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Are You at Risk for Degenerative Eye Disease?

Preventing Macular Degeneration, Glaucoma and Cataracts

Degenerative eye disease affects millions of people worldwide, and the numbers are continually growing. One out of six adults age 45 and older will be affected by some type of sight-threatening vision problem. The most common of these eye diseases are macular degeneration, cataracts and glaucoma. Although the causes and progression of these diseases have many factors, a healthy lifestyle may contribute most to maintaining healthy vision.

Macular Degeneration

Macular degeneration is the leading cause of blindness in Americans 65 years of age and older. The center of the retina, called the macula, breaks down, causing a gradual or sudden loss of vision. Macular degeneration is classified as either dry or wet. About 90 percent of patients have the dry form, which may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two. The wet form occurs when new blood vessels grow beneath the retina, leaking blood and fluid. The leakage causes retinal cells to die and creates blind spots in central vision. Early signs of macular degeneration are gradual, painless and include: visual hallucinations, straight lines appearing wavy, fuzzy vision and shadowy areas in central vision.

In time, a person with macular degeneration may find it difficult or impossible to read, drive or recognize familiar faces. If a loved one is experiencing any of the signs or symptoms listed above, it's important to seek professional help. There are new treatments that may help to slow or stop the progression of the disease. When vision loss is experienced, low vision aids can improve eye function and quality of life.

It's important (and simple) to take steps to prevent macular degeneration. After considering other risk factors, a study of 4000 people ages 43-86 were found to be 70 percent less likely to have or develop macular degeneration if they led a healthy lifestyle, including a healthy diet, plenty of exercise and not smoking.

Individuals who smoke are up to four times more likely to have macular degeneration than non-smokers — quitting will decrease your chance of eye disease and many other health complications.

One study found that people who consumed the most vegetables rich in carotenoids had a 43 percent lower risk of developing macular degeneration than those who ate less of these foods. Maintaining a diet rich in antioxidants, such as lutein, vitamins C and E, zinc and copper can help decrease the likelihood of an eye disease.

It’s also important to eat fish or take a fish oil supplement. A recent study showed that senior men with the highest levels of fish consumption were 45 percent less likely to have macular degeneration and vision problems than those who didn't consume fish. Another study found that participants who ate fish at least once a week were 40 percent less likely to have beginning-stage macular degeneration develop than those who reported eating fish less than once a month or never. The recommended amount is 500 mg/day of DHA/EPA essential fatty acids.


Glaucoma classifies a group of vision diseases that can damage the eye’s optic nerve, resulting in vision loss and blindness. The pressure inside of the eye is similar to our blood pressure; there is a “normal” range, but when the pressure becomes higher, it can damage the photoreceptors we use for sight. Although glaucoma affects people of all ages, people 40 years of age and older have an increased risk of being affected. Other risk factors include hypertension, diabetes, lack of exercise and heredity.

It's estimated that 4 million people in the U.S. have glaucoma, and about half may not even know they're affected, as the early stages often have no signs or symptoms. This is a dangerous statistic, as the vision loss caused by glaucoma is irreversible. The testing for glaucoma is a standard part of an annual eye examination, so it’s important to make it to the eye doctor each year. If diagnosed, prescription eye drops are the most common treatment, but surgical intervention is sometimes necessary.

A healthy lifestyle can do wonders for preventing glaucoma. Researchers in Oregon have shown that aerobic conditioning can lower pressure in and increase blood flow to the eye, and a further, transient lowering occurs on an acute basis with exercise. If you are part of any high-risk groups for glaucoma, be sure to take care of your condition — being in control of health problems can lower the risk of development. Although there is no proof (yet), there’s increasing evidence that points to high doses of antioxidants benefiting some patients with glaucoma.


The natural lens inside our eye is the clearest at birth. With age and exposure to environmental elements, protein can clump together and begin to cloud, blocking the light that passes through. This creates a cataract, which may grow larger and cloud more of the lens over time, significantly impairing vision. Symptoms include cloudy or blurry vision, colors seeming faded, glare (headlights, lamps or sunlight may appear too bright, and a halo may appear around lights), poor night vision, double vision or multiple images in one eye, and frequent prescription changes in contacts or eyeglasses.

By age 65, about half of the human population has a cataract, and by age 75, almost everyone has a cataract. However, cataracts are highly treatable, and through advances in both cataract surgery and lens implants, more people are experiencing full restoration of lost vision than ever before. It is the most frequently performed surgery in the U.S., and will continue to benefit the older (and increasingly active population). Unlike macular degeneration and glaucoma, cataracts are “cured” by having surgery and will not recur later in life.

Many studies suggest that exposure to UV light is associated with cataract development. Wearing sunglasses and a wide-brimmed hat while outdoors will reduce your exposure. Other external risk factors include cigarette smoke and air pollution.

Researchers also believe that good nutrition can help reduce the risk for developing cataracts. A diet full of green, leafy vegetables, fruit and other foods high in antioxidants can help. Stay away from diets high in salt, and avoid heavy alcohol consumption.

If symptoms of cataracts appear, it's best to visit an eye care professional. Being prescribed new glasses, strong bifocals, or using other visual aids can help. The doctor and patient can decide together when the time is right for cataract surgery.

As with most health problems, less risk of development is present alongside better overall health. Regular exercise, not smoking, wearing sun protection and eating healthily are the best things one can do for overall health and healthy vision. Just as routine doctor visits are important, so are annual eye check-ups — even if you don't notice a change in vision. The American Academies of Optometry and Ophthalmology both advise an annual examination for those 60 years of age and older.

Dr. Kristin Gurholt practices at Boulder Vision Center in Boulder, Colo. She has been in primary care optometry since 1997, treating patients' current needs while preventing future problems through education.

Kristin J. Gurholt, O.D.

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