The question of how to maintain quality healthcare standards while forging ahead into new discoveries and developments is baffling to many clinicians. Optometry’s success in the coming years will depend on the ability of ODs to overcome challenges like economic competitiveness and utilize and grow alongside technological advances that are changing the way business is conducted, like artificial intelligence. Diving into the approximately 5,500 publications of peer reviewed materials exchanged on the National Library of Medicine every day is a great place to start if ODs can come up with the energy and time expenditures to do so. AI is here to help.
However, five iterations of universal United States Department of Agriculture (USDA) dietary recommendations have failed to take into account the tide of cellular insulin insensitivity, non-alcoholic fatty liver disease, and the growing diabetes epidemic that currently plagues our most vulnerable citizens.4,5
According to the Centers for Disease Control, more than 100 million U.S. adults are living with diabetes or prediabetes.6 Our own experience as patients and optometric physicians suggest a broken “disease management system,” inconsistent with scientific data available through NLM. We know that genetics plays a role in chronic disease such as age-related macular degeneration (AMD), but the story does not end there, even if the way we tell it does. Epigenetics plays a much larger role.7
Furthermore, there is no single magic diagnostic test, pharmaceutical, or nutrient for progressive retinopathy/choroidopathy. Lifestyle, which encompasses a broad range of ancient nutrients and minimization or modulation of modern stressors, is the task at hand as exemplified by my own life’s work and more recently by ophthalmologist Chris Knobbe, MD.8-10
Perspectives of residency educator
My challenge as a residency coordinator is to cover the medically essential information first, then the chronic ocular disease aspect of the teaching program. That is, I must emphasize to new optometrists their responsibilities to detect, diagnose, and manage (i.e., appropriately refer) life- and vision-threatening diseases.
The most prevalent challenges include an aging population and the resulting high clinical traffic in medical emergencies, chronic oculo-vascular disease, and eye cancers. All contemporary optometric institutions embrace this approach. This is no small task for even seasoned practitioners. Several “must know” conditions for residents are listed in Table 1.
1. Topol E. Deep Medicine. 1st Edition. Hatchett Books, New York, NY. 2019.
2. Lipton BH. The Biology of Belief, Unleashing the Power of Consciousness, Matter and Miracles. 10th Edition. Hay House, Inc. Carlsbad, CA. 2016.
3. Lustig, R. Video: Sugar the Bitter Truth, https://youtu.be/ dBnniua6-oM. Accessed 1/29/20.
4. Lustig, R. Sugar the Bitter Truth. Plume, Penguin Group. New York, NY. 2014.
5. Richer S. Is there a prevention and treatment strategy for age related macular degeneration? J Am Optom Assoc. 1993;64(12):838-50.
6. Centers for Disease Control. National Diabetes Statistics Report, 2017. Available at: https://www.cdc.gov/diabetes/ pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed 1/29/30.
7. Richer S, Gelb K, Jaffe R. Windows into Wellness: Eight Biomarkers You Should Know. Rev Optom. 2018 Sept 15, 2018, pages 30-33..
8. Knobbe C. Ancestral Dietary Strategy to Prevent and Treat Macular Degeneration. 1st edition. Cure AMD Foundation. Boulder, CO. 2016.
9. Richer S, Poteet J, Ruskin D, Summerton S, Hitchmoth D. Wellness Essentials for Clinical Practice, 2nd Edition. Suppl Rev Optom. 15 October 2018.
10. Richer S, Poteet J, Ruskin D, Summerton S, Hitchmoth D. Wellness Essentials for Clinical Practice. 3nd Edition. Suppl Rev Optom. 15 October 2019.
11. Bureau of Labor Statistics. Occupational Outlook Handbook: Optometrists. Available at: https://www.bls.gov/ ooh/healthcare/optometrists.htm. Accessed 1/29/20.
12. Chester W, Engfehr K, Gelb, K. Open your Eyes. https:// www.imdb.com/title/tt11487298/?ref_=nm_knf_i2. Accessed 1/29/20.