“For and About Your and My Eyes”

 

These Antioxidant-Rich Snacks Slow Wet AMD Progression

by Lambeth Hochwald Health Writer
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TURNS OUT, CARROTS are just the tip of the iceberg when it comes to foods that are good for your eyes. While Wet AMD—the chronic kind of age-related macular degeneration (AMD)—rarely leads to total blindness, it can stop you from activities like driving and reading. Eating antioxidant-rich foods (like the snacks in this slideshow) along with diligently taking your meds might help slow down that progression. Who’s hungry?

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Your Eyes and What You Eat

A well-balanced diet, rich in fruits, vegetables, whole grains, seafood, nuts, and seeds has been shown to help promote health, including that of your eyes. “Certain nutrients help maintain healthy eyes primarily because of their role in regulating inflammation,” says Kristin Gillespie, R.D., a registered dietitian and certified nutrition support clinician in Virginia Beach, VA.

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Look for Lutein (and Zeaxanthin)

No, lutein and zeaxanthin aren’t Greek gods. They’re antioxidant-packed carotenoids (a.k.a. key phytonutrients generally found in pistachios and dark green leafy veggies), and they’re crucial to maintaining eye health because they help slow damage to healthy cells. “Fruits and vegetables, in general, are excellent for promoting eye health as a result of their rich antioxidant contents,” says Laura Ali, RDN, a registered dietitian and culinary nutritionist in Pittsburgh whose father had AMD. “Antioxidants are important because they help prevent cellular damage throughout the body, including within the retina.”

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Snack on This

Cooking lutein- and zeaxanthin-containing produce helps your body better absorb them as does preparing them with a healthy oil, such as olive oil. “Olive oil is rich in antioxidants and thought to have eye-protective properties of its own,” Gillespie says. “Therefore cooking your leafy greens in olive oil may boost their nutritional content and impact on eye health.” Consider snacking on sautéed spinach in olive oil or add arugula to a slice of pizza for a midafternoon snack to help your body get the full benefit of these carotenoids. Egg yolks are also rich in lutein so pack some hardboiled eggs when you’re on the go.

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Add Omega-3 Fatty Acids

For optimal retinal health, you’ll want to consider becoming BFFs with foods filled with omega-3 fatty acids such as walnuts, albacore tuna, and avocados. “They’re anti-inflammatory in nature and regulating inflammatory pathways may help prevent macular degeneration,” says Gillespie. Researchers have found that people who ate fish at least once a week had a lower risk for developing Wet AMD than those who did not eat fish, Ali adds.

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Snack on This

Aim to get your omega 3s in whole-food form whenever possible, says Ali. “Many health organizations, including the Dietary Guidelines for Americans, recommend eating at least eight ounces of seafood a week to get approximately 250 mg of DHA and EPA Omega-3 fatty acids.” Fish not your thing? Reach for a handful of walnuts or drizzle EVOO in a half avocado for maximum eye health benefit.

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Seek Out Plenty of C

To protect your eyes, aim to snack on vitamin C rich foods such as citrus fruits, strawberries, red peppers and kiwi, says Lisa Young, Ph.D., R.D., a nutritionist in private practice in New York City. “These foods are rich in antioxidants and support the health of blood vessels in the eye, which can, in turn, help to prevent or slow AMD and visual acuity loss.”

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Snack on This

Getting your fill of vitamin C doesn’t have to mean a hefty glass of OJ. Instead, make it a daily habit to munch on red peppers and carrots with hummus, a kale and baby spinach salad topped with walnuts, a fruit salad with orange, berries and kiwi, a grapefruit with honey or a cup of strawberries and yogurt. “Luckily excess vitamin C intake isn’t generally harmful,” Gillespie says. “This vitamin is water-soluble so anything in excess of what your body needs is excreted in the urine.”

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Amp Up the E

Vitamin E is an antioxidant that protects your eyes from damaging free radicals found in things like tobacco smoke, pesticides and air pollutants. Vitamin E deficiency can weaken light receptors in the retina and affect areas of the eye that are susceptible to oxidative damage. “That’s why you want to be sure to eat foods that are rich in this essential nutrient,” says Ali.

