Health & Wellness

Mind, Body, Soul

I think it’s fair to say 2020 has been a tough year that has upended our lives in many different ways. Getting through a global pandemic, along with the added pressure of optometry school, challenged my mental and physical health in ways they’ve never been before.  

As someone who truly values routine in my life, I found myself struggling when this structure was no longer there. The turning point for me was when I stopped resisting all these changes and accepted it. This acceptance shifted my mentality from victimhood to a growth mindset which then allowed me to adapt to the changing circumstances. 

Now whether you’ve had a similar experience to me this past year or maybe you’re battling your own respective challenges, I would love to share some tips that helped prosper my health and wellness during these turbulent times. My approaches focused on nourishing the three domains of my wellbeing that I felt were most important: mind, body and soul.  

Mind 

As students in optometry school, I feel like our mind and mental capacity are challenged on the daily. Or maybe it challenges how much information we can shove in our head four hours before an exam. Nonetheless, our minds are consistently engaged in this aspect. 

As important as it is to challenge our mind, I think it’s just as important to give it the rest it needs. Prioritizing my sleep has been one of my goals this past year and it has had profound impact on my mental health. If I have an exam the next day, I try my best to study all the material before a reasonable time so that I can get at least 7-8 hours of sleep. This shift was made possible after I self-acknowledged that my well-being is more important to me than getting a perfect score on a test. 

Another realm of our minds is our thought processes. This past year I realized the importance of having these thought processes challenged. Oftentimes, our views on certain topics and the way we think about certain things can be linear and based on the way we were raised along with our individual experiences. Having these thoughts challenged can possibly widen our perspective and provide a deeper sense of compassion. I believe developing compassion is one of the most empowering characteristics to possess as health care providers. 

Body 

As up and coming health care professionals, I believe the importance of staying active and getting a daily dose of physical activity has been stressed more than enough. I can attest to the countless benefits I’ve experienced in my everyday life due to this practice.  

Prior to lockdown, my routine consisted of going to our school gym first thing in the morning. However, once lockdown started, I was left in my bedroom with a yoga mat and some make-shift dumbbells that were less than ideal. My motivation to get that daily exercise became extremely diminished, but I knew it had to get done. That 45 minutes of physical activity resulted in a full day of increased energy and better mood. I also came to the realization that starting my day off with exercise made the other tasks I had to complete in the day much more attainable. 

If you’ve already established this habit in your life, I’m sure you’ve also experienced these wide range of benefits. If you’re someone who‘s been looking for some extra motivation to get started, I hope reading this has been able to give you some of that. You should get started with an activity you enjoy (biking or yoga) at a time interval that’s comfortable and slowly start working your way up. 

Soul 

The soul is the core of our being. The times where I feel the most in tune with it is when I’m not thinking about anything and just focused on the moment at hand. As trite as it may sound, I feel the most connected when I’m walking through the forest. There’s something about the organized chaos that grounds me and engages all my senses in a way that nothing else can. I have tried to make this a habit once a week and I’ve noticed that it provides me with this sense of clarity and awakening that coffee can’t achieve.  

In today’s world, it can get hard to have some time to yourself where you’re not bombarded with notifications and the upsetting news around the world. Therefore, actively seeking those moments where you don’t have to engage in anything except yourself can be very powerful. I live close to a forest so those walks are what bring me peace, but your practice can be individual to you. Whether it’s meditation, yoga or just sitting on grass and watching the sky; I think you’ll find profound benefits in slowing everything down in a world that’s constantly moving. 

I personally don’t have it all figured out, but these are just some of the things that have helped me this past year. I’m sure these are things you already know, but sometimes it takes reading it at the right time to actually implement it. As we move into 2021, let’s prioritize our health and wellbeing and start to welcome change.

