What can I do to slow down or prevent macular degeneration in my eyes?

Answer: Age Related Macular Degeneration (ARMD) is a condition resulting from damage or breakdown of the small part of your retina that is responsible for central or reading vision.

This disease affects both distance and close vision and can make some activities like reading, recognizing faces or threading a needle very difficult or impossible. ARMD is the leading cause of severe vision loss in Caucasians over the age of 65.

Researchers have identified several genes that are linked to macular degeneration, but we know that individuals in the same family may have quite different levels of severity of this condition. Other contributing factors that may make macular degeneration worse include smoking, a diet lacking in certain nutrients and poor cardiovascular health.

Early studies found that people who ate more dark green, leafy vegetables (spinach and kale) had fewer problems with macular degeneration as they aged. The National Eye Institute (NEI) undertook a major research project (the Age Related Eye Disease Study or AREDS) that followed thousands of patients for nearly seven years to try to see if certain nutrients could do even better. They found that antioxidants and zinc may reduce the impact of ARMD in some people with the disease.

Among people with intermediate to severe macular degeneration already in place, taking high amounts of vitamins A (beta carotene), C and E and zinc lowered the risk of the disease progressing by 25 to 30 percent. However, these supplements did not seem to offer any benefit to those with little or no macular degeneration.

Zinc, one of the most common minerals in our body, is concentrated in the retina and macula. It is needed by more than 100 enzymes, including chemical reactions in the light-sensitive cells of the retina. Some older people have low levels of zinc in their blood.

Light may affect the eye by stimulating oxygen, leading to the production of damaging compounds called free radicals. Vitamins A, C and E are antioxidant vitamins. These substances may help to counteract these chemicals and slow the progression of macular degeneration.

However, in the AREDS study, smokers and ex-smokers were found to have a higher risk of lung cancer if they took the high amounts of beta carotene (vitamin A) used in the study.

The NEI started a new study in 2006 to evaluate the use of Lutein, Zeaxanthin and omega-3 fatty acids (found in fish oil) in eye health. So far, we have no hard medical evidence that these substances can lower the risk of macular degeneration. However, there are good reasons that they may be useful.

Self-medication with high doses of vitamins — such as those in the AREDS — is not recommended. These doses can have significant interactions with prescription medications. As a result, you should not take these products without talking to your primary care doctor or ophthalmologist. They can help you determine formulations and dosages best for you.

If you are concerned about macular degeneration, you should see your ophthalmologist for a complete eye exam. If you smoke, you should stop. Exercise regularly if you are able. Eat plenty of vegetables as part of a balanced diet, and, if recommended by your ophthalmologist, take nutritional supplements and have your eyes examined regularly.



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