Macular Degeneration and Nutrition

What is macular degeneration?
Macular degeneration is damage or breakdown of the macula of the eye. The macula is a small area at the back of the eye that allows us to see fine details clearly. Macular degeneration effects both distance and near vision and can make some activities-like threading a needle or reading-difficult or impossible.

Macular degeneration is the leading cause of severe visual loss in persons over 65 years of age. Exactly why it develops is not known, and no treatment has been uniformly effective. (See the American Academy of Ophthalmology brochure on macular degeneration for more information).

What do vitamins and minerals have to do with macular degeneration?

Everyone knows that good nutrition is important for good health in general. Good nutrition requires a diet with a healthy mixture of proteins, carbohydrates, fats, vitamins and minerals. Probably no part of our diet has been as misused or misunderstood as our requirement for vitamins and minerals.

Protein creates the building blocks and chemical machinery in our bodies; carbohydrates supply immediate fuel and energy; fats are used for long-term storage of fuel and energy. Vitamins are organic compounds that our bodies cannot manufacture and are essential for maintaining good health. Minerals, in small amounts, are required for the body's enzyme system (enzymes assist chemical reactions such as the breakdown of food into energy.) Certain vitamins and minerals may delay the development of macular degeneration.

Antioxidants
Normal chemical reactions caused by the effect of light on the macula may activate oxygen and cause macular damage over a long period of time. Some vitamins and minerals function as antioxidants, chemicals which work against this activated oxygen, and perhaps protect the macula from damage. Some experts believe that the following antioxidants may help slow down macular degeneration and other aging factors:

• Vitamins C and E
• Selenium (a mineral)
• Carotenoids (a family of compounds which includes betacarotene) especially those found in green leafy vegetables.

Zinc
Zinc, one of the most common trace minerals in our body, is highly concentrated in the eye, particularly in the retina and tissues surrounding the macula. Zinc in necessary for the action of over 100 enzymes, including chemical reactions in the retina.

Studies have shown that some older people have low levels of zinc in their blood, either because of poor diet or poor absorption of zinc from food. Because zinc is important for the health of the macula, some doctors think that supplements of zinc in the diet may slow down the process of macular degeneration. As in the controversy over antioxidants, there is no agreement that zinc can definitely help macular degeneration. It is possible that too much zinc may interfere with other trace minerals such as copper.

Should I take antioxidant vitamins or zinc for macular degeneration?
The first step to overall good health is a balanced diet. Vitamins and minerals are commonly given as supplements to the diet in amounts determined by recommended daily allowances. These supplementary dosages cause no apparent harm and are commonly available. But large doses of vitamins, called therapeutic doses, in amounts many times the daily recommended allowances, may not be completely safe.

Research is still in progress about nutrition and macular degeneration. It is best to consult with your ophthalmologist (Eye M.D.) to decide whether it is advisable for you to begin such treatment.

Why are regular medical eye examinations important for everyone?
Eye disease can occur at any age. Many eye diseases do not cause symptoms until the disease has done extensive damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an Eye M.D. are very important.

What can be done to help my vision beside laser treatment?

Very bright light has been shown to help patients read better. Also, a magnifying glass may help too. Get a goose-neck lamp and insert an outdoor flood light with high wattage and use this to read. Also, use a magnifier in conjunction with this lamp. The results will surprise you.

Things I can do to prevent ARMD:

• Stop smoking
• Eat healthy
• Wear sunglasses as much as possible
• Take vitamins
• See your eye doctor on a regular basis

New treatments:
Maybe you have heard of "Miracle Cures" that are coming out of new research and you are interested to find out more. Let us assure you that we too are very excited about new research and are keeping up with the latest in the field. As of this printing, there are many new techniques being studied.

• Rhufab and Macugen: Both of these drugs are presently experimental and as such are not available to the general public. The FDA requires proof that all drugs are both safe and effective before allowing doctors to prescribe them. Both of these drugs work on the principle of stopping the formation of abnormal new vessels, which are believed to be the cause of age related macular degeneration. As soon as these drugs are approved by the FDA, we will be able to incorporate them into our practice.
• Rheophoresis: This is another experimental technique that is not FDA approved as of yet. The process is much like dialysis, where the blood is removed from the patient and filtered, cleansing the impurities and then putting the blood back into the patient's body. This technique is currently experimental and if it proves to work, we will be able to offer it to our patients.
• Bionic Eyes: For patients with extensive damage to the retina, there is hope in the form of a bionic eye. New technology that uses computers and microchips and mini-cameras may one day make it possible for people with severe vision loss to see again. Presently this is still in the experimental stage, but if it proves to be effective, we will be able to offer it to our patients.

As you can see, there are a number of promising devices presently on the horizon. Once these devices have been approved by the FDA, we will be able to offer them to you. In the mean time, eat right, take your vitamins, keep your recommended eye appointments and don't give up hope.