Eyeworld

AUG 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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EW CATARACT 24 "A lot of this is multifactorial, and some of the finding may be coin- cident and circumstantial to other factors," he said. For instance, peo- ple may be representing an overall decrease in age-related deterioration in sensory functioning of all types, not just vision. "There was no comparison made to a random mix of the general population simply for age and then to compare the modifiable behaviors with that group as a true baseline, rather than to 'cleaner-living' people," he said. While people who are moderate drinkers may not be harming their vision, "that it's protective against visual impairment makes little sense to me," Dr. Patterson said. "A lot of older people have other ailments and are not allowed to drink on their medication, which may be a factor that was not discussed." Take-home messages Dr. Berstein added that healthier people tend to see more specialists (ophthalmologists and optometrists among them) and may, therefore, have any visual impairment, in- cluding cataracts, recognized at an earlier stage than people who are sedentary and not as likely to see eyecare specialists. While the study had some interesting points, "we would have to be extraordinarily careful before concluding that we should start tell- ing our teetotaler patients to start drinking," Dr. Patterson said. "Up to 1 drink a day for women and 2 for men is fine. There's very little that contradicts that in the literature or here. One or 2 drinks probably won't hurt your eyes." According to the study authors, "those who had not consumed alco- holic beverages in the past year had a 100% increased odds of incident visual impairment compared with occasional drinkers." The authors further stated that there were no statistically significant protective associations of drinking at least 1 drink (be it beer, wine, or liquor) and "no deleterious association of heavy drinking with change in the number of letters read correctly or the incidence of visual impairment." Dr. Patterson said it would be helpful if the authors would elaborate on the associative factor compared with the risk and effect, and recommends "a more caution- ary aspect" to interpreting the data. "The 'link' may end up being just circumstantial," he said. The active lifestyle measures showed 70% lower odds of develop- ing exudative macular degeneration, "so once again in terms of clinical recommendations, not smoking, occasional drinking, and physically active lifestyle would be the take-home messages relevant to patients in clinical practice," Dr. Berstein said. "However, these behaviors may simply be 'markers' for other root factors that are the true underlying association with preservation of vision," he said. "Further study is needed to actually address if the modification of the behaviors will achieve the anticipated outcome." EW Reference 1. Klein R, Lee KE, Gangnon RE, Klein BEK. Relation of smoking, drinking, and physical activity to changes in vision over a 20-year period: The Beaver Dam Eye Study. Ophthalmology, in press. Editors' note: The physicians have no financial interests related to their comments. Contact information Berstein: larpbmd@aol.com Patterson: larryp@ecotn.com August 2014 Unlike Any Other! Drinking in moderation continued from page 23

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