As people live longer eye diseases such as macular degeneration and cataracts are on the rise which has a negative effect on eye health. This often robs people of their freedom and quality of life. Age related macular degeneration (AMD) is the leading cause of irreversible blindness in people over 65. AMD occurs when the cells in the central part of the eye, which is called the macular, begin to degrade. This causes loss of sight in the central part of the field of vision, but leaves peripheral vision intact.
It is estimated that as many as 16 million Americans show signs of the initial stages of AMD. To put that into perspective that is roughly twice the population of Los Angeles. While this seems like a very high number the fortunate thing is that 90% exhibit the dry form of AMD which occurs over time and can be corrected with nutrition and lifestyle changes. The dry form of this disease is not associated with blindness, but, if left untreated can progress to the wet form of AMD. This sudden form of the disease leads to blindness in about 10% of AMD patients.
There are a number of factors that are known to lead to the development of AMD. Some of these include age, eye color, gender, exposure to sunlight, smoking, alcohol consumption and heart disease to name a few.
Lutein is a carotenoid found in some vegetables and fruits. It acts as a powerful antioxidant that can protect the eyes from disease and is essential for good vision and eye health. It is not made by the body and can only be obtained by the foods that we eat and nutritional supplements. The problem is that large amounts of fruits and vegetables would need to be consumed to get the required amount of lutein. It is found in green leafy vegetables such as spinach and kale. It is also found in corn and egg yolks. Carotenoids have shown benefits in reducing the risk of cancer, heart disease and eye disease and enhancing the body’s immune system.
Lutein is found in the macular which is the central part of the retina. While it is not a vitamin lutein is an antioxidant that may help to protect the macular tissue from destructive oxidation reactions by eliminating free radicals. It can also filter high energy blue light that has been known to damage the macula and skin.
It was first discovered by a researcher at Harvard University in 1994 that lutein plays an important role in eye health. Since that time there has been significant research on its ability to protect the eyes and is recommended by many eye doctors for their patients.
According to a recent study done by Kemin Foods 91% of eye doctors believe that lutein plays an important role in promoting good eye health. In addition, 58% of those surveyed believe lutein is the best nutrient for promoting long term eye health. This survey consisted of 150 ophthalmologists and 150 optometrists in the United States about their perceptions of lutein.
When the color of one’s eyes starts to fade it is not a result of aging but a loss of lutein. It is used by the eye as a natural antioxidant to eliminate damaging free radicals. Lutein as acts to filter damaging light from the eye. You can think of it as a pair of natural sunglasses.
Assuming that we are getting enough lutein thru diet or nutritional supplementation the good news is that it has the ability to build reserves in the eye to assure long term eye heath. Even for people that are not experiencing any eye problems they can benefit from lutein in preserving the good eye health they already have. Think of lutein as doing the same thing for your eyes as sun block and moisturizer does for your skin. If you start using it when you are young you maintain the healthy appearance of your skin as you age. The same analogy can be applied to your eyesight. When you are 60 it would be nice to have the same vision as when you were 30.
We know that we can not change our age, genetics or gender but there are things in our lifestyle that we can change to protect our eyesight. A few of these are to quit smoking, protect your eyes with sunglasses, limit your intake of alcohol and supplement with lutein.
For more information go to www.maculardegenerationassociation.org
Friday, November 27, 2009
Monday, November 16, 2009
Cataract Surgery Does Not Worsen Age-Related Macular Degeneration
Fran Lowry
Cataract surgery does not appear to increase the progression of age-related macular degeneration (AMD). Instead, it might reveal pre-existing AMD that had been hidden by the cataract, suggests a new study published in the November issue of the Archives of Ophthalmology.
"There has been a longstanding controversy among clinicians as to whether cataract surgery is contraindicated in eyes with nonneovascular AMD," write Li Ming Dong, PhD, from Stony Brook University School of Medicine in New York, and associates from Johns Hopkins University School of Medicine in Baltimore, Maryland. "A major concern has been whether cataract surgery increases the risk of progression to neovascular AMD in eyes at risk of progression, such as those with intermediate AMD (extensive medium-sized drusen, large drusen, or nonfoveal geographic atrophy)."
The aim of this study was to evaluate the course of AMD during the year after cataract surgery in individuals with preconfirmed nonneovascular AMD.
The investigators analyzed 86 patients with nonneovascular AMD who underwent cataract surgery to note the incidence of neovascular AMD development in the 12 months after the operation. Only 1 eye from each patient was analyzed.
