Macular Degeneration:

Five Steps to Help Prevent Macular Degeneration

by Orlin Sorensen

Walking down the street one day, you notice that the telephone pole in front of you is looking rather odd. Instead of standing upright as it ought to, it looks, well... wavy. You glance around at the side of the building next to you, and it, too, is not its usual straight self.

Don't worry, you're not going nuts! But you may be one of 13 million Americans who have a common, age-related eye disease called macular degeneration.

Macular degeneration, often called AMD or ARMD (for "age- related macular degeneration"), is the leading cause of vision loss and legal blindness in Americans age 65 and older, according to the eye-health organization Prevent Blindness America. The macula is the part of the retina we use for reading, driving, recognizing faces, watching television, and fine work: in short, it is the region of maximum visual acuity. The exact causes of AMD are still unknown, but risk factors include:

  • Age - the risk increases with age.
  • Cigarette smoking
  • A family history of macular degeneration
  • Excessive exposure to sunlight
  • High blood pressure and/or cardiovascular disease
  • Being female and/or Caucasian - these groups tend to get the disease more than their counterparts.

Vision loss usually occurs gradually and typically affects both eyes at different rates. How do you know if you have AMD? If straight lines look wavy, as mentioned above, or there are shadowy areas or dark or empty spots in your central vision, you may be experiencing early signs of the disease.

There are two forms of age-related macular degeneration: "wet" and "dry." Most patients have the dry form, which may result from the aging and thinning of macular tissue, or disturbances in its pigmentation. In the wet form, new blood vessels grow beneath the retina and leak blood and fluid, which causes retinal cells to die and creates blind spots in central vision. The formation of blood vessels and deposits known as "drusen" from blood vessels in and under the macular is often the first physical sign that AMD may develop. The "wet" form accounts for 90 percent of all cases of legal blindness in macular degeneration patients.

While there is no cure for AMD, there are five steps you can take to lower your risk or slow down the progression of dry AMD.

  1. Don't smoke. Smoking is a powerful risk factor for loss of vision with AMD. In fact, one study showed that smoking more than doubles the risk of AMD. This study also found that AMD is more than twice as common in people who smoke more than a pack of cigarettes a day, compared with people who do not smoke.

  2. Wear sunglasses. UV protection may play an important role in preventing AMD. Beginning at a young age, begin protecting the eyes from UV light. Look for sunglasses that afford 100% UV protection or prescription eyewear with the same. A brimmed hat offers extra protection to shade the eyes when you are outdoors.

  3. Care for your cardiovascular system. Recently published data shows that people with uncontrolled hypertension were approximately three times as likely to develop the wet, or more severe, type of macular degeneration, compared to those without hypertension. Regular cardiovascular activity, such as walking or biking, may reduce the rate of progression to advanced AMD by as much as 25 percent.

  4. As Mom always said, eat your fruits and vegetables! Studies have shown that a diet rich in dark, leafy green vegetables will help decrease an individual's risk of developing AMD and/or help delay progression of the disease once it has begun. A recent study sponsored by the National Institutes of Health found that individuals who had the highest consumption of vegetables rich in carotenoids, especially lutein and zeaxanthin, had a 43% lower risk of developing AMD than those who ate these foods the least. Vegetables that are rich in these two carotenoids include raw spinach, kale, and collard greens. A new study also shows that people who eat three or more servings per day of fruit have a 36 percent lower risk of AMD compared to those who ate less than one-and-a-half servings per day. If an intermediate degree of AMD has already developed, or an advanced degree of AMD has developed in one eye, studies indicate that dietary supplementation with vitamins E and C, beta-carotene, zinc and copper may help to delay progression of the disease.

    Always consult your doctor before taking any supplements.

  5. Limit dietary fat. Before you reach for that pint of Ben & Jerry's Wavy Gravy, consider that high fat intake is associated with an increased risk of AMD. A study published in the August 2001 issue of Archives of Ophthalmology found that consumption of omega-3 fatty acids, which are particularly prevalent in cold-water fish, had a protective effect against advanced macular degeneration. Meanwhile, consumption of omega-6 fatty acids, prevalent in vegetable oils, was associated with an increased risk. But go nuts for nuts! Eating one serving a day of any type of nut, according to AgingEye Times, reduces the risk of progression of AMD by 40 percent.

Of course, regular eye exams are key to preventing vision loss. Although AMD appears to be hereditary in some families but not in others, if you have a family history of the disease, it pays to be on the alert. If you are 65 or older, you should get a complete eye exam every one or two years, even if you have no problem seeing well.

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