Health & Wellness

Building Community Care as Mental Health Support in Optometry School

My Experience with Mental Health
During my first year of optometry school, I had a difficult transition that eventually led to challenges academically. I wish I could tell a straightforward story of how I didn’t know how to properly study or balance my academic life, and that working harder led to my success–but my story, as with any person’s story, is much more nuanced than that. Living with mental illness, my story often gets reduced by the common discourse around mental health that is shaped by the medical model of mental health and disability​. The medical model defines a person by their impairments or differences, and focuses on how to fix or change these differences by medical or other treatments, with the goal of eventually curing a person so they can be normalized and reintegrated into society. Even language around mental health often uses stigmatizing words such as “suffering from” or “struggling with” a certain mental illness, and that the individual must be responsible for fixing what is wrong with them in order to be productive, functioning, and successful. Alternatively, there is the social model of mental health and disability. The social model focuses on the way society is organized and what barriers and opportunities are available for a person. It is not about what is wrong with a person, but rather what can be changed about the system or environment a person is in. Suddenly I realized that my difficult transition into optometry school wasn’t because of my mental illness–it was because accessing resources and support systems for me to thrive with my mental illness were particularly challenging in respect to my unique circumstances and marginalization of my identities. With this understanding of the social model of mental health, I became determined to share my experiences and work with others to shift the mental health discourse within my own community.
Mental Health During 2020
Fast forward two years to today, conversation about the increase in mental illness during the COVID-19 pandemic has become widespread. In a September 2020 ​article from Science​,40% of surveyed graduate students in STEM had reported symptoms of anxiety and depression, increasing nearly 20 percentage points from 2019. When considering our optometric student community, I can only imagine how this has been a particularly difficult year,especially for our first year students or any students experiencing a drastic transition. But let’s remember to be specific about what’s causing this current increase in mental illness. This year’s COVID-19 pandemic and protests for racial justice brought us a heightened understanding of inequity and injustice–so when we speak about how COVID-19 has increased mental illness, we must speak specifically about the social and economic conditions that impact mental illness because doing so enables us to find tangible ways to shift our focus from awareness to action.
Student Action
Last year, a small group of us students formed a Wellness Committee to augment the existing mental health resources at our school and highlight events throughout the city that address mental health and well being. But this year, we recognized awareness and self-care
wasn’t enough. As diversity and inclusion efforts at colleges of optometry have been working to address systemic racism and the environments of our schools, we saw that ableism and mental health were often addressed separately or left out of this picture. Shining a light on privilege causes us to no longer assume that everyone can access the same routes of healing or have universally successful experiences with mainstream mental health care. We decided to form the first optometry school chapter of the national organization ​Project LETS​ (Let’s Erase the Stigma); a peer-led grassroots organization that centers the voices of people with lived-experience of trauma, mental illness, chronic illness, disability, and neurodivergence. Our goal became that of building: community care, peer support collectives, inter-sectional education,and our capacity for responding to and transforming harm.
What is community care?
Community care is how we will be able to begin addressing issues of oppression such as racism, xenophobia, Anti-semitism, Islamophobia, homophobia, transphobia, ableism, and soon​. ​It is the ways in which we facilitate community interactions, conversations, and structures of support. It is rooted in how we hold empathy within groups and between groups, such as that of students, faculty, staff, and patients. It is our understanding that there are factors affecting all of us that self-care and individual pursuits of healing alone cannot achieve. When it comes to trauma and oppression of marginalized peoples and identities, we need relational healing.
What are different barriers to mental health support?
We cannot assume everyone has supportive friends and family, are able to talk to someone, has access to therapy or medication, has insurance, is able to advocate for themselves, is able to safely share their story, can access certain mental health language or information, or is empowered by the same resources. For example, not all students can feel safe sharing their experiences to individuals of greater hierarchical power such as faculty or administrators. Not all people find hotlines or textlines helpful during times of crisis, and could potentially be further harmed if police or emergency responders are called while in crisis. Our widespread discourse can also be a barrier to mental health support. As a community, challenging the medical model of mental health and disability, and opening up to other models could be a helpful tool for some to contextualize and navigate healing in a way that won’t further their feelings of being isolated and pathologized due to their experience. In doing so, we also can shift away from thinking happiness means being free or cured of mental illness. We can begin to view healing as a non-linear journey that is about the process more than it is about the end goal. Considering the ​intersections​ of a person’s identities, we must also recognize the barriers that exist due to systemic and societal marginalization and oppression. These are factors we don’t always consider when we are thinking about a student’s academic success.
What can peer support in optometry school look like?
Having structures for peer support is important because it breaks down some of the barriers listed above for accessing mental health resources. Peers can share their similar experiences and help their peers find autonomy and hope. For us, forming a chapter of Project LETS enables students with lived experience to apply to become Peer Mental Health Advocates (PMHAs) and be provided training by the national organization. This is a ​16-hour training that isdeveloped by peers with lived experience, and informed by Intentional Peer Support (IPS) and Certified Peer Recovery Specialist (CPRS) curricula. PMHAs engage with a variety of topics during training including: principles of Disability Justice, the history of psychiatry,empathetic listening skills, crisis response skills, cultural competency in peer support,building crisis and safety plans, etc. Our hope in the future is to have faculty and staff become PMHAs for each other as well.
Why is community care important for the broader optometric community?
When we talk about community care, we are extending our responsibility of addressing mental health, ableism, marginalization, and harm to the greater community and society rather than the individual. With community care, we are viewing mental health through a disability justice lens. Our goal in optometry is to help people see, but through a disability justice lens, our goal is to prevent or reduce the impacts of visual disability and make environments more accessible. For example, it could even be as simple as ensuring a person with myopia has eyeglasses so they can learn at school–but through the social model of disability we know that accessing eyeglasses isn’t so simple for everyone. It is through these frameworks that a parallel between mental health and optometry exists, and we become better able to address the barriers for people with mental illness, and the barriers for our optometric patient community. Without recognizing this, the ableism that we internalize as students later becomes the ableism we practice with as optometrists.
Advocacy