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Snack on This

Whole grain crackers and nuts (such as almonds and sunflowers) are the perfect swap for when you’re craving crunch. Just keep an eye on your salt intake “One of the risk factors for Wet AMD is high blood pressure,” says Ali. “If you have high blood pressure you should be mindful of your salt intake and look for unsalted or reduced-sodium options.” And if avocado toast is your jam, have at it—the green goodness comes packed with 28% of your daily requirement of vitamin E. Guacamole every day? We’ll take it.

Lambeth Hochwald
Meet Our Writer

Lambeth Hochwald

Lambeth Hochwald is a consumer lifestyle reporter covering health, fitness, marriage and family.

 

 

8 Top Myths About AMD

by Judy Koutsky Health Writer
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AGE-RELATED MACULAR DEGENERATION (AMD) isn’t exactly known for its subtlety: It’s not only a mouthful to say, it’s the leading cause of vision loss in people over the age of 50 in the United States, according to Cleveland Clinic. But, as prevalent as the condition is, there’s still a ton of mystery that surrounds it. We reveal some of the biggest misperceptions about AMD and share expert advice for dealing with it.

MYTH: You’ll know right away if you have AMD.

FACT: “The vast majority of patients I diagnose with macular degeneration do not know that they have it,” says Ming Wang, M.D., Ph.D., an ophthalmologist at Wang Vision Institute, a private practice in Nashville, TN. “It generally creates only subtle vision changes at first or occurs with no symptoms at all. Only more advanced stages of the condition cause major vision impairment.” For this reason, it is essential to have regular eye exams.

People who do have early symptoms of macular degeneration may experience: blurred central vision, blank or dark spots in vision, and curved vision (such as seeing something wavy when it is really straight).

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MYTH: AMD leads to total blindness.

FACT: AMD can contribute to vision loss, but not always blindness. “Age-related macular degeneration affects the macula, the most central part of our retina,” says Caesar Luo, M.D., a board certified vitreo-retinal surgeon in Oakland, CA. This area of the retina is responsible for our most discriminating and focused vision—it’s what we use to read and recognize faces.

“Even in the worst forms of AMD, the peripheral vision will remain functional,” says Dr. Luo. “Often my patients will still be able to navigate while walking, dress themselves, and learn how to use their peripheral vision more effectively.”

MYTH: Eating carrots will improve your vision.

FACT: Not exactly. “Unfortunately, if glasses or contact lenses are needed for vision correction, extra vitamins in the diet cannot take away or reduce that need,” says Dr. Wang. “Vitamin supplementation also cannot improve acuity, or how low you can read down the eye chart with vision correction.” Those vision issues are typically caused by a mismatch between the length of the eye and curve on the eye. This mismatch creates nearsightedness, farsightedness, and astigmatism, all of which would need to be corrected with glasses or surgery such as LASIK.

How Nutrients Do Help Eye Health

Antioxidants, like vitamins A (found in carrots!), C , and E, help protect the eyes from developing drusen, the debris buildup in the innermost layers of the retina that can contribute to AMD. What’s more, good nutrition does in fact promote good eye health over a lifetime and may reduce the risk of several vision-threatening diseases, says Dr. Wang. So yes, keep filling your plate with colorful produce and work in E-rich snacks like nuts and seeds.

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Ali Yahya
MYTH: Smoking doesn’t affect vision.

FACT: Smoking is one of the biggest risk factors for AMD, according research in the Journal of Ophthalmology. In fact, it doubles someone’s risk of having macular degeneration, says Nathan D. Rock, O.D., an optometrist at Wang Vision Institute.

Because the macula has a very delicate blood supply, its vessels are particularly prone to dangerous chemicals like tar. “While we don’t understand the link with certainty, it’s possible that tar damages the small blood vessels, which then contributes to the development of the abnormal waste, or drusen.”

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MYTH: Many young people get AMD.

