Why ODs should monitor patients after weight-loss surgery

Why ODs should monitor patients after weight-loss surgery

If you have patients who have undergone weight-loss surgery, they may need you to keep a close eye on them, according to a new review of existing research.

"Optometrists should be aware of potential ocular sequelae associated with weight loss surgeries..."

Weight-loss surgery patients who fail to take prescribed vitamin and mineral supplements may be at risk for vision problems, say study authors, who reviewed case reports involving ocular complications following primarily gastric bypass procedures.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), bariatric surgeries include those that cause weight loss by restricting the amount of food the stomach can hold, those that cause weight loss primarily as a result of malabsorption of nutrients, and those that cause weight loss both by gastric restriction and malabsorption.

These procedures reduce nutrient absorption from food, which study authors say can lead to a wide range of eye conditions. These conditions include night blindness, ulcers, scarring of and changes to cornea, involuntary eye movement, paralysis of the eye muscles and dry eye.

While it is well-known that proper nutrition is essential to eye health, study authors point to the danger of lower intake of particular vitamins (A, E, B1 and copper) in these patients, due to their close link with normal eye function.

ODs can help monitor vision health after surgery
The ASMBS notes that patients who undergo bariatric surgery will need to take a multivitamin and calcium or iron supplements for the remainder of their lives to maintain good health. However, as with any medical regimen, adherence is key. Optometrists and other health care providers can have an influence.

A. Paul Chous, O.D., who specializes in diabetes eye care and education and is AOA's representative to the National Diabetes Education Program, thinks optometrists have a role to play in monitoring the eye-health of weight-loss surgery patients.

"Optometrists should be aware of potential ocular sequelae associated with weight loss surgeries, especially worsening retinopathy in patients with pre-existing diabetes, and severe dry eye and keratitis as a function of frank vitamin A deficiency," Dr. Chous says. "It also makes sense for optometrists to inquire if patients are taking prescriptive supplements."

December 16, 2014

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