We Are Legislated

Leading up to optometry school, I was excited to learn about the human eye and how it interacted with the rest of the human body. On the first day of school, I was met with a number of important names, phrases and guidance that I was told would help me be successful through the program. However, one phrase emphasized by the dean of our college that stuck out to me was,Optometry is a legislative profession.” He repeated this sentence over and over, hammering it into our brains like it was gospel, ensuring we would never forget. I was surprised by his determination to make such a point on the importance of legislation in the profession of optometry. I thought to myself,I signed up to be a doctor, not a lawyer!” However, I quickly grew to realize how important being involved in the laws shaping optometry are for each state. 

As a second-year optometry student, I will be the first to admit I still have much to learn about the role of advocacy and how a student can be involved in promoting the legal scope of their profession. However, I wanted to use this short paper to recount my journey with advocacy and share what I have learned over the past year and a half: 

  1. Optometry is a legal profession.

As I discovered very quickly, optometry is a legal profession, meaning the procedures and techniques optometrists are allowed to perform on patients varies based on the states where they practice. The “laws” setting the boundaries for which optometrists can practice are adjusted primarily through the passing of state laws. Because of this, much work is required to promote and push for the advancement (or protection) of the scope of practice in each state. This is a driver behind why having a strong state affiliation is essential for the health of each state’s profession. To take a deeper look into the varying scope of practice for each state, I have included a link to a great resource for comparing among states. 

https://www.optometrystudents.com/legislative-list/ 

  1. Lawmakers are people, too.

Prior to getting involved in AOSA, I assumed the individuals involved in policymaking were untouchable or completely out of reach to a student like me. However, I soon realized state and federal law makers are just people looking to serve us and are able to be contacted and talked with if the correct arrangements are made. A directory for each state and federal legislator is available online. I’ve posted a link to an example of one below.  

https://www.house.gov/representatives/find-your-representative#:~:text=If%20you%20know%20who%20your,the%20U.S.%20House%20switchboard%20operator. 

  1. Even as a student, you can get involved.

While one act may seem small or insignificant, every step you take really counts. Since getting involved at my school, I have had the opportunity to lobby at the state capital, meet with federal senators, help campaign door-to-door for a local state representative, and even discuss with patients state questions that were coming up on the ballot. If I am completely honest, there were times I felt my time and effort pushing for a new bill was falling on deaf ears. However, when my investment of time or energy was met with interest and acceptance, I realized the effort invested into the promotion of the profession was worth it.  