Fluorescein angiography was performed preoperatively, and at 1 week, 3 months, and 12 months postoperatively.
The median age of the patients was 76 years (range, 58 to 92 years); 48% were women, 97% were white, and nearly two thirds were current or former cigarette smokers. The median preoperative visual acuity (Snellen equivalent) was 20/50 (range, ≥20/40 to 20/400).
Photographic documentation of AMD status was done in 71 patients (83%) at the 12-month visit. Sixty-six patients (77%) also completed a clinical examination at this visit.
Neovascular AMD was observed in 9 eyes (12.7%; 95% confidence interval [CI], 6.0% - 22.7%) by 12 months, including 1 that was graded as probable neovascular AMD. Five eyes displayed signs of neovascular AMD at the 1-week follow-up, but the size and location of the lesions indicated that they might have been present before surgery but not visible because of the opacity caused by the cataract, the authors report.
One eye did not have a 1-week follow-up. After excluding this eye, as well as the 5 eyes that showed lesions at the first follow-up period, the rate of confirmed progression to neovascular AMD between week 1 and month 12 decreased to 3 (4.6%) of 65 eyes (95% CI, 1.0% - 12.9%), the investigators report.
The investigators also noted the progression to neovascular AMD in the study subjects' phakic contralateral eyes. They report that neovascular AMD developed in only 1 eye (3%) at 12 months.
Previous Reports Might Be Biased
"Our findings suggest that previous reports of the association or progression of nonneovascular AMD to advanced AMD after cataract surgery could be biased by the absence of immediate preoperative and postoperative fluorescein angiography to rule out pre-existing neovascular AMD or geographic atrophy," the study authors write, adding that a strength of their study — the first to their knowledge — was the use of color fundus photographs and fluorescein angiography in the immediate pre- and post-cataract surgery setting.
However, they point out, their study is limited by its small size and limited duration of follow-up to just 12 months. In addition 15 eyes (17%) at risk for neovascular AMD had to be excluded from the analysis because their postsurgery AMD status at 12 months could not be determined because of unavailable or ungradable images.
"Only a small percentage of study participants with AMD had definite progression to either neovascular AMD or geographic atrophy within 1 year of cataract surgery when eyes were carefully monitored with immediate preoperative and postoperative fundus photographs and fluorescein angiograms," the study authors conclude. "Our findings do not support the hypothesis that cataract surgery accelerates the progression of AMD."
In an accompanying editorial, Barbara E. K. Klein, MD, MPH, from the University of Wisconsin in Madison, writes that several reports have shown an association between cataract surgery and AMD since the late 1980s.
"Some report a cross-sectional association, some, incidence of AMD after surgery, and yet others report progression to more severe AMD. Still, there are some studies that do not find a significant association after controlling for relevant confounders. What might explain the disparate results? In my estimation, the diversity of findings in no small part begins with differences in study design," Dr. Klein noted."
Discussing these inconsistencies will help patients and their physicians make a more informed decision about the risks for progression to early AMD and development of late AMD after cataract surgery, she writes. "Until we have better information regarding the risk of developing AMD in those undergoing cataract surgery, it is the best we can do for our patients."
For more information go to www.maculardegenerationassociation.org
Cataract surgery does not appear to increase the progression of age-related macular degeneration (AMD). Instead, it might reveal pre-existing AMD that had been hidden by the cataract, suggests a new study published in the November issue of the Archives of Ophthalmology.
"There has been a longstanding controversy among clinicians as to whether cataract surgery is contraindicated in eyes with nonneovascular AMD," write Li Ming Dong, PhD, from Stony Brook University School of Medicine in New York, and associates from Johns Hopkins University School of Medicine in Baltimore, Maryland. "A major concern has been whether cataract surgery increases the risk of progression to neovascular AMD in eyes at risk of progression, such as those with intermediate AMD (extensive medium-sized drusen, large drusen, or nonfoveal geographic atrophy)."
The aim of this study was to evaluate the course of AMD during the year after cataract surgery in individuals with preconfirmed nonneovascular AMD.
The investigators analyzed 86 patients with nonneovascular AMD who underwent cataract surgery to note the incidence of neovascular AMD development in the 12 months after the operation. Only 1 eye from each patient was analyzed.
Fluorescein angiography was performed preoperatively, and at 1 week, 3 months, and 12 months postoperatively.
