Lenscrafters - Macular Degeneration

[eyesee123]

Advertisement - Members don't see this ad

I have a question about testing for macular degeneration. Lenscrafters now has a machine called Quantifeye that tests the level of the pigment in the macula by pressing a button when you see a light shimmer. If the number is low then they sell supplements and the patient has to be re-checked every 6 months to see if the supplements are working. What I don't understand is that ONLY Lenscrafters sells these particular supplements and has this machine. The supplements are supposed to be twice the amount of carotenoids than anything else out there in the market. If someone has low macular pigment shouldn't they be referred out, also because if they are then their medical insurance can cover the costs of treatment.

 

[admiralbean]

I have a question about testing for macular degeneration. Lenscrafters now has a machine called Quantifeye that tests the level of the pigment in the macula by pressing a button when you see a light shimmer. If the number is low then they sell supplements and the patient has to be re-checked every 6 months to see if the supplements are working. What I don't understand is that ONLY Lenscrafters sells these particular supplements and has this machine. The supplements are supposed to be twice the amount of carotenoids than anything else out there in the market. If someone has low macular pigment shouldn't they be referred out, also because if they are then their medical insurance can cover the costs of treatment.

We have the same machine in our clinic. I am a little skeptical of it since it is made and was loaned to us by the vitamin company (sketchy?). I took the test and got the lowest result possible as did many of my classmates. The majority of people barely got above what is considered "low risk" or "normal". Personally, I would never freak a patient out by telling them that they have higher risk of macular degen based solely on the results of that particular test. I may suggest vitamin supplements to patients with a family history of macular degen and/or a patient with a suspicious DFE...but that's about it.

 

[JMK2005]

I may suggest vitamin supplements to patients with a family history of macular degen and/or a patient with a suspicious DFE...but that's about it.

Why would you recommend vitamins to someone with just a family history? Will it reduce their risk?

 

[eyesee123]

Well I guess supplements have been given to patients suffering from macular degeneration for like 20 years. The difference now is the research has shown that Lutein and Zeaxanthin is the most important and this particular company (making the testing machine) has the patent to sell twice the amount of those carotenoids than any of the competitors and they have an exclusive deal to sell this supplements at Lenscrafters...so that is interesting that the machine is being used in optometry schools too. Do you guys also prescribe the supplements in your clinic? This is the company website, and it's interesting that they use one of the same images from the optomcas website lol! Maybe it's like a stock photo or something. http://www.zeavision.com/quantifeye.html

 

[eyesee123]

I'm pretty skeptical too. I have a friend that works at LC and he said that they practiced using the machine on each other and one day they had a low score and the next day had a high score. So I don't know how accurate it actually is. It just sounds like a sales gimmick to me because if someone has a low score the patient is scared into buying these supplements, has to be re-checked every 6 months, and on top of that will have to continue the supplements the rest of their life. Is there another way to test for macular pigment that is more consistent?

 

[admiralbean]

Why would you recommend vitamins to someone with just a family history? Will it reduce their risk?

Well, several studies have shown that vitamin supplements may reduce the risk and slow the progression of macular degeneration. A patient with a family history has a greater risk for development of the condition.

Also, I just want to make it clear that I haven't done any research on that instrument and I really don't know much about it. I am just speculating. We just got the machine a few weeks ago and as far as I know, we are not testing it out on patients. It is strictly being done on students for research purposes. I think the vitamin company came to SCO to do a presentation about it and then left it for some of the professors to try out.

 

[DOCTORSAIB]

Well, several studies have shown that vitamin supplements may reduce the risk and slow the progression of macular degeneration. A patient with a family history has a greater risk for development of the condition.

Your logic is not based on facts my friend. Please refer to the AREDS study for the correct answer.

Supplemental vitamins were proven to be beneficial in patients with INTERMEDIATE AMD. Not patients with early AMD and certainly not patients with just a FH (or with no signs of AMD whatsoever).

Evidence-based medicine!

 

[PBEA]

Your logic is not based on facts my friend. Please refer to the AREDS study for the correct answer.

Supplemental vitamins were proven to be beneficial in patients with INTERMEDIATE AMD. Not patients with early AMD and certainly not patients with just a FH (or with no signs of AMD whatsoever).

Evidence-based medicine!

absolutely true

 

[PBEA]

I have a question about testing for macular degeneration. Lenscrafters now has a machine called Quantifeye that tests the level of the pigment in the macula by pressing a button when you see a light shimmer. If the number is low then they sell supplements and the patient has to be re-checked every 6 months to see if the supplements are working. What I don't understand is that ONLY Lenscrafters sells these particular supplements and has this machine. The supplements are supposed to be twice the amount of carotenoids than anything else out there in the market. If someone has low macular pigment shouldn't they be referred out, also because if they are then their medical insurance can cover the costs of treatment.

this "device" is a gimmick nothing more.

 

[admiralbean]

Your logic is not based on facts my friend. Please refer to the AREDS study for the correct answer.