  1. Go!

As discussed in a previous article by the Michigan College of Optometry trustee (https://theaosa.org/where-do-i-start/), you can get involved by connecting with your school’s AOSA chapter, reaching out to your state affiliation, talking with your legislators and staying up to date on recent optometric news. Life isn’t going to slow down when you leave school, so if being involved in the expansion and protection of optometry is something you want to be a part of, start now! Even if that first step looks like signing up to be a member of AOSA, keep looking for the next opportunity to get involved and make your voice heard in your industry.  

It is my hope that the profession of optometry will continue to evolve so that patients will have better access to the best care possible. I believe this can only be done through the combined efforts of students, doctors and legislators working to promote and protect the optometric profession. I look forward to the lessons I will continue to learn about advocacy and hope these small tips will help you grow in your own career and student journey.  

Advocacy

Local Action

Regardless of how you feel about the outcome of this year’s presidential election, I’m sure most people will agree that it’s a stressful time to live in the United States. That single day in November feels like it will set the tone for the next four years of our lives and we all have our own ideas about what’s best for ourselves, our family, and our country.

As student optometrists I’m sure you are already aware, or soon will be, that our future profession is heavily intertwined with the legislative process. But when we advance the optometric profession’s scope of practice, it often has nothing to do with what’s going on at the federal level. For example, the American Optometric Association’s major breakthrough in Arkansas, allowing optometrists to continue doing procedures like a selective laser trabeculoplasty and injections, was all done at the state level. The implications for this outstanding result will have ripple effects on the national level, however, as the precedent has been set.

Change starts at the local level and spreads. Continue to pay attention to focus on the big picture, but engage with what you can actually have an impact on. The future of the profession is decided by state and local politics. Some states, like Arkansas and Louisiana, are permitting optometrists to perform laser procedures, while Massachusetts just recently allowed optometrists to pharmaceutically treat glaucoma.

This means we have to pay attention to far more than who is currently sitting in the oval office. Get involved in your school’s AOSA, enroll in the AOA when you graduate, pay attention to local politics, and be sure to fill out your entire ballot the next time you vote!

Student Experience

Snapshot of AOA and AOSA’s Plan to Increase Cultural Competency

During 2020, the murder of George Floyd catalyzed nationwide outrage and frustration around systemic racism and racial injustices. In response to these events, the American Optometric Association (AOA) released a statement condemning racism, intolerance and hate. Moreover, the AOA has reviewed how its structure, policies and culture around race has impacted the optometric profession. Minority members make up 38.8% of the AOA and 48.6% of the American Optometric Student Association (AOSA) membership, according to the 2020 membership report. Although student membership of other minority groups, such as Asian members, has increased in the past years, the proportion of specifically Black and Brown have remained stagnant. 

In an effort to combat this trend and work toward a membership that better reflects the American population, the AOA formed the Diversity and Inclusion Task Force in June of 2020. Current actionsinclude increasing the representation of all races and ethnicities in the optometric profession and working to emphasize and support cultural competency amongst its members. Cultural competency and racial representation are crucial in providing better patient care. Research has shown that diversification of health care providers results in more inclusive decision-making, increased efficiency and improved health outcomes. Similarly, the AOSA Board of Trustees formed the Diversity and Inclusion Project Team with the same actions in mind.

To increase diversity amongst members, the AOA is further promoting Black EyeCare Perspective events such as “Impact HBCU” and “Pre-Optometry Club”. Furthermore, the AOA has renewed its commitment to cultivate and expand long-term relationships with Historically Black Colleges and Universities (HBCUs). Specifically, the AOA, with the help of the AOSA, is working to increase awareness, interests and opportunities to students interested in pursuing a career within optometry, especially to Black and Brown students.

