Cataracts and Macular Degeneration

Authors: Sachdeva S, Dhull AK

Overview of Cataracts and Macular Degeneration
Cartoon characters see spots or stars before their eyes, and everyone laughs. But there's nothing funny about sight-robbing cataracts and age-related macular degeneration (AMD). Both of these eye diseases are hallmarks of aging, but that doesn't mean you must surrender your sight to them as you get on in years. Adding vision-valuable foods to your diet may help you protect your eyes from the damage that occurs over time.In this article we'll look at the causes of cataracts and AMD, as well as some alternative treatments -- in other words, ones that don't involve surgery -- for relief from this age-related problem.

Understanding Cataracts

The reality is sobering. If you live long enough, chances are you'll get cataracts. As the population ages, the numbers creep ever upward -- each year, more than a million people are diagnosed with cataracts severe enough to require surgery. Almost two-thirds of all 60-year-olds have them.A cataract starts off as a cloudy spot on the clear lens of your eye (which is located behind your colored iris), almost as if you smeared grease on it. Some cataracts develop so slowly, you aren't even aware of them.But often, the cataract gets worse, or you get more of them. You may begin to notice double or blurred vision, sensitivity to light (glare may be especially troublesome), and changes in color perception. The upshot will be progressively more-frequent changes in your eyeglass prescription, until the glasses no longer seem to help the problem. Your distance vision gradually decreases and near vision improves (also called second sight).Your eye doctor will probably detect your cataract and, if it gets severe enough, suggest the latest in eye surgery.Until the late 1970s, cataract surgery. was certainly no picnic. It never really restored normal vision, and you had to wear thick eyeglasses, declaring to the world your advancing age. Now, cataract surgery is a mere hour-long affair ( in fact the actual procedure taking only 10 to 15 minutes), usually performed on an out-patient basis and is totally suture less. The cloudy natural lens is removed and replaced with a plastic intraocular lens. In the vast majority of cases, the operation is extremely successful: The implanted lens restores sight lost to the clouded-over lens and corrects most of the need for eyeglasses after surgery. But wouldn't preventing cataracts in the first place be even better? Well, tell those eye surgeons to hold their scalpels and lasers, because cataracts may not be the inevitable consequence of aging we've come to expect.

Understanding Macular Degeneration

Cataracts may affect more people, but macular degeneration is the most common cause of age-related blindness. That's why researchers are furiously working to better understand how to prevent and treat this eye disease, as well.The macula is an area of the retina, which is in the back of your eye. The retina is like the screen onto which the lens focuses the light (and hence the images) that enters the eye. But only a small area of the retina, the macula, contains the specialized cells responsible for the sharp central vision that you need to read, drive, and perform many other daily activities requiring clear, crisp focus. As the macula degenerates, some of the messages from your eye to your brain that tell you what you're seeing can't be transmitted, and your vision slowly becomes blurred or distorted; you may see shapes, but not fine lines, and you may experience a blank spot in your central vision. Eventually, you lose your vision altogether. There is currently no effective treatment to restore vision once the macula begins to degenerate.

Researchers have discovered that the retina of the eye is constantly bathed in vitamin C, at levels much higher than those normally found in the blood. Some researchers speculate that the vitamin C is there for protection and that the amount may need bolstering as we age. Perhaps antioxidant nutrients, therefore, could help prevent this condition, too.

Fig: Amsler grid to detect ARMD

Treatment Options
Where there's exposure to ultraviolet (UV) light (such as from the sun), there's potential for cell damage. The eye is certainly no exception. In fact, the more UV exposure, the more cataracts -- up to three times the risk.
The eye is constantly exposed to light and air -- typically polluted air as well -- and that's just the recipe for oxidative damage. When cells are oxidized, they set off chain reactions that can destroy whatever is in their path -- including healthy cells in the lens or the macula of the eye.Suddenly, a dietary connection to eye disease no longer seems so farfetched. Research into the possible connections between nutrition and vision has grown by leaps and bounds over the past decade. It is now evident that antioxidants may work to slow the progression of cataracts and may even help prevent them. The antioxidant nutrients linked to decreased cataract incidence include beta-carotene, vitamin C, and vitamin E.In one study, women who ate lots of fruits and vegetables had a whopping 39 percent lower risk of developing severe cataracts (the kind that require surgery) than those who didn't eat much produce. Among the strongest protectors were spinach, sweet potatoes, and winter squash, all high in beta-carotene. Another study found daily intake of 180 milligrams of vitamin C from foods (nearly three times the recommended daily amount) reduced the odds of developing cataracts by nearly 50 percent.With macular degeneration, National Eye Institute researchers were thrilled with the remarkable results from a six-year study. At least 25 percent of the people at risk for developing advanced macular degeneration experienced a protective effect from supplements containing vitamins C and E, beta-carotene, and zinc. The nutrients certainly don't cure the disease, nor will they restore vision already lost. However, they may help to slow progression of macular degeneration, a wonderful prospect for people suffering from this vision-robbing disease.Another interesting finding from recent research is that people with higher macular concentrations of two beta-carotene cousins, called lutein and zeaxanthin, seem to experience greater protection from damage caused by sunlight and other environmental factors. Research shows that people eating a diet with the most lutein+zeaxanthin (as much as 5.8 milligrams (mg) per day) had a significantly lower risk for AMD than those whose diet contained the least amount (as low as 1.2 mg per day). Lutein and zeaxanthin are found in yellow-colored vegetables, spinach, turnip greens, collard greens, romaine lettuce, broccoli, zucchini, corn, garden peas and Brussels sprouts. Research also suggests higher intakes of omega-3 fatty acids, which are found in higher-fat fish, soybeans, wheat germ, and canola oil, may help protect the eyes from AMD.Admittedly, we are still in the infancy of learning about the connection between nutrition and eye disease. And not all the results from the research have been promising. But the possibilities are indeed worth looking into.Taking precautions and augmenting them with foods and supplements can provide benefits to the eyes, if not an all-out cure.
A Feast for the Eyes
Vitamin C, vitamin E, and beta-carotene can protect your eyes from cataracts and macular degeneration. Below, we list some foods that provide these nutrients:

For vitamin C: Broccoli*, Brussels sprouts*, Cantaloupe, Cauliflower, Citrus fruits and juices, Papaya, Strawberries, Tomato juice.

For vitamin E: Almonds, Corn and safflower oils, Eggs, Peanuts, Sunflower seeds.

For beta-carotene: Apricots, Cantaloupe, Carrots*, Leafy, dark greens* (kale, spinach, turnip and collard greens), Mangoes, Peppers, red bell, Sweet Potatoes, Squash winter.

*These also supply lutein and zeaxanthin.
Tips for Saving Your Sight
There are plenty of simple steps you can take to ensure the health of your eyes, such as:
· Limit your sun exposure between the hours of 10 A.M. and 4 P.M., when sunlight is most intense.
· Wear a wide-brimmed hat when in the sun.
· Choose sunglasses with UVA and UVB protection (they are labeled voluntarily by the manufacturer), and wear them.
· Stop smoking. Smoking increases the amount of oxidative damage inflicted on your eyes.
· If you have diabetes, keep your blood glucose under control. High blood glucose levels can damage the lens of the eye.
· Eat a diet rich in fruits and vegetables. Aim for five to nine servings per day. Be sure to include those rich in vitamin C and beta-carotene.
· See an ophthalmologist regularly for early detection.

DISCLAIMER: This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Health Mirror, the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

In case of any queries please feel free to contact Dr Sumit Sachdeva or Dr Anil K Dhull