Nutrition & Lifestyle
Age-Related Macular Degeneration (AMD) is the leading cause of blindness and partial sight in the developed world and up to 3 million people may be affected in the UK. The exact cause remains unclear but is thought to be influenced by a combination of genetic and environmental factors including increasing age, heredity, smoking and poor diet.
Oxidative stress is thought to be a major componant in the disease process. The combination of high biological activity within the central retinal cells, increased concentration of polyunsaturated fatty acids and exposure to short wavelength light make the macula especially prone to the production of reactive oxygen species including free radicals that damage healthy tissue.
A 10 year Age-Related Eye Disease Study (AREDS) conducted by the American National Eye Institute has identified specific antioxidant and antioxidant enzyme co-factors that are of benefit in individuals with intermediate and advanced AMD. It has been suggested that people over the age of 55 years should have thorough retinal examinations to determine risk factors of developing AMD and those with extensive intermediate-sized drusen, at least one large drusen or non central geographic atrophy in one or both eyes and those with advanced AMD in one eye should consider taking antioxidant supplements such as those used in the study.
In 2006, the same research group began a second study called AREDS2 to determine if they could improve on the AREDS formulation. They added omega-3 fatty acids as well as the antioxidants lutein and xeaxanthin from the same family of nutrients as beta-carotene, which in prior studies had been associated with an increased risk of lung cancer in smokers. The study found that whilst omega-3 fatty acids had no effect on the formulation, lutein and xeaxanthin together appeared to be a safe and effective alternative to beta-carotene.
As a result of secondary analysis of the AREDS2 data we have firm evidence that patients with well established non-advanced AMD will benefit from supplementation with broad spectrum antioxidants that include the constituents of macula pigment and that formulation should not include beta-carotene or omega-3 fatty acids.
Whilst there is no current evidence that supplements have benefits in people without AMD, we advise those who have a family history of the disease to consider a healthy balanced diet rich in green leafy vegetables such as kale, broccoli and spinach
How to maintain healthy eyes
- Nicotine is a significant factor in AMD and should be avoided.
- Alongside protecion from UV, there is a growing body of evidence that short wavelength blue light may have a cumulative effect on our eyes so blue light filtering should be considered.
- Dark leafy green vegetables like spinach, kale, mustard and collard greens all contain high levels of lutein.
- Antioxidants are also present in brightly coloured fruit and vegetables such as red grapes, peppers, corn, oranges, cantaloupe melon and mango.
- Fish, such as salmon, tuna and sardines containing omega-3 may reduce the risk of developing AMD.
- It has also been shown that reducing your intake of saturated fat may make a difference to your risk of developing AMD.
Dry Eye Management
In our air conditioned offices and with increasing age, many of us suffer with irritated dry eyes. Sometimes these symptoms come and go depending on our environment. Here at Christopher Nixon Optometrists we recognise that dry eye is an ongoing issue in the lives of sufferers and needs careful, considered assessment and management.
Our optometrist Giles Price takes the lead in assessing your dry eye and developing an individual plan to help you manage this condition. There are a number of excellent products ranging from lubricant drops and sprays to lid wipes and heated Eyebags that can help to alleviate your symptoms. Often just a better understanding of the underlying causes can improve your management of dry eyes.
Top Tips for Tears
- Be aware of your environment - air conditioning, heating and windy days may all irritate your eyes.
- Stay hydrated - It may sound like common sense but you need to be well hydrated to make good quality tears - remember, if you are thirsty then you are already dehydrated.
- Omega 3 - the fatty acids from oily fish such as salmon and tuna and also from nuts can help with dry eye.
- Vitamin D - plays a role in the inflammatory aspect of dry eye.
- Artificial Tears - there are a plethora of drops and sprays to support the water and lipid elements of your tear film. Some are contact lens friendly too and we are happy to advise on appropriate products.
- EyeBag - this provides sustained warming of the eyelids and meibomian glands which along with gentle massage can improve your tear quality.
- Lid wipes - good lid hygeine is essential when lid inflammation (blepharitis) is contributing to dry eye.