they did,” Dr. Bower noted. The researchers also found that ophthalmologists practicing in rural areas were significantly more likely to believe that compliance with prescribed medication was affected by alternative medicine use than those in urban areas or those in academic practices. A total of 46 per cent of survey respondents indicated they believed that alternative medicines sometimes result in morbidity. On this note, those in practice less than 20 years
were significantly less likely to believe alternative medicine use results in morbidity than those in practice for 20 years or more. Only nine per cent of respondents actually recommend the use of alternative medicines to glaucoma patients. If they did, those in practice less than 20 years were significantly more likely to recommend their use than those in practice at least 20 years. Ginkgo biloba was the most commonly recommended alternative
at 21 per cent followed by exercise, antioxidant vitamins and a healthy diet. However, some studies suggest ginkgo can cause increased bleeding, others suggest a possible improvement in blood flow, and some suggest there is an interaction with blood thinner medications that could affect eye disease such as glaucoma or macular degeneration. Currently, there are no randomized control studies or other types of studies to prove the usefulness or harm of complementary and alternative medicines for a patient’s glaucoma. Dr. Cindy Hutnik, Associate Professor of Ophthalmology and Pathology, University of Western Ontario, was not involved in the study but offered additional comments. She notes complementary and alternative medicines (CAMs) are somewhat like the generics in the pharmaceutical industry—there is no incentive to do good science on them because of poor financial returns. A ‘real danger’ is that some patients believe alternative therapies are as good as, or better than, what their doctors suggest. Some may stop their prescribed therapy in favour of a herbal remedy or other treatment. “You think patients are doing what you told them to do, but they’re not and unfortunately, the CAM industry is not regulated,” Dr. Hutnik said. “Communication with patients has to be more in depth because patients can really start going off on the wrong pathway.” In a past survey, 14 per cent of Canadian glaucoma patients indicated they were currently using or had used alternative medicines for treatment of their eye disease. •
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OPTICAL PRISM | SEPTEMBER 2013