The median age of the patients was 76 years (range, 58 to 92 years); 48% were women, 97% were white, and nearly two thirds were current or former cigarette smokers. The median preoperative visual acuity (Snellen equivalent) was 20/50 (range, ≥20/40 to 20/400).
Photographic documentation of AMD status was done in 71 patients (83%) at the 12-month visit. Sixty-six patients (77%) also completed a clinical examination at this visit.
Neovascular AMD was observed in 9 eyes (12.7%; 95% confidence interval [CI], 6.0% - 22.7%) by 12 months, including 1 that was graded as probable neovascular AMD. Five eyes displayed signs of neovascular AMD at the 1-week follow-up, but the size and location of the lesions indicated that they might have been present before surgery but not visible because of the opacity caused by the cataract, the authors report.
One eye did not have a 1-week follow-up. After excluding this eye, as well as the 5 eyes that showed lesions at the first follow-up period, the rate of confirmed progression to neovascular AMD between week 1 and month 12 decreased to 3 (4.6%) of 65 eyes (95% CI, 1.0% - 12.9%), the investigators report.
The investigators also noted the progression to neovascular AMD in the study subjects' phakic contralateral eyes. They report that neovascular AMD developed in only 1 eye (3%) at 12 months.
Previous Reports Might Be Biased
"Our findings suggest that previous reports of the association or progression of nonneovascular AMD to advanced AMD after cataract surgery could be biased by the absence of immediate preoperative and postoperative fluorescein angiography to rule out pre-existing neovascular AMD or geographic atrophy," the study authors write, adding that a strength of their study — the first to their knowledge — was the use of color fundus photographs and fluorescein angiography in the immediate pre- and post-cataract surgery setting.
However, they point out, their study is limited by its small size and limited duration of follow-up to just 12 months. In addition 15 eyes (17%) at risk for neovascular AMD had to be excluded from the analysis because their postsurgery AMD status at 12 months could not be determined because of unavailable or ungradable images.
"Only a small percentage of study participants with AMD had definite progression to either neovascular AMD or geographic atrophy within 1 year of cataract surgery when eyes were carefully monitored with immediate preoperative and postoperative fundus photographs and fluorescein angiograms," the study authors conclude. "Our findings do not support the hypothesis that cataract surgery accelerates the progression of AMD."
In an accompanying editorial, Barbara E. K. Klein, MD, MPH, from the University of Wisconsin in Madison, writes that several reports have shown an association between cataract surgery and AMD since the late 1980s.
"Some report a cross-sectional association, some, incidence of AMD after surgery, and yet others report progression to more severe AMD. Still, there are some studies that do not find a significant association after controlling for relevant confounders. What might explain the disparate results? In my estimation, the diversity of findings in no small part begins with differences in study design," Dr. Klein noted."
Discussing these inconsistencies will help patients and their physicians make a more informed decision about the risks for progression to early AMD and development of late AMD after cataract surgery, she writes. "Until we have better information regarding the risk of developing AMD in those undergoing cataract surgery, it is the best we can do for our patients."
For more information go to www.maculardegenerationassociation.org
Monday, November 9, 2009
Obese Britain Blind to Risk of Sight Loss
ANDOVER, England,
As the UK's obesity crisis burgeons, millions of overweight Brits are blind to the fact that their unhealthy lifestyles mean they are twice as likely to lose their sight as someone with a normal BMI (Body Mass Index).
A shocking new report launched by the sight charity Eyecare Trust and healthcare provider Simplyhealth to mark National Eye Week (9-15 November 2009) reveals that just eight per cent of us associate obesity with sight loss(1), despite weight being a major risk factor in the onset and progression of many sight-threatening eye conditions.
With more than half of all adults across the UK tipping the scales above their recommended weight and a staggering 23 per cent now classed as obese (2), millions of Brits are needlessly putting themselves at risk of poor vision or even worse - total sight loss.
Iain Anderson, Chairman of the Eyecare Trust warns: "Carrying excess weight causes pulmonary problems which can lead to irrevocable damage to the delicate blood vessels in the eye. A Body Mass Index of 30 or more doubles your risk of age-related macular degeneration - the UK's leading cause of blindness - and significantly increases your chances of developing cataracts or glaucoma."
The survey also found that people's perceptions about weight - and in particular obesity - are seriously wide of the mark. For example, four fifths of those polled (82 per cent) believed a man of 6ft weighing 13st 3lb is healthy, when in fact he is overweight.