FACT: Not really. “True macular degeneration is an age-related condition. It is very rare to see macular degeneration in someone under the age of 40 to 50,” says Dr. Wang. “Risk has been shown to steadily increase with increasing age. However, there are conditions which can mimic macular degeneration and cause similar vision affects that can affect younger patients.”

Children and young adults may experience similar symptoms if they’ve inherited one of the rare forms of juvenile macular degeneration, according to the American Academy of Ophthalmology. Unfortunately, there’s no currently no way to prevent or slow vision loss with these conditions.

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MYTH: Everyone with wet AMD will eventually go blind.

FACT: Fifteen years ago, this was basically true, says Dr. Luo. “We had no effective treatment for wet AMD, and ultimately all patients would proceed to legal blindness.” This is not true today. This most advanced stage of AMD is caused by abnormal blood vessels that leak fluid or blood into the retina. Thanks to anti-vascular endothelial growth factor (anti-VEGF) medication, doctors can now halt the progression of wet AMD and actually improve vision. The key to is act quickly, because unlike dry AMD, the wet form can progress quickly. The only downside? The medicine must be injected into your eye. (We can help you get over those fears though!)

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MYTH: Dry ADM is easier to treat than the wet form.

FACT: “Unfortunately, there isn’t any treatment for dry macular degeneration,” says Dr. Rock. “There is, however, a special formulation of vitamins called AREDS 2 that’s been shown to reduce the risk of progression for those with intermediate-stage AMD, but it doesn’t treat the condition itself or help to improve vision,” says Dr. Rock. Research by the National Eye Institute found that this unique combination of antioxidants (including vitamins C, E, zinc, copper, lutein, and zeaxanthin) can reduce the risk of advanced AMD by 25% over five years.

Ask your doctor if the supplement could be beneficial for you.

MYTH: Reading in dim light will damage your eyes.

FACT: No matter what your mom might have told you, this isn’t true and it has no impact on AMD. “Reading in dim light is not inherently dangerous, though there is an ideal balance between the amount of light on the object you are focusing on, such a printed book or a television, and the surrounding environment,” says Dr. Wang. If you read something lit in a completely dim room (or read a dimly lit page) it can cause strain on the focusing system and make the experience less enjoyable. Who wants that? Flip on those lights instead.

Judy Koutsky
Meet Our Writer

Judy Koutsky

Judy Koutsky is an award-winning writer and editor and her work has appeared in over 30 publications including Conde Nast TravelerTravel + LeisureParents, WebMD, Prevention and Scholastic. You can see her work at   … at … JudyKoutsky.com or follow her on Instagram @JudyKoutsky.

 

Demystifying Wet AMD Treatment

by Erin L. Boyle Health Writer
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SO YOU’VE BEEN diagnosed with wet age-related macular degeneration (or wet AMD), a frustrating condition that significantly affects your vision. You probably have a lot of questions. One of your first ones, we’re guessing, is: Can this disease be treated? After your doctor likely says yes, wet AMD is treatable (very treatable, in fact), you probably have a few more questions about the treatment itself. Stick with us—we asked two ophthalmologists specializing in the disease to answer 10 questions about wet AMD treatment that just might be on your mind.

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What Wet AMD Treatment Is Most Common?

The short answer: anti-VEGF medication. Having nothing to do with vegetable hatred, these drugs work by blocking something called vascular endothelial growth factor (VEGF), a protein made in your cells that slows the growth of abnormal blood vessels. These abnormal vessels leak fluid or blood into your macula, the part of your retina in charge of central vision, making it difficult to see.

Will Treatment Help Me See Better?

In the best possible outcome, yes. “About a third of patients can expect improvement in vision,” says Jason Hsu, M.D., an attending surgeon at Wills Eye Hospital in Philadelphia. Research shows that after two years of anti-VEGF treatment, more than 95% of patients with wet AMD maintain their vision, and up to 40% experience improvement. But something you need to know about anti-VEGF drugs: They’re given via (painless, we promise!) injections into your eye.

Will I Just Need One Treatment?

