Focus on Preventing Macular Degeneration

Written by: Holly Timberline

Every year, hundreds of thousands of seniors are diagnosed with age-related macular degeneration, or AMD, an incurable eye disease caused by the deterioration of the central portion of the retina, called the macula. Although it rarely causes total blindness, AMD is the leading cause of poor vision and legal blindness in people over 65.

AMD affects central vision, causing blurring and other visual distortion. In the later stages of the disease, AMD sufferers have trouble seeing details, including printed material, road signs or even features of the human face.

The "dry" form of AMD, accounting for about 90 percent of cases, is characterized by deposits on the retina. These deposits lead to thinning and drying of the macula and a gradual loss of vision. Dry AMD is generally untreatable. In the "wet" form, comprising about 10 percent of cases, abnormal blood vessels growing beneath the retina can leak fluid into the eye, causing the macula to bulge. Swift and severe vision loss can result. The progression of some forms of wet AMD can be slowed down with laser surgery and other emerging techniques. However, in either form, vision already lost to the disease cannot be recovered.

Although AMD can strike younger people, the disease is most common in seniors. It is also more prevalent among both women and whites, particularly those with blue eyes. Thankfully, there are a few guidelines that anyone can follow to help prevent AMD:

Eat a balanced diet rich in dark green, leafy vegetables. Frederick Ferris, M.D., head of the Clinical Trials Branch of the National Eye Institute (NEI), a branch of the National Institutes of Health, says studies are underway to determine whether antioxidants, zinc and other vitamins may help prevent AMD. (Preliminary indications suggest they might.) Results should be published in the fall of 2001. Meanwhile, Ferris suggests adding a daily dose of spinach, kale, or other greens, all of which are rich in important nutrients.

While taking mega-doses of specific vitamins is not considered safe or wise--"When you start taking vitamins or supplements in large doses, that's when there is potential for side effects," Ferris cautions--some eye doctors do recommend a reasonable antioxidant supplement. Kerry Beebe, an optometrist in Brainerd, Minn., and chair of the Clinical Care Division of the American Optometric Association, says his own father has "the worst retina you could observe as a doctor, and his vision is still 20-20." Beebe notes that his father has taken antioxidants for 15 years. Check with your doctor before adding any vitamin supplement.
Stop smoking. Smokers are at higher risk of developing AMD than nonsmokers, maybe because tobacco seems to interfere with the absorption of lutein, an antioxidant that helps shield the retina from the damaging effects of ultraviolet light.
Maintain low blood pressure. The link between AMD and high blood pressure is well established. Have your blood pressure assessed by your doctor, and if it is high, make the necessary changes to lower it.
Protect your eyes from ultraviolet light. Ultraviolet rays can damage the retina and may increase risk of AMD. Protect your eyes with a visor or sunglasses (or both) when you are outside.
Have annual eye exams.
See your eye doctor immediately if you experience any visual disturbance, including print that appears blurred, straight lines (such as telephone poles or light posts) that appear wavy or dark or empty spots in the center of your vision. You can check yourself for potential problems by using the Amsler grid.

Ferris says that AMD treatments on the horizon include radiation treatment; a class of anti-angiogenic drugs, which stop the growth of abnormal blood vessels; and the possible use of lutein as a preventative.

Holly Timberline is an assistant editor at Style Weekly, a city magazine in Richmond, Va. She writes frequently on health, lifestyle and the arts.