.

Here, I explain how to use certain portions of the comprehensive exam to stress the importance of sun protection, which leads to an increase in sunwear sales.

Be Aware of Photosensitizing Drugs

Certain substances can increase sensitivity to light and the reactions it induces, often at low exposure levels. Chromophores are molecules that absorb light energy in our tissues. A photosensitizing (or phototoxic) reaction occurs when the chromophore remits the light energy and initiates potentially harmful changes in other molecules.

Some systemic medications are photosensitizers and exacerbate the damaging effects of UVR on ocular structures and vision.

The following is a list of photosensitizing drugs:

• Cardiac antiarrythmia (amiodorone)
• Antihypertensive agents (diuretics)
• Antidepressants
• Antipsychotics
• Isotretinoin
• HIV/AIDS agents
• Cancer drugs
• Erectile dysfunction agents
• Nonsteroidal anti-inflammatory drugs
• Psoralens
• Oral contraceptives
• Tetracycline
• Verteporfin
• Herbal products

Biomicroscopy

During, this part of the exam, I say, “I’m looking at the lens on the front of your eye, called the cornea, and it is clear. Much like it tans your skin, the sun ‘tans’ the lens inside your eye. The difference is we get new skin cells an average of every 26 days, while the lens inside your eye has to last your entire life. As you age, your lens get darker and darker until the light cannot get through it, and we call it a cataract. With today’s sunlenses, you significantly decrease your risk of cataracts.”

"Much like it tans your skin, the sun 'tans' the lens inside your eye."

Ophthalmoscopy

I point to the intraocular lens in a cross-section of the eye and say: “This is the lens that absorbs the sunlight and gets dark. If we don’t protect it, it will continue to get dark and cloudy until the light can’t get through it, or it becomes a cataract. You should know that cataracts don’t ‘grow’ — that is a misnomer. It is the lens inside our eye getting dark and distorted.” I also refer to the process as the cataract ripening, much like fruit ripens. I tell patients if they wear good sunglasses, it slows the “ripening” process. Then I point to a photo of the fundus and say, “Sunglasses also help prevent macular degeneration, for which there is no cure.”

Additional education

We also need to teach our patients that light has energy that can cause changes in our eyes. For an example of how much energy light has, point out the difference of standing in the sunlight vs. the shade: “If you want to get an idea of how much light can be reflected, just go outside in the sun with your sunglasses, and cup your hands on the sides of the frame. You will notice instant relief.”

UV-Blocking Contact Lenses

Stephen Cohen, O.D., Scottsdale, Ariz.

For patients who need vision correction, I always recommend UV-blocking contact lenses as part of a comprehensive approach to sun protection, in conjunction with high-quality sunglasses and a wide-brimmed hat.

I practice in one of the sunniest spots in the U.S., but the reality is that UV damage accumulates even in the winter and on cloudy days–times when people can benefit from the additional protection of a UV-blocking contact lens.

I discuss the potential for both short and long-term UV damage and options for UV protection with every patient. I explain that not all contact lenses offer UV protection, and of those that do, not all provide similar absorption levels.

I strongly recommend contact lenses that meet industry standards for Class 1 or Class 2 UV transmission. All else being equal, I think wearing a contact lens with this degree of UV protection is a smart choice.

When patients learn that contact lenses can help block UV rays that reach the cornea, while still offering the comfort and vision they expect, there is a high level of enthusiasm for them, particularly among parents who recognize that their children spend lots of time outdoors and aren’t always perfectly compliant with other forms of sunwear.

Although there are no long-term human studies on it, we do know that ultraviolet rays damage the eyes over time. Recommending contact lenses with added UV protection is not only sound advice, but it also sends a message to my patients that I care about the long-term well-being of their families.

— Dr. Cohen is a paid consultant for VISTAKON Division of Johnson & Johnson Vision Care, Inc. E-mail him at stephen.cohen@doctormyeyes.net.

End of exam

I end the exam by explaining: “I am prescribing sunlenses for you to protect your eyes and help prevent eye disease. They will be brown to cut out high energy blue light and polarized with sunshield to reduce the disabling glare with sunshield to block the UV light from going through the lens while also preventing the UV rays from reflecting off the back of the lenses. When you return next year, we’ll see whether the lens inside your eye is getting any darker. (See “Be Aware of Photosensitizing Drugs,” page 62.) Here is our optician. He/she is going to show you what we have and how we can ensure your sunwear won’t block your peripheral vision from driving.”

An educated patient

Once your patients learn of what sunglasses can do for them, they will be willing to buy them. It is up to us to educate them. After all, no one else is going to. OM

1. Vision Council Research. Vision-Watch December 2012 Plano Sunglass Sales.

2. Vision Council Research. The Vision Council Consumer Sunglass Survey: January 2012.

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Dr. Shaw-McMinn practices at Woodcrest Vision Center Optometry. He is a diplomate of the American Board of Optometry and an assistant professor at the Southern California College of Optometry. E-mail him at shawmc1@me.com, or send comments to optometricmanagement@gmail.com.



Optometric Management, Volume: 48 , Issue: May 2013, page(s): 62 - 65