MACULAR DEGENERATION
Macular degeneration is a common eye disease that afflicts older adults. It causes scarring in the central part of the retina called the macula. This is the area of the eye where our sharpest central vision occurs. The cause of macular generation (MD) is unknown. This disease is typically slow in onset but is unfortunately the leading cause of blindness in older adults. Total blindness is rare but loss of central vision makes it difficult or impossible to drive, read or perform fine motor skills. The disease affects men and women equally. Women who smoke have a higher risk of getting it. Exposure to large doses of ultraviolet light may be a risk factor.
There are two types of MD, wet and dry. No current conventional therapies have been shown to reverse the damage. Sometimes the symptoms fluctuate and get better and worse. The dry type occurs in about 90% of cases. This type has no effective drug or surgical treatment. The wet type is characterized by overgrowth of blood vessels in the retina. The initial visual changes are a perception of waviness in straight lines. As MD progresses, blank spots in the central vision can occur. One treatment of wet MD that may halt progression of the damage is laser photocoagulation of the blood vessels. This can stop bleeding and continued growth of the abnormal vessels. However, it also damages the underlying retina and may itself cause loss of vision. Low dose radiation therapy to slow vessel growth has been studied but it is not considered a mainstream approach at present.
A variety of nutritional approaches have been advocated for MD. Since most degenerative conditions in the body are worsened by nutritional deficiencies, it makes intuitive sense to supply the eye with all essential nutrients. Studies show that lutein and zeaxanthin appear to slow disease progression. Other nutrients that may be of value include zinc, Vitamin C, Vitamin A complex, Vitamin E, folic acid, Vitamin B6, and magnesium. Omega-3 fatty acids found in fish are thought to be protective. Diets high in these nutrients are more effective at prevention than at stopping the disease once it has started.
Gingko biloba is an herb that improves microcirculation. It may be helpful but good studies are lacking. A Chinese medicine treatment can include herbs known to be beneficial to the eyes and massage of the acupuncture point called Gallbladder 1 located just lateral to the eye. Another treatment that claims some anecdotal success is use of a microcurrent stimulator to various points around the eye. A book titled “Miracle Eye Cure” by Edward Kondrot MD has more information about this technology. A website with information about MD is www.macula.org. It has links to several other sites that may provide useful information.
This best treatment, as in so many other diseases, is prevention. Avoiding excessive ultraviolet rays in eyes is a good idea. However, regular exposure to natural sunlight has many health benefits so 30 minutes daily of light exposure is not likely to be harmful. Avoiding tobacco smoke, especially if you are a woman, is prudent. Finally, eating a diet of high quality vegetables and fruits will supply the nutrients needed to keep this disease from ever darkening your vision.
Daniel Blodgett MD