Supplemental vitamins were proven to be beneficial in patients with INTERMEDIATE AMD. Not patients with early AMD and certainly not patients with just a FH (or with no signs of AMD whatsoever).

Evidence-based medicine!

Yeah you're right. Maybe my point will hold true when AREDS 2 comes out...

 

[KHE]

Your logic is not based on facts my friend. Please refer to the AREDS study for the correct answer.

Supplemental vitamins were proven to be beneficial in patients with INTERMEDIATE AMD. Not patients with early AMD and certainly not patients with just a FH (or with no signs of AMD whatsoever).

Evidence-based medicine!

That is what the study said yet at the same time, everything we know about the pathophysiolgy of AMD would suggest that there's something peculiar about that result.

IIRC, there was something in the OHTS that actually suggested that being a diabetic actually had protective value with respect to glaucoma.

Yet I don't think too many doctors out there think that diabetics have less risk for glaucoma than non-diabetics.

 

[aarlan]

Well, several studies have shown that vitamin supplements may reduce the risk and slow the progression of macular degeneration. A patient with a family history has a greater risk for development of the condition.
.

correct me if I'm wrong but the AREDS study showed no benefit in terms of preventing the onset of AMD, NOR did it seem to affect Mild dry AMD progressing to Moderate dry AMD, OR moderate dry to severe dry, OR mild dry to proliferative NOR severe dry to proliferative.

My recollection was that it showed their combination of supplements showed a 25% reduction in Moderate dry AMD from progressing to proliferative (from 12% likely to 9% likely...not much benefit, but apparently statistically significant).

AA

 

[PBEA]

correct me if I'm wrong but the AREDS study showed no benefit in terms of preventing the onset of AMD, NOR did it seem to affect Mild dry AMD progressing to Moderate dry AMD, OR moderate dry to severe dry, OR mild dry to proliferative NOR severe dry to proliferative.

My recollection was that it showed their combination of supplements showed a 25% reduction in Moderate dry AMD from progressing to proliferative (from 12% likely to 9% likely...not much benefit, but apparently statistically significant).

AA

yeah and that's about it, not very exciting. I'm sure retail sales of "eye vitamins" has sky rocketed, despite limited value (and often NO value).

 

[Oogilily]

yeah and that's about it, not very exciting. I'm sure retail sales of "eye vitamins" has sky rocketed, despite limited value (and often NO value).

Agreed. Especially since they have a fancy machine that "measures" those pigments in their eyes. Patients will fall for that and be buying up the vitamins. I wonder if the docs at the Lenscrafters have any say whether to use the machine or not.

 

[eyesee123]

I don't think they have ANY say, at least in California where EyeExam of California is inside Lenscrafters. In other states, the optometrist is located next to a Lenscrafters but cannot share office space. That brings up a point about my initial question, if Lenscrafters is using this machine and selling these supplements shouldn't it already have been mainstream at the optometry schools?

 

[PBEA]

That brings up a point about my initial question, if Lenscrafters is using this machine and selling these supplements shouldn't it already have been mainstream at the optometry schools?

No, this machine is a gimmick with no value and/or accuracy. The only reason lenscrafters sell this test is to dupe the public. They want to sell vitamins and create the illusion that they give ashiit about you. It is a ploy, a bait, or a hook. They want to make money, and will sell as many pointless items they can think of, to do so. Do you "get it" NOW?

 

[eyesee123]

I totally understand what you are saying about the machine, but the supplements are good right? They are already sold (in lesser quantities) already to patients for macular degeneration. I just saw Dr. Oz a while ago and he said to the 2 carotenoids that are in these supplements improve vision. That's what I don't understand that if they are so good, why aren't they sold more places.

 

[JMK2005]

I totally understand what you are saying about the machine, but the supplements are good right? They are already sold (in lesser quantities) already to patients for macular degeneration. I just saw Dr. Oz a while ago and he said to the 2 carotenoids that are in these supplements improve vision. That's what I don't understand that if they are so good, why aren't they sold more places.

More is not always better.

Water is good for your body right? There is a certain amount you need. Anything over that is wasted.

With any treatment (including supplements), your risks have to outweigh the benefits. AREDS1 showed that the supplements did not make a difference for people with mild AMD but a small difference in the high risk group.

AREDS1 did not study Lutein. AREDS2 is looking at Lutein and Zeaxanthin. The results are not out yet, but it will give us better direction as to who will benefit most.

You don't want to recommend something if you're not sure if it will help or may even hurt the patient. We are professionals who are entrusted to advise our patients with the best available evidence, not be salesmen. Leave that to chiropractors who claim to cure cancer and a bunch of diseases "naturally".

Making the machine and selling the supplements is a serious conflict of interest and you should be very cautious about that. What do these test measurements mean anyways? If you have a certain score, does that mean you have an increased risk of developing AMD? If so, a 2x risk, 3x risk, etc? You can't treat people based on promises and scare tactics.

 

[eyesee123]

Yeah I agree about the conflict of interest between the machine/supplements. The test measures the macular pigment in the patient.

