Macular Degeneration Eye Health
Healthy Living
People who are visually impaired benefit from a healthy lifestyle that contributes to overall well-being. This includes regular exercise - adjusted to ensure safety - and a nutritious diet that may help protect remaining vision.
Healthy Living Tips
These suggestions may help protect vision and improve overall health, and they may lower the risk of developing AMD. Even after diagnosis, continue these healthy habits:
- Maintain a healthy weight
- Eat a nutritious diet that includes green leafy vegetables, yellow and orange fruit, fish, and whole grains
- Maintain normal blood pressure and control other medical conditions
- Exercise regularly
- Wear sunglasses and hats outdoors
- Get annual eye exams, and consult your doctor if you notice vision changes
- Don't smoke
"Vision" Foods to Include in your Diet
You might be able to reduce your risk of AMD or slow its progression by eating certain foods. Carotenoids (especially lutein and zeaxanthin), antioxidants (such vitamins C and E), vitamins A and D, zinc, and omega-3 fatty acids may all contribute to better vision.
Choose whole grain versions of pasta (sometimes called "brown pasta"), rice, and bread that contain complex carbohydrates, which are metabolized more slowly and are healthier than their "white" counterparts. White rice, bread, and pasta have a high glycemic index, meaning that the carbohydrates are broken down rapidly into glucose or blood sugar
They provide quick energy but contain few nutrients and little fiber, and in large amounts they may damage cells. Some studies have shown that eating foods with a high glycemic index may increase the risk of developing age-related macular degeneration.
It’s important to find the right vitamins,
since many are marketed for eye health but only a few have formulas that have proven effective.
Vitamins for Dry Age-Related Macular Degeneration
Once dry age-related macular degeneration reaches the advanced stage, or geographic atrophy, there is no form of treatment at present to prevent further vision loss. However, there is an intervention measure that could delay and possibly prevent intermediate age-related macular degeneration from progressing to the advanced stage in which vision loss occurs.
The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking nutritional supplements with a specific high-dose formulation of antioxidants (vitamins C and E and beta-carotene), zinc, and copper delayed or prevented the progression of age-related macular degeneration from the intermediate to the advanced stage.
A follow-up trial, called AREDS2, found that the addition of omega-3 fatty acids to the supplements did not improve the formula’s success. The antioxidants lutein and zeaxanthin proved safer than beta-carotene, which increases the risk of lung cancer for smokers or ex-smokers.
Risk Factors
Age-related macular degeneration (AMD) can rob people of their central vision, impacting their ability to read and drive. Fortunately, over the past 10 years research has uncovered some of the clues to what may be causing the disease, and this has helped shape efforts to prevent and treat AMD.
Medical experts are not sure exactly what causes age-related macular degeneration (AMD), but some factors may increase your risk of developing it. Find out how you can protect your eye health and prevent macular degeneration.
- Risk factors for age-related macular degeneration
- Heredity and macular degeneration
Age-Related Macular Degeneration
Controllable Risk Factors
- Smoking
- Prolonged Sun Exposure
- Diet
- Obesity
- Inactivity
Smoking
Smoking increases a person’s chances of developing AMD by two to five fold. Because the retina has a high rate of oxygen consumption, anything that affects oxygen delivery to the retina may affect vision. Smoking causes oxidative damage, which may contribute to the development and progression of this disease.
Prolonged Sun Exposure
Although the evidence is not conclusive, some studies suggest an association between AMD and cumulative eye damage from ultraviolet (UV) and other light. This light may damage the retina and increase the risk of AMD. Learn how to properly protect your eyes
Diet
People with diets that are elevated in fat, cholesterol and high glycemic index foods, and low in antioxidants and green leafy vegetables may be more likely to develop AMD. High-glycemic index foods, such as white rice, bread and pasta raise blood sugar rapidly, whereas low-glycemic foods, such as whole grain breads or oatmeal can lower the risk of AMD by stabilizing blood sugar levels.
Obesity
A person with a BMI (body mass index, a measure of body fat) of greater than 30 is 2.5 times more likely to develop the disease than a person with a lower BMI.
Inactivity
In dry AMD, the retina does not receive adequate oxygen, leading to the death of cells in the macula. Exercise improves cardiovascular health and might help prevent AMD.
Genetic Risk Factors for AMD
- Age
- Family History of AMD
- Gender
- Race
- High Blood Pressure
- Eye Color
- Presence of AMD in One Eye
Age
Age
The number one risk factor is age. Age-related macular degeneration typically affects people over 50. One-third of adults over 75 are affected by AMD.
Gender
Gender
Females are more likely to develop AMD than males. This factor may be because females live longer than males, and thus have more time to develop the disease.
Race
Race
Caucasians are more likely to develop AMD than other races. This factor may be related to differences in genetic background or pigmentation.
High Blood Pressure
High Blood Pressure
High blood pressure, like smoking, leads to a constriction (narrowing) of the blood vessels that nourish the retina, restricting oxygen flow.
Eye Color
Eye Color
People with light-colored eyes are more likely to develop the dry type of AMD. This factor may be because light-pigmented eyes offer less protection from damaging UV light.
Presence of AMD in One Eye
Presence of AMD in One Eye
If a person has AMD in one eye, he or she is more likely to develop it in the other eye.
People who inherit certain genes in the “complement cascade,” which is part of the immune system, have a higher risk for AMD, probably due to inflammatory damage to the retina.
Early-Stage AMD
All AMD patients start out with early-stage (early) AMD, which often shows no noticeable symptoms. Eye doctors detect little white spots in the retina called drusen that can occur with advancing age. The retinal cells become less efficient at performing “housekeeping” tasks and small “garbage” deposits develop. The causes of early AMD are thought to involve oxidative stress and inflammation.
Oxidative stress is a disturbance in the balance between the production of very reactive oxygen-containing molecules that can adversely interact with other molecules inside our cells, and our body’s ability to neutralize these molecules. Oxidative stress can be caused by a number of things, including bright light, a poor diet with not enough antioxidants, and too much iron in the retina. The resulting inflammation can contribute to a number of age-related diseases, including age-related macular degeneration. Antioxidants are molecules present in cells that can prevent these harmful reactions.
Patients with early AMD may maintain good vision for their entire lives, or they may progress to late AMD. Changes in vision can be monitored at home with an Amsler grid or the ForeseeHome Monitor®.
Also, if another part of the retina, called Bruch’s membrane, is damaged, new, abnormal blood vessels can invade the retina in a type of healing response gone wrong. These blood vessels leak blood and fluid into the retina, causing it to become wet. This fluid in the retina immediately disrupts vision and, over time, can lead to damaged retinal scar tissue.
Late-Stage AMD
Late-stage (late) AMD comes in two forms: wet AMD, or the dry AMD condition known as geographic atrophy. Wet AMD is always considered a late stage of AMD. In this condition, abnormal blood vessels sometimes grow behind the macula (choroidal neovascularization), the central part of the retina. Fluid leaks and vision is distorted.
In advanced dry AMD, there are regions of the retina where cells waste away and die (atrophy). Sometimes these regions of atrophy look like a map to the doctor who is examining the retina, hence the term geographic atrophy.
Geographic atrophy is caused by the death of light-sensitive cells known as photoreceptors, and their support cells known as retinal pigment epithelium cells or RPE. The area of atrophy usually expands slowly over time until it involves the entire central retina (macula). This causes a blind spot in the center of the visual field.
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