Ongoing efforts include joint AOA/AOSA meetings, diversifying AOSA’s social media content and addressing barriers to the application cycle. In January 2021, the AOA and AOSA announced a long-term financial commitment to support the newly created Opportunities in Optometry Grant program to assist in alleviating costs associated with the application cycle. Up to 30 students will receive grants in 2021. Additionally, the AOA/AOSA are working to set up a mentorship program with practicing doctors for grant recipients. For more information or to partner with the AOA/AOSA to ensure the success of this grant in future years, visit the official grant page here.

The AOA also is encouraging ASCO to expand its “Optometry Gives Me Life” campaign to include more targeted messaging to members of the Black and Brown community. To promote diversity among AOA leadership, the AOA has developed the AOA Leadership Institute, chaired by Andrea Thau, O.D. The program is targeted toward newly graduated doctors 5-10 years out of school, empowering them to become leaders on the state and national level. This year’s Leadership Institute consists of 125 doctors who were nominated by affiliates, schools and colleges.

To further encourage cultural competency, both organizations have engaged in conversations with doctors of color to gain the perspective and knowledge to influence the most effective change. AOA and AOSA leadership have undergone training on diversity and cultural competency. Furthermore, the AOA and AOSA are committed to evaluating policies and resolutions to reshape organizational culture. For the past three years, the selection process for authors and speakers for Optometry’s Meeting® has been based on content rather than demographics, resulting in an increase of young, female speakers. The AOA will continue removing demographic information during this process in efforts to minimize implicit bias.

In conjunction with AOA’s efforts to facilitate diversity, equity and cultural competency, this year’s Optometry’s Meeting will have several continuing education courses centered on diversity, including “Understanding Diversity & Inclusion in Eye Health & Vision Care for Enhanced Compliance, Continuity of Care and Practice Growth” and Improving Patient Communication: What Does Culture Have to Do with It?” Finally, the AOA intends to increase optometry’s exposure and accessibility to the topics covered in these courses by offering them virtually on EyeLearn Professional Development Hub, an AOA member-exclusive education portal.

The AOA Diversity and Inclusion Task Force consists of AOA Board of Trustees members Jacqueline Bowen, O.D., James P. DeVleming, O.D., Steven T. Reed, O.D., and Lori L. Grover, O.D., Ph.D. The AOSA Diversity and Inclusion Project Team consists of Jaime Antonio (OSU), Devyn Hayes (IUSO), Mikala Herr (WUCO), Kimber Mapili (ICO), Anjali Paramanandam (UCB), Helene Pippin (PUCO), Madi Sachs (UCB), Lotus Schifsky (IUSO), Veronica Schuver (OSU), Shaily Sheth (NECO) and Anna Venizelos (NSUOCO).

Advice Column / Health & Wellness

Make Mental Health A Priority

COVID, elections, zoom, family, friends, sanity. The list goes on and on. It can be difficult to step out of your own bubble to realize everyone around you is going through their own version of the same thing. We worry about our loved ones’ health and safety; we worry about the state of our nation; we worry about keeping up with countless online platforms just to stay on track with school, and all while maintaining our personal and romantic relationships.  

 

It can become very easy to feel desensitized by all the negativity we are bombarded with on the internet and it has become almost normal to expect the worst in the year 2020. We’ve all heard the jokes and the seen the memes. It feels almost unnatural to continue regularly scheduled curriculum while the world around us seems to be in a state of instability. Add the presidential election to the mix, and you have yourself the perfect recipe for anxiety. Not only is the abrupt transition having an impact on our learning, but also on our mental health.  

 

I challenge you to take charge of your mental health and reach out to various resources available to you. Many universities offer counseling/therapy free of charge to their students and you would be surprised how beneficial it is to talk about your personal experience with someone outside of your close circle. Personally, I had never participated in counseling sessions until recently, but it took a small weight off my shoulders and that made all the difference. Normalize saying no to others once in a while and take time for yourself to catch a breath. I know a lot of us are overachievers and want to do it all, both in our personal and academic lives, but it is important to take a step back and remind yourself how far you’ve come and to put yourself first. As someone who’s always had trouble reaching out for help, I can understand the hesitation.  

