Save Your Sight
Taking preventative measures now may keep you from losing your vision later
By Lisa James
One of life’s great disappointments is to reach a cherished milestone without being able to fully enjoy it. That dilemma confronts millions of older Americans who, after working hard for decades, find their worlds growing dimmer because of degenerative eye disease. “People look forward to retirement—to play golf, read books, play with their grandchildren—and then they lose their eyesight. This is an epidemic in our society,” says Marc Grossman, OD, LAc, a nutritional consultant to two ophthalmology practices in the metropolitan New York area.
The incidence of disorders such as cataracts and macular degeneration, for which risk increases with advancing years, is rising. Part of this increase can be explained by the ever-growing number of aging baby boomers. However, “there are studies showing that our lifestyle is contributing to eye disease and chronic disease in general,” says Jeffrey Anshel, OD, of Corporate Vision Consulting in Encinitas, California, and author of Smart Medicine for Your Eyes (Square One).
Although modern surgical techniques have allowed many people to recover their sight, surgery isn’t the only answer. “I work with one of the best cataract surgeons in the country and I recommend her to people all the time,” says Grossman. “But I still want to work with patients on underlying causes. We can use nutrition and other complementary therapies in conjunction with Western medicine.”
What’s more, living a healthy lifestyle and getting adequate amounts of key nutrients may help prevent eye disease—and the blindness it causes—from developing in the first place. As Grossman notes, “Almost every professional journal over the past 10 years has articles on the effect nutrition has on vision. The eye is a reflection of the rest of your body.”
What It Is: A condition in which the lens, which focuses light onto the retina in the back of the eye, becomes cloudy
How It Affects Sight: Early signs include halos around lights, especially at night, and problems with glare; colors may look faded; vision becomes increasingly cloudy, blurry and/or dim
Number of people affected: 20.5 million now, with a projected rise to 30.1 million by 2020 (statistics provided by the National Eye Institute’s Eye Disease Prevalence Study Group)
Risk Reduction: Several factors increase cataract risk including heredity, smoking and drug side effects. But the biggest culprit is over-exposure to the sun’s UV rays, which cause proteins in the lens to clump together. The best way to prevent cataracts? “Sunglasses, in a nutshell,” says Robert Abel MD, of Delaware Ophthalmology Consultants in Wilmington and author of The Eye Care Revolution (Kensington). He points out that airline pilots, who are bombarded by high levels of UV radiation, have a 60% higher risk of cataracts.
Poor nutrition also plays a role in cataract development. UV exposure is just one source of cell-damaging free radicals. Antioxidant nutrients such as vitamins C and E help neutralize free radicals; one study found lower blood levels of both vitamins in cataract patients (Annals of Nutrition & Metabolism 9/08). Citrus bioflavonoids, many of which fight free radicals and inflammation themselves, help make vitamin C more effective. The mineral selenium is another antioxidant found in high levels within the eye. In addition, eating a produce-rich diet has been linked to lower cataract risk.
The body produces its own antioxidant, glutathione, that helps protect the lens. According to Abel, nutritional factors that support glutathione include MSM (methylsulfonylmethane), a bioavailable form of sulphur, and the antioxidants alpha lipoic acid and NAC (N-acetylcysteine).
What It Is: Damage to the optic nerve, often linked to increased pressure within the eye; pressure rises when circulation of aqueous humor, the fluid that fills the eye, is blocked; two forms, closed- and open-angle, with open-angle glaucoma being more common
How It Affects Sight: Gradual development of blank areas in the visual field (open-angle); blurry or lost vision and halos, along with severe eye pain and headache (closed-angle)
Number of people affected: 2.2 million now, 3.3 million by 2020 (projected)
Risk Reduction: According to Abel, open-angle glaucoma, also known as chronic simple glaucoma, “is a disease of stress.” This helps explain why the B-complex, often referred to as the stress vitamins, may be helpful in reducing cataract risk; Grossman says that vitamin B1 (thiamin) is “essential for the health of the optic nerve.” Abel warns that sleep apnea, a condition that disrupts nighttime breathing, can lead to a number of eye diseases including glaucoma.
Both Grossman and Abel recommend omega-3 fatty acids. People with glaucoma have been found to have reduced levels of DHA and EPA, the omega-3s in fish oil, in their blood, and DHA and EPA have decreased pressure within the eye in animal studies (Investigative Ophthalmology & Visual Science 2/07). Another marine-based nutrient, the carotenoid astaxanthin, was found to reduce retinal damage caused by increased eye pressure, while the herb bilberry has been found to protect nerve cells in the retina (RTP 10/10, Molecular Nutrition & Food Research 7/09). In addition, “there have been a couple of studies on Pycnogenol, which has been shown to reduce eye pressure a little bit and increase blood flow to the optic nerve,” says Anshel.
