We’ve all been there. It usually occurs right in the middle of what we are convinced is a brilliant explanation of whatever condition is plaguing the patient sitting in front of us. We are going over pictures, graphs and using all the scientific words we were taught in school. We are certain the patient is totally absorbed in our speech but then we see it…a slight lid droop, the sparkle of the eye dims and then, sure enough, "The Glaze Over". We’ve lost them.

The last time this happened to me I was explaining Diabetic Retinopathy to a patient. When I saw the light go out I quickly wrapped up with some printed information and scheduled them to come back for a follow up. When I reflected on what had gone wrong in my explanation I realized I had included the following words in my discussion: retinopathy, exudates, macula, hemorrhage and edema.

The optometrists reading this didn’t skip a beat in that last sentence, but if a patient stumbled across this article they just had to hop back on the Schoolhouse Rock phonics page to get through it. This certainly isn’t an indication of intelligence. It’s simply that those aren’t words they use in a daily conversation so they have ZERO meaning to them. In addition to being devoid of meaning they also sound scary. I’ve found the two most common risk factors for Eye Glaze are poor communication and fear. I managed to induce both in my patient.

If we fail to communicate with our patients on their terms we might as well have not spoken in the first place. I find this frequently when I speak to my patients regarding supplements and particularly when I’m talking to patients who have no visible macular degeneration but have low MPOD scores that I want to address. Although I always manage to eventually squeeze in the words zeaxanthin and lutein, I certainly don’t lead with them. After years of bumbling through this presentation I’ve found a few key statements that seem to help me connect.

1.) “At this time you do NOT have Macular Degeneration.” I know this seem like a ridiculously silly statement to lead with but I’ve found that if I go straight into a discussion about how they can prevent future damage from this disease instead of telling them what THEIR status is, the Eye Glaze happens immediately. This occurs because as soon as their doctor starts having a serious conversation with them they are immediately certain they are going blind. They may be nodding at you but all they are thinking about is the allergy shots they are going to have to take to adapt to their new seeing-eye dog.

2.) “But you did score in a higher risk level on a test we perform that measures your macular health. That’s the part of your eye that controls all of your central vision.” They need to get what exactly what your talking about. Again, “macula” really doesn’t mean anything outside of the Eye Doctor world.

3.) “I love this test for two reasons. One, it lets us predict problems instead of dealing with them after they’ve occurred. Two, it allows us to monitor your risk over time.” Again, another seemingly benign statement but I’ve also found that patients want me to be excited about the technology I’m using and to tell them why. Excitement is contagious. Also, the “monitor your progress” part leads in to my next statement.

4.) “The beautiful thing about Macular Degeneration is that it can many times be controlled simply by nutrition alone. We don’t need to add a new prescription medication with side effects to deal with to your day. Now, I know taking vitamins can be confusing because there are so many different opinions out there about whether or not they are even needed, but when it comes to Macular Degeneration everyone actually agrees. Can you believe that?” Here’s the thing, everyone’s worried about being scammed. Vitamins are a very “scammable” business. We need to be up front, address the skepticism head on and give them the facts. “Everyone agrees on this” is the truth. I’ve yet to meet a doctor of any specialty that argues the benefits of supplementation for eye health. The research is too solid.

At this point I do introduce the vitamin I recommend and tell them why. I very briefly explain the fact that it follows the body’s lead and supplements in the same ratios that the nutrients zeaxanthin and lutein are already present in the human eye. To “supplement” means to add to what’s already there. If we truly want to preserve what their own eyes already have, why not just give them a boost rather than introducing it in a new way.

Supplements are such a tricky area. I’ve found that learning the correct verbiage not only prevents Eye Glaze, it also opens up a line of communication and trust that my patients come to depend on. I have been so pleasantly surprised at how open my patients are to discussing vitamins as well as how eager they are to share their own knowledge. This is a new era of the informed patient. Let’s work to keep their eyes not only healthy but bright and interested as well. Dr. Susan Lake is a native of Nebraska and a graduate of the University of Nebraska. She completed her Doctorate of Optometry from Southern College in Memphis. She is Board Certified in Vision Development and Vision Therapy and has a strong pediatric emphasis to her practice. She speaks frequently to parent and professional groups, sharing with them the importance of early recognition of vision problems. In her spare time she reads and contributes to her own blog discussing being a working Optometrist and Mom at Babyfocals.com. She and her husband share three Optometry practices and three daughters and they can all usually be found on a lake, in a boat and waterskiing.

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