 

The first few months into the pandemic it seemed easier to stay productive with projects, trying new recipes, learning TikTok dances and even catching up on schoolwork. Now that we are more than half a year into the new normal, motivation can be harder to come by. For those 1st years who are beginning their journey in optometry virtually, for those 2nd years that are struggling to keep your clinical skills up to date with limited in person practice, for those 3rd years that are struggling to study for boards and keep up in clinic, and for those 4th years that are trying to learn as much as they can on rotations before setting forth onto the real world, remember that we are all doing the best we can and that is all anyone can ask of you.  

Student Experience

Optometry Externship In Bush, Alaska

After three crazy years of trying to balance classes, clinic, labs, and life, everyone in my class at Southern College of Optometry (SCO) was looking forward to our fourth-year clinical rotations. At SCO, we select two sites one institutional and one private in addition to our in-house rotation. In the summer of my second year, I was introduced to an institutional site in Bethel, Alaska: the Yukon-Kuskokwim Health Corporation (YKHC). This site is an Indian Health Service located in the heart of the Yukon-Kuskokwim Delta in the southwest Alaskan tundra. After researching all night when I should have been studying for pathology or pharmacology, I began counting down the days until I could begin my journey in the Last Frontier.  

When SCO closed secondary to the pandemic, my first thought was: Would this carry over into the summer? Fortunately, I was still able to fly north to work at the hospital, and I am extremely thankful both SCO and YKHC Optometry granted me this incredible opportunity.

Helping at-risk populations and those in need of eye care has always been a burning passion of mine, and this past summer in Bush, Alaska, re-fueled that love. 

 So, what is optometry like in an area surrounded by water that is only accessible by plane, boat, or snow machine in the winter? I was wondering the same thing about four months ago. 

The YKHC provides comprehensive care— medical, dental, optometric, auditory, and more—to the village of Bethel as well as the 58 surrounding villages in the Delta. The region is about the size of Oregon and contains over 23,000 people. There are five sub-regional clinics in the area, and each village has its own clinic that houses traveling workers, such as nurses, dentists, and optometrists. The YKHC opened a brand-new hospital last year, including an eye clinic with an in-house optical, a technology room with a fundus camera, OCT, visual field, an anterior segment camera, and over 10 exam lanes for patient care. 

In the summer, optometry does not travel out to villages as frequently because most people are fishing or at fish camp smoking and preparing their fish. Due to this, more patients travel to the YKHC to receive eye care. Usually, there are a plethora of flights bringing people into Bethel, but flights were very limited this summer as a result of the pandemic. Most of our patients took a boat from their villages, some traveling several hours both ways to receive care. To offset this, YKHC Optometry traveled to eleven villages between May and August; I was fortunate enough to partake in two of these village trips. 

For my first trip, we traveled via plane to Akiak, and on my second trip, we took my preceptor’s family’s boat upriver to Kwethluk. The populations of these villages were just under 400 and about 750 people, respectively. Our housing was located at the back of each clinic as there was a room with bunk beds and a kitchen, as well as a private bathroom with a shower. Both trips were similar in that it was me with one other extern and one staff doctor providing care to as many people as we could in one week. Case history, chair skills, and ocular health examination took place in a nurse’s exam room, and we performed refraction in the dental room. Between the two clinics, we saw a total of 136 people. Most of the patients were either young children or elderly people who were either unable or uncomfortable to travel to Bethel due to the circumstances. There were a few patients we had to refer to Bethel for specialty testing or emergency follow up care at the hospital.  

To protect ourselves and our patients, all of us providers had to be tested for COVID-19 before traveling to the villages. In the clinic, masks were required at all times, and if a patient did not have one, face shields were provided. Tonopen was performed to check IOPs, and between patients, we completely sanitized our rooms, including chairs, equipment, and anything the patient had contact with during the exam. Patients were scheduled in 15minute increments to cut down on the number of people in the waiting room at a time. When choosing glasses, there were only a few options, and each frame was disinfected afterward. Additionally, a janitor cleaned the entire facility twice a day, including our housing quarters in the back of the clinics. 

