It is the perfect coupling – a celebrity and a charming doctor – and the result is sexy. Damn sexy, in fact. But more importantly, it is effective in generating awareness for dry eye disease.
Betty Ford was one of the first western celebrities to use her own illnesses to educate the public about prevention and early detection of breast cancer. According to the National Center for Biotechnology Information “detection rates rose dramatically in a phenomenon known as “the Betty Ford blip.” Since Betty Ford, many other celebrity sufferers have publicly disclosed their conditions and served as spokespeople for educational campaigns.
Whether or not such publicity leads to improvements in public health has been consistently debated, most notably at a symposium in New York sponsored by the Columbia Graduate School of Journalism and moderated by George Lundberg, editor-in-chief of Medscape.com and former editor-in-chief of the Journal of the American Medical Association. Some suggest that said publicity only leads to a rise in unnecessary testing (e.g. prostate cancer) and a pseudo injection of funds to manufacturers of tests and diagnostic equipment, whereas others argue that celebrity advocacy leads to a direct increase in testing.
But advocacy can also benefit patients by sharing the following message you are not alone in your suffering and you deserve to be heard. There are innumerable ailments, diseases and conditions – many of which receive little to no notice, let alone funding. As such, in order to get interest and funding and interest, factors that move us towards a cure, there must be a trigger.
In the case of dry eye, the initial massive trigger to generate interest was academic, pushed forward by the TFOS 2007 DEWS Report. TFOS DEWS was the first real massive undertaking to spread information regarding dry eye in the greater ophthalmological community (to both doctors and industry). “Excuse the pun, but even my eyes were opened,” laughs Dr. Starr. He concludes, that, because it was not considered a blinding illness, dry eye was traditionally undervalued or underplayed in the field. The implications of dry eye, however, for one’s vision and overall quality of life are tremendous. If you suffer from dry eye, working with a computer will become challenging. If you drive a truck, working will become challenging and potentially dangerous. If you are a model, wearing eye makeup or taking photographs under bright lights will become challenging. If you are a librarian, working with books will become challenging. And, in light with this article, if you are a celebrity like Jennifer Aniston or Marisa Tomei, you cannot read your scripts so working becomes challenging. In other words, blinking can be so debilitating, so excruciating that people have been forced to not only suffer in silence, but also resign from their jobs.
Another trigger for dry eye awareness has also stemmed from Dr. Starr and his messaging. His message is simple, logical, effective, and based on the fact that it makes more sense to prevent dry eye with prophylactic measures rather than have to diagnose and treat it at a later date, especially since dry eye is a progressive disease. One way in which people get dry eye is from digital strain. He explains that dryness can be caused by reduced blinking while staring at screens since a persons blink rate can decrease up to half when looking at a screen. “When you’re not blinking, and you’re staring and your eyes are wide open, tears evaporate very quickly,” Starr said. “You get dry spots, blurred vision, it can cause redness, pain, and over the course of the day it just worsens and worsens.” To take some respite from their prolonged strain, or computer vision syndrome, is “to follow something called the 20-20-20 rule. Every 20 minutes that you’re on a computer or a mobile device, look away from the computer at an object at 20 feet away or further for 20 seconds or more. And that will let those eye muscles relax.” Despite its logic, it can be challenging to encourage people to adhere to this preventative rule until they find themselves actually suffering from dry eye. In addition to the 20-20-20 rule above, we can follow computer hygiene. Did you know that Apple is now integrating a mechanism that allows you to dim blue light, offering some protection and impeding the disruption of melatonin released. While there is no need to panic, there is some evidence that the higher energy of blue and violet light could have negative long-term repercussions on eye health.
And for those who question whether media or celebrities should be one of his messaging platforms, remember that our objective is to find a cure for dry eye syndrome. In the past, artificial tears weren’t enough and dry eye was often misdiagnosed. Dr. Starr suggests that “there wasn’t a silver bullet” and the diagnosis was long and cumbersome leading to the frustration. Whereas now we are privy to a new understanding, diagnostics, tools, and awareness. There is a steep learning curve and it is an exciting moment for doctors and patients alike since new treatments and innovations are in the pipeline.
Doctors need to be trained to both understand the metrics of the new diagnostics and tools, and to apply them to their patients. Of course, this can be hard to do as busy practitioners. Furthermore, it is difficult for doctors to make an accurate diagnosis since symptoms of all these ocular diseases overlap – to the patient they are presented the same way, so in order to treat it you have to make the right diagnosis.
Of course, more messaging linked to a more consistent protocol will not only compel patients to receive early testing but will also allow doctors to more readily diagnose them. In addition to working with TFOS, ASCRS (dry eye awareness is one of their major initiatives), and speaking at meetings, Dr. Starr also raises awareness and educates doctors as an associate professor.
In fact, as I mentioned earlier, Dr. Starr suggests that eye care has become sexy. Lets hope that this compelling characteristic propels a cure. But let us not forget that “You can’t depend on your eyes when your imagination is out of focus.” (Mark Twain)
Director, TFOS Global Ambassador Program