For 1.75 million older Americans, retirement dreams can be ruined by age-related macular degeneration, a condition that causes central vision loss manifested by a gray blind spot in the center of vision of one or both eyes. The National Eye Institute also reports that another 7 million Americans are at substantial risk of developing AMD.The NEI predicts that 2.95 million Americans will have AMD by 2020.”Until recently, AMD wasn’t well known as a diagnosis. People are now becoming more aware of it,” said Dr. Andrew Royer, owner of Falcon Family Eye Care.”More research is being devoted to prevention and cure, but unfortunately we don’t know the exact cause of AMD.”Exposure to ultraviolet light, especially at high altitude where UV light is strongest could play a vital role in the development of AMD, as well as cataracts, he said.Worldwide, people most at risk for developing AMD are older Caucasian women with blue or green irises, Royer said. Dark-colored irises block UV light from entering the eye, while light-colored irises allow more light into the eye.The light damages the cells that make up the center of the retina, known as the macula, which is responsible for central vision and the detection of color.According to the Mayo Clinic, symptoms of macular degeneration include
- the need of bright light when reading or doing close work
- increasing difficulty in adapting to low light, such as when entering a dark room
- increasing blurriness of printed words
- decreased intensity or brightness of color
- difficulty recognizing faces
- a gradual increase in haziness of overall vision
- a blurred or blind spot in the center of the field of vision
The most severe form of macular degeneration is characterized by
- abrupt onset
- rapid worsening
- the appearance of geometric shapes and visual distortions, such as straight lines that look wavy, doorways looking lopsided and objects appearing smaller and farther away than they actually are
It’s important to have eyes dilated and examined when experiencing any change in vision because there are treatments that can slow down AMD, Royer said.”We give patients an Amsler grid to take home. By looking at the grid, patients can detect really small changes in the macular area,” he said.In Falcon, Royer sees more men than women with AMD, which may be consistent with men working outdoors in the area.Royer said other factors associated with the development of AMD include smoking, obesity, high blood pressure, sleep apnea and family history.Some medications, such as Fosamax – a treatment for osteoporosis – may predispose a person to develop AMD, he said.In 2001, the NEI and the eye care company, Bausch and Lomb, released the results of their Age-Related Eye Disease Study.The study showed that people at high risk of developing advanced AMD lowered their risk by about 25 percent when treated with a combination of vitamin C, vitamin E, beta-carotene and zinc.Other eye-healthy supplements are lutein and zeaxanthin, Royer said.When lutein was first identified, the recommendation was four milligrams per day, said Dr. Tyson Reuter, owner of Alpine Vision Eye Care in Falcon. Then it went to six milligrams and now it’s six to 10 milligrams per day, Reuter said.Vitamin manufacturers are now marketing eye vitamins containing lutein, zeaxanthin, beta-carotene, zinc and vitamins C and E.”Can eye vitamins make AMD go away? No. Can they prevent it? Possibly. Can they slow it down? Possibly,” Reuter said.”It’s better if you get eye nutrition from the food you eat than from an oral supplement. A good, healthy and well-balanced diet with exercise is really the best medicine we can give ourselves,” Royer said.According to the American Macular Degeneration Foundation, the best sources of lutein and zeaxanthin are kale, collard greens and spinach.The best source of vitamin E is wheat germ oil, according to the National Institutes of Health, and oysters are the best source of zinc.The NIH ranks carrot juice as the best source of beta-carotene and citrus fruits, kiwi and red and green peppers as the best vegetable source of vitamin C. For meat eaters, liver is another good source.Eye protection also is important.Wearing sunglasses with built-in UV protection is a good idea, Royer said.”Research is pointing out that the majority of damage done to our eyes by UV exposure happens before the age of 18,” he said. “We don’t often think about having our kids wear sunglasses, but it definitely wouldn’t hurt.”Just because a glass looks dark doesn’t mean it has UV protection, Reuter said.”You can have a clear lens with UV protection, and you can have a tinted lens without UV protection,” he said.A simple solution is having a UV treatment applied to the glasses, Royer said, adding that it’s also a good idea to wear a hat with a brim when outside.”Once vision is lost, there’s not much we can do to restore it, but there are low-vision devices that help,” Royer said.”I had a patient who was sent to Arizona on a grant for a week of training. They taught him how to use all the devices and how to navigate the world with macular degeneration.”Royer said there is hope: Research is always going to advance so health care providers can get a better handle on the causes and treatment of AMD.
