As a Retina specialist who sees patients with macular degeneration on a daily basis, I am constantly asked by patients "What can I do to help my vision?". Elderly patients are aware of the blinding effects of macular degeneration, and are desperate for ways to stop this dreadful disorder. Most have turned to nutritional supplements and herbal remedies, and consider these their only hope to preserve vision. The good news is that with some simple dietary and lifestyle modifications, most adults can prevent vision loss from macular degeneration.
Age related macular degeneration, or AMD, is the leading cause of blindness in people over the age of 60. It affects the macula, the central portion of a specialized lining of the eye called the retina, which is responsible for our reading and distance vision. As AMD progresses, people are forced to give up driving, and must rely on low vision aids to assist with reading. In its advanced stages, individuals can no longer recognize peoples faces, and reading becomes difficult to impossible. AMD is divided into 2 categories, Dry AMD and Wet AMD. Dry AMD affects 85% of individuals with macular degeneration, and progresses slowly over a period of many years. In 15% of individuals with macular degeneration, abnormal blood vessels have grown in the macula, causing a more rapid loss of vision. This is called Wet AMD. Most individuals who develop Wet AMD have preexisting Dry AMD.
Although the true cause of AMD is unknown, several risk factors have been identified. Increasing age, Caucasian race, a family history of AMD, and light iris color (blue or hazel), are all established risk factors.
Additional risk factors do exist for macular degeneration. Since these are related to diet and lifestyle, changes can be made to lessen your risk of developing AMD and losing vision.
Studies have shown that individuals with diets primarily consisting of fruit and vegetables have the lowest rates of macular degeneration development. We now recognize that lutein, a carotenoid pigment found exclusively in fruit and vegetables, serves as the primary protector of the eye. Lutein accumulates in the macula and likely blocks the damage caused by sunlight, one proposed cause of AMD.
Fruits and vegetables are also high in antioxidant vitamins such as Beta- carotene, Vitamin E, and Vitamin C. Interesting, research has shown that the use of anti-oxidant supplements in tablet form does not reduce the rate of macular degeneration development. This highlights the need to incorporate fresh fruit and vegetables into your diet.
But which fruit and vegetables are best? Traditionally, patients have been told to eat lots of green leafy vegetables, which have high lutein content. However, lutein is found in a wide variety of fruits and vegetables, with the highest concentrations seen in the colorful foods. Examples include kiwi, squash, red grapes, and corn. It is not necessary to limit your fruit and vegetable variety in order to maximize your eye health.
Other dietary habits have been shown to increase the risk of AMD. Individuals with a higher percentage of vegetable, monounsaturated, and polyunsaturated fats in their diet have higher rates of Wet AMD development. This is in contrast to the relative benefits of these products in protecting against heart disease. Obesity, often the end result of a high fat diet, is also a separate risk factor for AMD development and progression. Therefore, weight loss plays an important role in fighting AMD.
In contrast, multiple studies have shown that diets rich in Omega 3 fatty acids reduce the risk of Wet AMD development by at least 50%. Since patients with Dry AMD are at high risk of converting to Wet AMD, all Dry AMD patients should eat foods rich in Omega -3 fatty acids. These are found naturally in cold-water fish such as salmon and tuna, and in flaxseeds and flaxseed oil. Two servings of fish per week are adequate.
Smoking is another modifiable risk for AMD. In addition to having higher rates of heart disease, lung cancer, and emphysema, smokers have a 5 times higher rate of advanced AMD compared to non-smokers. Smokers, on average, lose vision from AMD 10 years earlier compared to non- smokers. For the nutritional changes outlined above to be successful, patients must first stop smoking.
The dietary and lifestyle changes described in this article can be adopted by anyone to prevent their risk of AMD development. However, for patients with a family history of AMD or with established AMD, I consider them mandatory. In addition, patients with AMD should use Ocuvite Preservision, an antioxidant and mineral supplement that has been proven in clinical studies to slow the progression of AMD. This is available without a prescription at pharmacies and retail stores.
In summary, there are several dietary and lifestyle changes that can be made to reduce one’s risk of developing AMD. These are also helpful in slowing vision loss in patients with established AMD. By adopting a diet rich in fruits, vegetables, and omega 3 fatty acids, while minimizing dietary fat intake and maintaining proper weight, you can increase the odds of living your retirement years with crisp, clear vision.
Michael E. Rauser, MD
Residency Program Director, Vice Chair for Clinical Affairs
Loma Linda University - Department of Ophthalmology
11370 Anderson Street, Suite # 1800
Loma Linda, CA 92354