Despite the continuing reports of how savvy today"s Internet-connected patient is on health matters, I doubt that many ophthalmologists would be surprised at the gaps in that education. An obvious one is the connection between nutrition and eye health.

It may surprise you, though, to learn just how many of your patients are ingesting all manner of herbal and other dietary supplements, and worse, how many keep that information from their physician. We have Dr. Mark Abelson and Lisa Lines to thank for this month's discussion of the topic (p. 70).

It's not surprising, however, that patients are confused or outright misinformed, thanks to the essentially unregulated nature of this marketplace. A typical supplement website (and you'll get more than 7 million hits if you search for one) will, as required, point out that the FDA has not evaluated the products they're developing, manufacturing, and marketing. The "nutritional support" products they describe are intended solely as supplements to enhance general health, and are "not intended to diagnose, treat, cure, or prevent any disease," they say.

That's if you ever reached the bottom of the page and the small type. Before you reached that you'd have seen that (italics added) :

• One product "contains well-known herbs and vitamins considered essential for strengthening the eyes, and for supporting the prevention of the onset of glaucoma." Another "helps to prevent cat­a­ract."

 • Goldenseal has an antibacterial action that "helps reduce or prevent infection."

 • Rutin helps "prevent cardiovascular disease."

 • The leaves of the ginkgo tree have been used for thousands of years "to treat lung ailments."

Honeysuckle flowers are promoted as a "treatment for chicken pox."

 • Horsetail … used for its diuretic and astringent properties, is a "useful treatment for cystitis, bladder and pro­state problems, and kidney stones."

 • Turmeric has been used effectively "for treatment of arthritis, high cholesterol, digestion problems, liver protection, and obesity."

Sure sounds like prevention and treat­ment to me. The pharmaceutical manufacturers certainly don't need any sympathy, but the disparity be­tween the regulation that they deal with and what the public contendedly overlooks from the herbal segment is more than a little baffling.