 My experiences this summer in Bethel, Akiak, and Kwethluk were unforgettable, despite the impact from the pandemic. I could not have asked for a better rotation as my preceptors, fellow externs, and patients all greatly contributed to my growth as a fourth-year clinician. Alaska has a special place in my heart that I will cherish as I wrap up my optometric education and begin my dream career. 


Autumn Killop (SCO) with Danielle Dyke AZCOPT(left), and Dr. Krystle Peñaflor (right)

 

 

Advocacy

Why Advocacy?

Advocacy: not exactly the first word that came into our minds when we decided to become doctors of optometry. Most of us decided on optometry because we wanted to help people, not argue with them. Yet, why are we constantly talking about advocacy, and why is it that we must advocate so much, when it feels like our colleagues in other health professions do not have to? Well, the truth is, they do. It is easy to look out at the world and think that our own circumstances are unique, and in some ways they are. However, when it comes to advocacy, every profession must advocate for themselves in some way. Some health professions must advocate that they are the specific medical specialty that should be doing a procedure within their own communities. Others, such as optometry, must advocate to help create/change laws that more accurately reflect our capabilities as doctors. This is why we advocatebecause at the end of the day, no one knows what a doctor of optometry can do better than a doctor of optometry 

Then why is it that so many of us feel such distain for the word? Well, I think that one of the main reasons is that a lot of people have a distaste for politics in general, and a word like advocacy makes most of us think of politics. That is not all that being an advocate means though. The Oxford English Dictionary defines advocacy as, public support for or recommendation of a particular cause or policy.”  Advocating for our profession means that we show it our support, but that does not necessarily mean you have to be involved in the political world. While yes, it would be amazing if everyone had the desire to go out and lobby for our profession, that is just not in some people’s comfort zone/skill sets and that is fine! Being an advocate for optometry can manifest in other ways. Staying up to date on the current issues facing our profession, voting for people who support our cause, or even just discussing some of the issues we face with your friends and family can all have positive impacts for our profession.  

However, if you are on the fence about becoming even more involved with advocacy, let me assure you that there are many opportunities out there for you! The AOSA and AOA do an outstanding job with educating and providing us with opportunities to present our profession to people in a positive light.For example, in September I was a part of the Virtual AOA on Capitol Hill event where we as students got to meet with politicians and staffers to discuss some of our concerns within the field. At first, I was nervous and thought that I would screw up or say something wrong, but the AOSA did a remarkable job briefing us and providing us the information that we needed to competently speak to these representatives. Another really interesting takeaway I got out of this event was just seeing how much politicians and people in general value and respect our opinions as future doctors of optometry. I know it is hard to believe when most of us are so young, but we worked very hard to get where we are, and people know and respect that.

I hope that if you can take anything away from this, it is that every one of us is important to the future of optometry, and if we want it to continue to be the best it can be, we all have to be good advocates and show people what we’re capable of.  

 

Health & Wellness

Optometry: Opening The Door To Disease Prevention

It is well known that chronic disease is a driving force for doctor visits today and comprises a large component of health care expenses. However, it has been found that a strong link exists between preventing chronic illness and proper education on smoking cessation, alcohol consumption, physical activity, and nutrition.

Overall wellness involves not just the physical aspects of one’s health, but the mental and social as well.The concept of an integrated health care team is becoming even more essential in the management of patient care.  

As optometrists-in-training, we have the knowledge to educate and guide our patients towards the right information and resources needed to achieve optimum wellness. Optometry in particular is especially unique in that the doctor-patient relationship created from examining the eyes sets up an opportunity to offer preventative health advice. Patient education on nutrition is just one important component in the multimodal approach to the management and prevention of chronic health problems. However, what healthful information we tell our patients is just as important as how we present it to them. In this article, we’ll talk about why optometrists are in a critical position to influence disease prevention, how to open up conversation about health to our patients, and what pieces of nutritional advice we can provide during patient education.  

