Have you ever noticed how hard it is to read something when you look even a little bit to the side of the word? That’s because we see our best when we line up print with the part of the eye that has the most acute vision with whatever it is we are trying to look at. This region is called the macula, and without it life would be much, much different than what we are used to. That’s because the macula is responsible for our central, fine detailed vision which is vitally important for nearly everything we do on a daily basis. Over the course of our lifetime damage and aging changes can occur in the cells that comprise the macula leading to blurry, distorted central vision or even a complete loss of central vision altogether. This is known as macular degeneration – a chronic, progressive disease that irreversibly kills off the cells in the macula.
Macular degeneration (also known as AMD) is becoming more well known because most of us know someone directly affected by it. Macular degeneration is the leading cause of blindness in people over age 74, and about 1 in 7 people will develop sight loss from macular degeneration as they age. Most people who develop macular degeneration are in their 80s but the condition can affect people as early as their 50s. Currently over 2 million americans suffer from AMD, but that number is projected to more than double to 5 million by 2050 due to the advancing age of our population. So you can see why this is both a personal and public health care concern.
Risk factors for macular degeneration are as follows:
- Increasing age
- Race: Caucasians are at the highest risk
- High cholesterol
- Female gender
- Heart disease
- Light complexion
- Early menopause
- Smoking
- Sun exposure
- Genetic family history
- Poor Diet
Patients often ask me if they will develop macular degeneration because their parent has it, and if there is anything they can do to prevent it. As we know from above, a genetic family history is a risk factor for macular degeneration – the single biggest one, in fact – but it is not set in stone. You are not guaranteed to develop macular degeneration just because your parent has it. Additionally, there are things you can do to help lower your risk of developing macular degeneration or decrease the risk of it progressing if you already have it.
UV radiation and blue light: We all know that UV radiation is bad for us, and that it is mainly from the sun (and UV tanning beds, I suppose). But did you know that the light coming from your LED devices (such as smartphones, laptops, computers, tablets) can be harmful as well? This light contains a high proportion of blue light – which is higher energy, and therefore more damaging, than other forms of visible light. Both UV radiation and blue light have been linked to an increased risk of macular degeneration. One major study showed that if you spend an average of 3 hours per day outdoors you are 10 times more likely to develop macular degeneration. For those of us who have to be outdoors it is extremely important to protect our eyes from the sun with a pair of high quality sunglasses. For protection from blue light we recommended blue light filtering lenses that reduce the amount of blue light reaching the macula by 30-90% (depending on the lens type). The two most important times to have blue light protection are when outdoors (because sunlight contains a large amount of blue light) and when using electronic devices. For outdoor lenses we recommend a lens type that blocks at least 80% of blue light, while for electronics use we recommend 30-60 percent. Using a blue light filtering product while on electronic devices has benefits beyond protecting the health of your eyes, it has been shown to increase clarity when looking at screens, decrease visual fatigue/eye strain, and improve sleep cycles. We will be posting a blog article in a few months going into more detail on blue light, but if you have any questions about blue light or the products to protect from it feel free to call our office for more information.
Green is good: Eating green leafy vegetables frequently, especially kale and spinach, is helpful as they are high in the macular pigment lutein which has been conclusively shown to reduce one’s risk of macular degeneration. Yellow and orange peppers are the next most important food to consider as they are high in another important macular pigment called zeaxanthin. I have attached a summary of the Eye Foods Diet recommended by Drs. Laurie Capogna and Barbara Pelletier. If you would like to learn more about the eye foods diet we carry a copy of the book in our office for purchase or you can visit their website at eyefoodsdiet.com. Studies have shown that certain supplements are better for certain people due to their genetic profile, and therefore genetic testing can be used to tailor a supplement program specifically to you. For this reason, we offer and routinely perform genetic testing in our office.
Drink to your health: We have known for a while now that mild to moderate consumption of red wine is associated with a decreased risk of macular degeneration as well as heart disease. It is felt the main substance responsible for this risk reduction is a molecule called resveratrol, which has been successfully isolated and processed into supplements. However, since it is an unstable molecule there is evidence that most resveratrol products are not very effective. For the last year we have conducted research in our office on a product called longevinex as a supplemental treatment for macular degeneration. This product uses a process called microencapsulation combined with other molecules (quercetin, rice bran phytate, green tea extract, chlorogenic acid, nucleotides and vitamin D), that seems to enhance the effect of resveratrol alone. While the results of our research are still being analyzed and formulated, a study conducted by Dr. Stuart Richer has been very promising. While we are not in the supplement business per se, we are in the preserving sight business. We have found it a service to our patients to offer high quality products in our office that we have tested and know produce results. If we have recommended a supplement for your eyes, ask how our supplement program can help keep you on the product that is best for you!
Exercise: With the increased use of smartphones and computers many of us have adopted a more sedentary lifestyle both at work and at home. Translation? Most of us don’t exercise enough! Exercise is not only great for your overall health, it also improves the health of your eye. Exercise improves blood flow to all parts of the body, including the eye. This is a good thing since insufficient blood flow to the macula is thought to be involved in the development of macular degeneration!
There are two main types of macular degeneration. The more mild form is dry macular degeneration and it can cause mild to moderate sight loss. Dry macular degeneration is a precursor to wet macular degeneration. In wet macular degeneration the blood vessels in the eye get a little leaky leading to fluid building up in the macula – hence the name. This can cause significant damage very quickly and lead to rapid progression and significant vision loss if not treated. The most common treatment available for wet macular degeneration are anti-VEGF (anti vascular endothelial growth factor) injections that are given with some regularity to dry up the leaking blood vessels. The good news is that if wet macular degeneration is caught early enough more than 90% of patients’ sight loss can be prevented. Patients with dry macular degeneration should be seen every 2 months to 1 year, while wet macular degeneration patients are typically seen monthly.
We recommend those over age 65 should be tested yearly for macular degeneration since early detection leads to better treatment outcomes. Individuals with a strong family history should start to be tested after age 50. At our office we have advanced diagnostic equipment that picks up early signs of macular degeneration up to 10 years or more before vision is affected which helps us pick up changes from macular degeneration very early on in the disease. If you have specific questions regarding macular degeneration please give our office a call.
-Dean Amundsen, O.D.