 

[KHE]

Making the machine and selling the supplements is a serious conflict of interest and you should be very cautious about that. What do these test measurements mean anyways? If you have a certain score, does that mean you have an increased risk of developing AMD? If so, a 2x risk, 3x risk, etc? You can't treat people based on promises and scare tactics.

I don't get where there's a conflict of interest. We can debate whether the machine is useful or not but where's the conflict?

 

[JMK2005]

I don't get where there's a conflict of interest. We can debate whether the machine is useful or not but where's the conflict?

The company has a financial interest in promoting the test and convincing people that a lower pigment score = increased risk of AMD = increased risk of vision loss.

Just like a drug sponsored talk. You have to be skeptical of the speaker when he is directly sponsored by the the drug he's talking about. Hard to be unbiased in that situation.

 

[PBEA]

I totally understand what you are saying about the machine, but the supplements are good right? They are already sold (in lesser quantities) already to patients for macular degeneration. I just saw Dr. Oz a while ago and he said to the 2 carotenoids that are in these supplements improve vision. That's what I don't understand that if they are so good, why aren't they sold more places.

"There is insufficient evidence to support the role of dietary antioxidants, including the use of dietary antioxidant supplements (including zeaxanthin), for the primary prevention of early AMD."

http://www.bmj.com/content/335/7623/755

That being true, then telling people that supplements will "prevent AMD", or even saying "will lower your risk for AMD", is purposely misleading. AREDS2 will attempt to shed more light on this.

 

[KHE]

The company has a financial interest in promoting the test and convincing people that a lower pigment score = increased risk of AMD = increased risk of vision loss.

Just like a drug sponsored talk. You have to be skeptical of the speaker when he is directly sponsored by the the drug he's talking about. Hard to be unbiased in that situation.

To me, that doesn't rise to the level of a "conflict of interest" because you can apply that line of reasoning to any drug, or surgical procedure. Is it a conflict of interest for a cataract surgeon to recommend cataract surgery?

 

[KHE]

"There is insufficient evidence to support the role of dietary antioxidants, including the use of dietary antioxidant supplements (including zeaxanthin), for the primary prevention of early AMD."

http://www.bmj.com/content/335/7623/755

That being true, then telling people that supplements will "prevent AMD", or even saying "will lower your risk for AMD", is purposely misleading. AREDS2 will attempt to shed more light on this.

In my practice we neither sell vitamins nor recommend them for people without AMD.

But knowing every thing we know about AMD, you would have to say that the supplementation would LIKELY lower the risk. We will see when AREDS2 comes out but I think we will find that this type of supplementation will reduce risk slightly. Then it becomes a personal choice. Do you want to spend the money?

 

[PBEA]

In my practice we neither sell vitamins nor recommend them for people without AMD.

But knowing every thing we know about AMD, you would have to say that the supplementation would LIKELY lower the risk. We will see when AREDS2 comes out but I think we will find that this type of supplementation will reduce risk slightly. Then it becomes a personal choice. Do you want to spend the money?

based on what? a hunch? There is pigment in the macula? so what? There is ALOT of speculation out there, and some people/companies are taking advantage of it. Even AREDS2 isn't looking at preventing of AMD, but like AREDS1, is looking only at progression of disease in those who ALREADY have AMD. So regardless of AREDS2 there will still be little to NO good evidence that taking vitamins does ANYTHING to prevent AMD in normals (which is what this quantifeye/maculoscope nonsense is trying to claim). If you've got good data showing otherwise, lets have it

I'd say buyer beware, for prospective lenscrafty patients there is a high probability that they will be sold on extra unecessary tests, falsely told that they have a "greater risk" for AMD, and mislead to believe that if they purchase their vitamins they will lower their risk. That's a pretty crappy trifecta (or as you prefer, "hat-trick"). No surprise really, as that powerful index of bullshiit is pretty reflective of the entire corporate optical business model.

 

[Visionary]

Interesting thread. Just ran across it.

The thing about AREDS is that when they initially evaluated the data, the supplements didn't do squat. It was only after they did post hoc analyses, the statistical methods of which were questionable, that they found the 25% reduction in 5-year risk of severe vision loss for those with intermediate to advanced AMD. That's really not a great effect, statistical methods notwithstanding. I actually don't push AREDS very hard, though I always offer them to potential candidates, because some already take so many meds. The extra expense and extra pills (sometimes 4/day) are an issue for some.

AREDS 2 is looking at the original formula, minus Vit A and with less zinc. It's also separately evaluating lutein, zeaxanthin, and omega-3 fatty acids. They're stacking the deck this time, though, by only including patients with intermediate and severe AMD. I'm still skeptical. Interestingly, AREDS is one of the few large, well-controlled studies that has shown any benefit to vitamin supplementation for any medical condition. Vit A has already been dropped from most formulas, because of the risk of lung cancer in smokers. There is a suggestion of heart failure risk and there are known bleeding issues with high doses of Vit E. We'll see in the next couple of years. Of course, companies are already peddling AREDS2 formula, despite the lack of any data.