Iain continues: "While people are more likely to be aware of threat to eye health from factors such as smoking, excessive alcohol consumption or poor diet, they just don't make the connection with obesity, which can also put people at risk of diabetic retinopathy whether or not they suffer from diabetes." The strong links between obesity and eye disease have been affirmed by recent international research undertaken by eminent ophthalmologists in Israel and Singapore(3).
Regular sight tests are vital for the early diagnosis and treatment of these eye conditions, yet the National Eye Week 'See the Benefit' poll found that obese people were the group least likely to visit their optician. Worryingly, the survey reveals that those with a BMI in excess of 25 are most likely to believe their eyes are in a state of 'good' or 'very good' health(4).
Raman Sankaran of Simplyhealth says: "As well as lifestyle choices having an impact on eye health, the research also worryingly found that cost - or the issue of perceived cost - affects whether people attend regular sight tests. In fact 75 per cent of people admit to putting off having their eyes tested due to the price of the examination and the expense of glasses or contact lenses if needed.
"Attending a sight test needn't be expensive or act as a barrier to good eye health as there are many options available to help people budget for eyecare, such as a cash plan from Simplyhealth," Raman adds.
The Eyecare Trust recommends that everyone should have an eye examination every two years, unless advised otherwise by an optometrist. As well as providing a valuable insight into the health of your eyes a sight test also acts as an essential general health check uncovering a number of other underlying health problems such as high cholesterol, high blood pressure, diabetes and an increased risk of stroke.
For more information go to www.maculardegenerationassociation.org
As the UK's obesity crisis burgeons, millions of overweight Brits are blind to the fact that their unhealthy lifestyles mean they are twice as likely to lose their sight as someone with a normal BMI (Body Mass Index).
A shocking new report launched by the sight charity Eyecare Trust and healthcare provider Simplyhealth to mark National Eye Week (9-15 November 2009) reveals that just eight per cent of us associate obesity with sight loss(1), despite weight being a major risk factor in the onset and progression of many sight-threatening eye conditions.
With more than half of all adults across the UK tipping the scales above their recommended weight and a staggering 23 per cent now classed as obese (2), millions of Brits are needlessly putting themselves at risk of poor vision or even worse - total sight loss.
Iain Anderson, Chairman of the Eyecare Trust warns: "Carrying excess weight causes pulmonary problems which can lead to irrevocable damage to the delicate blood vessels in the eye. A Body Mass Index of 30 or more doubles your risk of age-related macular degeneration - the UK's leading cause of blindness - and significantly increases your chances of developing cataracts or glaucoma."
The survey also found that people's perceptions about weight - and in particular obesity - are seriously wide of the mark. For example, four fifths of those polled (82 per cent) believed a man of 6ft weighing 13st 3lb is healthy, when in fact he is overweight.
Iain continues: "While people are more likely to be aware of threat to eye health from factors such as smoking, excessive alcohol consumption or poor diet, they just don't make the connection with obesity, which can also put people at risk of diabetic retinopathy whether or not they suffer from diabetes." The strong links between obesity and eye disease have been affirmed by recent international research undertaken by eminent ophthalmologists in Israel and Singapore(3).
Regular sight tests are vital for the early diagnosis and treatment of these eye conditions, yet the National Eye Week 'See the Benefit' poll found that obese people were the group least likely to visit their optician. Worryingly, the survey reveals that those with a BMI in excess of 25 are most likely to believe their eyes are in a state of 'good' or 'very good' health(4).
Raman Sankaran of Simplyhealth says: "As well as lifestyle choices having an impact on eye health, the research also worryingly found that cost - or the issue of perceived cost - affects whether people attend regular sight tests. In fact 75 per cent of people admit to putting off having their eyes tested due to the price of the examination and the expense of glasses or contact lenses if needed.
"Attending a sight test needn't be expensive or act as a barrier to good eye health as there are many options available to help people budget for eyecare, such as a cash plan from Simplyhealth," Raman adds.
The Eyecare Trust recommends that everyone should have an eye examination every two years, unless advised otherwise by an optometrist. As well as providing a valuable insight into the health of your eyes a sight test also acts as an essential general health check uncovering a number of other underlying health problems such as high cholesterol, high blood pressure, diabetes and an increased risk of stroke.
For more information go to www.maculardegenerationassociation.org
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