With the nation’s eyesight worsening, fuelled by an ageing population and unhealthy lifestyles, pharmacy teams should be advising on a healthy diet and recommending supplements where appropriate, says Victoria Goldman

Eye and ear care tend to be overlooked as pharmacy categories, yet the summer provides peak selling time for many OTC products. Pharmacies are often the first port of call for people with allergic conjunctivitis, sore red eyes, or ear discomfort. They are ideally placed to provide one-to-one expert advice and pharmacy-only products that supermarkets and groceries can’t offer.

“While these appear to be small categories for community pharmacy, among Numark members, eye care is the fourth largest sub- category within the P med section, taking 5.4 per cent of the category,” says Lynne Armstrong, director of marketing at Numark. “It is larger than sleep and women’s health. Within GSL, this story changes and its category share is 2.5 per cent.” Ear care accounts for 1.5 per cent of both the P and GSL categories, with most growth being seen in the GSL sector against last year.

Pharmacists play a vital role in advising customers on reducing the risk of sight loss from undetected and/or under-treated chronic eye conditions. “During medication reviews, pharmacists may come across patients undergoing hospital treatment for cataracts or age-related macular degeneration (AMD),” says Michelle Sutton, pharmacist for Butterflies Healthcare.

“They also dispense prescription products for dry eyes, blepharitis, glaucoma, eye infections and AMD supplements. The advice they give on using these treatments can dramatically improve compliance. Health promotion messages – such as the importance of regular eye tests for adults and children and giving up smoking – can also be conveyed.”

According to National Eye Health Week (September 22-28 this year), the nation’s eyesight is in decline, fuelled by an ageing population and unhealthy lifestyles. Francesca Marchetti, self-employed optometrist and former chair of National Eye Health Week, recommends that pharmacists use this year’s campaign as a launch pad to promote eye health to customers. “Go online to www.visionmatters.org.uk and register for a resource pack,” she says.

“Independent pharmacists could run an eye health event from a retail or health promotion point of view. In the past, some pharmacies have arranged a mascara amnesty – customers hand in their old mascara and get a discount on a new one, as they should be changing their eye make-up every three months to avoid infections. This provides the ideal opportunity to discuss wider eye health issues and introduce other relevant pharmacy services.”

Macular protection

Studies show that diet has a significant impact on vision. Customers at higher risk of sight loss, such as smokers or those with diabetes, should make sure they are eating enough antioxidants, in foods such as green leafy vegetables, brightly-coloured fruits and oily fish. Pharmacies can stock a wide range of eye health supplements, such as Vitabiotics’ Visionace and Quest’s Vision Life. “If a customer’s diet is inadequate, especially in carotenoids, they need to protect their eyes, especially in relation to macular health,” says Sharon Morey, Quest Vitamins’ nutritionist.

Customers who have been diagnosed with AMD should be advised to take eye care supplements such as Viteyes2 with formulations based on the AREDS2 clinical trials. “AREDS2 is a clinical trial published last year that fine-tuned the original formula, proven to reduce the risk of progression of AMD by 25 per cent,” says Ms Sutton. “These supplements are available on prescription in certain areas.”

Customers who have been diagnosed with AMD should be advised to take eye care supplements

MacuVision Gold is also based on the trial’s recommendations. “Supplementation of macular pigment, using its three constituent nutrients (lutein, zeaxanthin and meso- zeaxanthin), is conclusively proven to enrich macular pigment and enhance vision under glare conditions,” says Dr Mark Kirby, MacuVision’s scientific advisor. “Anyone with a poor intake of fruit and vegetables (particularly green, leafy vegetables) is likely to have low macular pigment. That individual, regardless of age or gender, can improve their visual performance through macular pigment supplementation in a period of four to eight weeks

Dry, irritated eyes

A consumer survey recently conducted for Murine revealed that 42 per cent of respondents said that the comfort of their eyes has a “fair amount” of impact on how they feel generally throughout the day. In the survey, the most common eye irritant was a lack of sleep, followed by sitting in front of a computer. “Eyes are a very delicate organ, and can be easily affected by external factors such as air conditioning and allergens, but also physiological factors such as diet and hormonal fluctuations,” says Murine’s optometrist Lara Hefson.

Fatty acids (especially omega-3s) may improve tear production and secretion. “The ratio of omega-3 fatty acids to omega-6 fatty acids in the diet has an important influence both on the risk of developing dry eye problems and the severity of symptoms,” says Melanie Tymm, product manager at Spectrum Thea Pharmaceuticals. “Subsequently, supplementation with the right balance of omega-3 and omega-6 can improve tear film stability and symptoms in dry eye sufferers. Hyabak Caps contain fish oil with 70 per cent omega-3 and borage oil with 22 per cent omega-6 and are designed to help compensate for the imbalance between omega-3 and omega-6 commonly found in UK diets.

Reckitt Benckiser recently launched the Optrex Eye Revive range, the first beauty products designed to restore moisture in and around the eyes. RB research shows that women take great care with their face, with 86 per cent regularly using moisturisers and anti-ageing facial skin care products. Despite the fact that eyes lose moisture and are affected by ageing as much as the skin, they are currently neglected until there is a problem.

“There is a big opportunity to drive eye care to the same levels as facial skincare,” says Mark Pearson, RB healthcare category marketing director. “Moisture is essential for youthful beauty and that goes for the eyes as well as the skin. We know that women place healthier, less tired-looking eyes within their top five priorities, but current products only enhance the appearance of skin around the eyes. We have developed three highly effective products that target the appearance of tired eyes from within.”

Ear, ear ...In March 2014, a study at the University of Manchester found that just a fifth of people with hearing problems wore a hearing aid. According to Action on Hearing Loss, of the two million people in the UK who do have hearing aids, only 1.4 million use them regularly. Pharmacists are ideally placed to identify customers who may have a problem with their hearing.

For example, customers may ask for advice on excessive ear wax (which can cause hearing loss, ear pain and a blocked ear). They can try suitable OTC products (eg, Otex Express ear drops or Cerumol Olive Oil ear drops). However, if their symptoms persist, they must seek professional advice from their GP or an audiologist. Swimmer’s ear is common during the summer holiday season, with around one in 10 people (mainly adults) being affected in their lifetime.

Also known as otitis externa, it often occurs when repeated or prolonged exposure to water damages the protective barrier function of the skin in the ear canal, allowing bacteria to flourish. EarCalm spray contains acetic acid, which may discourage bacterial growth. If OTC products fail to work, GPs can prescribe ear drops containing antibiotics, antifungals or steroids (or a combination product).