No, sorry. Wet AMD is a chronic eye disease that can worsen significantly (to the point of vision loss in the center range of your eye), so you’ll need regular injections. “Unfortunately, treatment is ongoing,” says Rukhsana G. Mirza, M.D., associate professor of ophthalmology and medical education, specializing in diseases of the retina, at Feinberg School of Medicine at Northwestern Medicine in Chicago. Don’t dodge it: Your vision will deteriorate rapidly without treatment.

So How Often Do I Need Injections?

This depends on a number of factors, including how advanced your wet AMD is and how your eye responds to treatment. Some patients need monthly injections indefinitely to manage their disease progression, says Dr. Hsu. Others can go four to even six months between treatments. “Usually, we start off doing monthly injections, then depending on the response as the swelling in the retina and the bleeding go away, often we’re able to gradually space them out,” he says. “It varies from doctor to doctor and patient to patient.”

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Who Should I See for This Treatment?

Shopping for trendy eyeglasses is one thing. When it comes to serious eye diseases like wet AMD (hello, needle-in-eyeball) being treated by an ophthalmologist (a.k.a. an eye doc with an M.D.) is a must. Best of all would be seeing an ophthalmologist who specializes in retina diseases, says Dr. Hsu—these specialists understand the nuances of the disease. Not sure where to look? The American Society of Retina Specialists features a useful “find a retina specialist” tool. You can also get a referral to a retina specialist from your general ophthalmologist.

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Does Treatment Always Work?

Usually, yes. However, the effectiveness/efficacy depends on what stage the disease is detected. Anti-VEGF drugs are the first-line treatment for wet AMD, so your doctor will likely have you start with these meds, selecting one based on your unique needs and insurance coverage. If for some reason it doesn’t work, eye docs have a few more tricks up their sleeves, including switching to a different anti-VEGF med, giving you a “drug holiday,” or combining different therapies. Ask your doctor about options: New drugs are in development and could be approved in the near future, Dr. Mirza says.

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Do Anti-VEGF Injections Hurt?

You’ll be awake during the injection but you shouldn’t feel pain, say Dr. Mirza. (If you didn’t freak a little though, you wouldn’t be human.) Your doctor will numb your eye with an anesthetic, including an eye drop, then put betadine on your eye to decrease infection risk—it’s a form of soap, so it may sting a little. Generally the eye is numbed with an eye drop or topical anesthetic and then cleaned with betadine drops to decrease the risk of infection. You’ll likely feel slight pressure during the injection. After, you might have a sensation like there’s sand in your eye, but it should resolve within a day.

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I’m Afraid of Needles. How Do I Deal?

First, anti-VEGF injections are so quick, they’ll be over before you know it. The syringe takes only a few seconds to empty. Second, you likely won’t see the needle—it’s injected from the side of your eye. Regardless, it’s important to share your fears with your doctor. Dr. Mirza’s office provides stress balls, the arm of the chair to hold onto as tightly as you need to, light classical music, even technicians who hold your hand. But first and foremost: “We get through it as fast as possible,” she says.

Where Does the Injection Go in My Eye?

You might be wondering, does the injection go into my pupil? Or my cornea? Neither, says Dr. Mirza. “We inject it into the white part of the eye,” she explains (called the sclera). Some offices use a device that does the work of holding your eye open for you. Others, like where Dr. Hsu practices, have an assistant gently hold the eye open by hand. If you’re still not sold on the idea of injection, the good news is that new and exciting treatments are in development that could change the way the meds are delivered, Dr. Hsu says. At the end of the injection, your doctor will also put an antibiotic eye drop to prevent infection.

 

Erin L. Boyle
Meet Our Writer

Erin L. Boyle

Erin L. Boyle, the senior editor at HealthCentral from 2016-2018, is an award-winning freelance medical writer and editor with more than 15 years’ experience. She’s traveled the world for a decade to bring the latest in medical research to doctors. Health writing is also personal for her: she has several autoimmune diseases and migraines with aura, which she writes about for HealthCentral. Learn more about her at erinlynnboyle.com. Follow her on Twitter @ErinLBoyle.

 


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