Macular Degeneration (MD)
What It Is: A thinning of the macula, the part of the retina responsible for sharp central vision; in dry MD, this causes yellow spots called drusen; may progress to the wet type, in which abnormal blood vessels leak, causing raised scars that distort vision; also known as age-related macular degeneration (ARMD)
How It Affects Sight: The need for increasingly brighter lights to do close work; difficulty adjusting from bright to low light conditions; blank areas in the center of the visual field
Number of people affected: 1.8 million now (advanced cases), 2.9 million by 2020 (projected)
Risk Reduction: The retina is prone to free radical damage from another type of solar radiation called blue light, especially in people with blue, green or hazel eyes. “Research has shown that two carotenoids, lutein and zeaxanthin, act as sunglasses for the back of the eye. They serve as antioxidants and filter blue light,” says Anshel. Together lutein and zeaxanthin make up what is called macular pigment; eyes affected by macular degeneration contain about 30% less macular pigment than healthy eyes. (To learn about other members of the carotenoid family, see page 48.) Low levels of vitamins C and E have also been associated with a greater risk of MD development.
Scientists have found high levels of other nutrients in the retina as well. DHA, one of the fish oil omega-3s, is concentrated in the membranes of retinal cells. “About 50% of your retina consists of DHA,” Abel says. The retina also contains high concentrations of zinc, a mineral required by enzymes within the retina. In addition, Abel recommends another mineral, magnesium, for its ability to promote healthy circulation.
For more information on sight preservation, contact Prevent Blindness America: www.preventblindness.org, 800-331-2020
Diabetes and Eyesight
Diabetes is such a destructive disease because it attacks capillaries, the tiny vessels that connect arteries to veins, throughout the body—including those in the eye. “The blood vessels start breaking down. The small vessels go first, and those in the eye are small vessels; blood and fluids start leaking out of them. As bleeds in the retina clot, they shrink and detach the retina,” explains Jeffrey Anshel, DO.
DR occurs in two forms. In the nonproliferative type leaked fluid causes the retina to bulge, which distorts vision. Abnormal blood vessels that grow in the proliferative form tend to bleed, which can cause retinal scarring. Symptoms include poor night vision, blank areas in the visual field, blurriness and an increase in floaters, or shadowy spots that move around within the eye. According to the National Eye Institute, 4.1 million people currently suffer from DR; 7.2 million cases are projected by 2020.
Changes in the eye may provide the first clue that a person has blood-sugar problems. “A lot of times I examine people and tell them, ‘I want you to go for bloodwork,’” says Marc Grossman, DO. “I just picked up diabetic retinopathy in an overweight 14-year-old the other day.”
Excess weight is often associated with type 2 diabetes, the most common form, which makes weight loss a key factor in controlling both diabetes and DR. Robert Abel, MD, had a DR patient who went from six hemorrhages in one eye and seven in the other to one hemorrhage between the two eyes after losing 50 pounds in a year. Another of Abel’s diabetic patients “lost 60 pounds and was off all medicine.”
Several of the nutrients shown to be of benefit in other degenerative eye diseases may help fight the effects of DR. In one study, diabetic rats given a combination of beta-carotene, zinc, copper and vitamins C and E showed signs of inhibited DR progression and fewer abnormal capillaries than other rats (Archives of Ophthalmology 9/08). Diabetic rats treated with the omega-3 fatty acid DHA and the carotenoid lutein didn’t experience the retinal deficits normally caused by diabetes (Current Eye Research 11/09); in another study, lutein helped prevent the development and progression of diabetes-related cataracts. And lutein’s carotenoid partner, zeaxanthin, has also inhibited retinal changes associated with DR (Investigative Ophthalmology & Visual Science 4/08).
Complementary practitioners employ a number of nutrients and herbs to help control diabetes, which in turn helps control DR. Natural blood-sugar regulators include beta-glucan, a type of soluble fiber that that helps keep glucose levels from rising too rapidly by slowing down the digestive process; banaba, an Indian herb that contains corosolic acid, which helps transport glucose into cells; bitter melon, a tropic fruit that helps reduce blood glucose levels; chromium, a trace mineral that fights insulin resistance; cinnamon, which helps make insulin more effective; and gymnema, an herb that helps lower levels of glucose and a harmful diabetes byproduct called glycosylated hemoglobin. (If you have DR or diabetes, always consult with a trained healthcare practitioner in creating a supplementation plan suited to your needs.)