In optometry school, we are taught to gather information along every step of the comprehensive exam: beginning with the key elements of a thorough patient history and ending with a complete vascular and neurologic assessment of the back of the eye. We get to know our patients’ personalities and lifestyles by asking targeted questions and using careful listening to deeply understand the entirety of their complaint and condition. By the end of the exam, we have a wholistic picture of our patients’ mental and physical wellbeing. This unique perspective places optometrists in a critical position to be able to impact the health of our patients. However, the manner in which we communicate with our patients is a crucial step in initiating change in their lives.  

Patients with chronic health conditions may feel overwhelmed and rarely motivated to act when given a laundry list of health checks they must meet.

Adopting a patient-centered approach by showing empathy, carrying open, non-judgmental conversation, and seeing the patient’s perspective is important in order to leave them feeling empowered to change.

Motivational Interviewing (MI) techniques have been found to be an effective mode of communicating to increase intrinsic motivation, particularly in diabetics. Below is a list of example questions, some of which have been adopted by the MI technique, that can be used to spark open conversation about health and establish rapport during patient education, a concept shown to leave patients feeling more confident about taking charge of their health.  

  • “With your permission, I’d like to propose a plan…” or “If you don’t mind, may I share a bit of information with you…”1  
  • Replace “I think…” or “You should…” with “Perhaps you could start with…” or “One option you may consider…”1 
  • “Tell me what you prepare for breakfast in the morning…” 
  • Patients in the past have found that…”1 

With the immense amount of health literature that we have access to today, it can be difficult to narrow down the most important take-home message regarding nutrition and health. Vitamins, minerals, and antioxidants play a critical role at the micronutrient level at impacting our metabolism, microbiome, and cognitive function as well as preventing eye diseases like age-related macular degeneration and diabetic retinopathy. While patients may have a generalized understanding that proper nutrition can affect their physical health and weight, not many are aware of the nutrients essential to eye health. Patients often respond the best when given a single piece of advice, and are surprised to hear that such small changes can make a large difference in their overall health.  Included below is a list of important elements in nutrition and eye health to steer patients towards healthier habits. 

  • Lutein & zeaxanthin. Xanthophylls are one of the two categories of carotenoids, antioxidants that play a role in protecting the health of the macula, ocular surface disease, cognitive function, and skin health. Add 1 cup steamed or 2 cups raw spinach to your meal each day. This could be in the form of a smoothie, a salad, or sautéed into your dinner. Sidekicks are kale, collard greens, swiss chard, arugula, and bok choy.2  
  • Carotenes. The second of two categories of carotenoids. Color your plate with red and yellow peppers, sweet potatoes, squash, cantaloupe, apricots, peas, and broccoli.2  
  • Vitamin C is a water soluble, potent antioxidant that plays a role in immune function and wound healing, among others. The most abundant natural sources include guavas, kiwis, and bell peppers, though a dissolvable supplement in a glass of water may be necessary in order to reach adequate levels.  
  • Vitamin D is a prohormone that has a supportive role against autoimmune disease, fractures and falls, depression, heart disease, influenza, and type 2 diabetes.2 For fair skinned individuals, spending a few minutes outside without sunscreen, or for darker pigmented skin, up to 15 minutes, would be enough.  
  • Healthy fats, specifically polyunsaturated Omega-3 fatty acids (EPA, DHA, ALA), have been found to support ocular surface disease, fight inflammation, improve cognitive function, and contribute to hormone production. One handful of walnuts, five times per week, or incorporating wild salmon, Alaskan halibut, or canned, chunk, light tuna (1,000-2,000mg/day) is recommended.2  
  • Absorption of vitamins with healthy fats. In order for proper absorption of vitamins, supplements or foods should be taken with or cooked in healthy fats including avocado, nut butters, and olive oil.  

While these are just a few aspects of health that we encounter during patient care, the optometric exam opens the door to caring for so many other areas of overall wellbeing. As largely a medical profession, we can positively impact our patients’ lives beyond their eyesight and significantly contribute to disease prevention in our community today.  

  1. Welch, G., Rose, G., et al. (2006). Diabetes Spectrum. Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work? 19(1). 6-8. 
  2. Richer, S., Poteet, J., Summerton, S, et al. (2018). Review of Optometry. Wellness Essential for Clinical Practice. 1(1), 6-17.