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Dry Eye

Dry eye is a condition in which there are insufficient tears to lubricate and nourish the eye. Tears are necessary for maintaining the health of the front surface of the eye and for providing clear vision. People with dry eyes either do not produce enough tears or have a poor quality of tears. Dry eye is a common and often chronic problem, particularly in older adults.

With each blink of the eyelids, tears are spread across the front surface of the eye, known as the cornea. Tears provide lubrication, reduce the risk of eye infection, wash away foreign matter in the eye, and keep the surface of the eyes smooth and clear. Excess tears in the eyes flow into small drainage ducts, in the inner corners of the eyelids, which drain in the back of the nose.

Dry eyes can result from an improper balance of tear production and drainage.

Inadequate Amount of Tears

Tears are produced by several glands in and around the eyelids. Tear production tends to diminish with age, with various medical conditions, or as a side effect of certain medicines. Environmental conditions such as wind and dry climates can also affect tear volume by increasing tear evaporation. When the normal amount of tear production decreases or tears evaporate too quickly from the eyes, symptoms of dry eye can develop.

Poor Quality of Tears

Tears are made up of three layers: oil, water, and mucus. Each component serves a function in protecting and nourishing the front surface of the eye. A smooth oil layer helps to prevent evaporation of the water layer, while the mucin layer functions in spreading the tears evenly over the surface of the eye. If the tears evaporate too quickly or do not spread evenly over the cornea due to deficiencies with any of the three tear layers, dry eye symptoms can develop.

The most common form of dry eyes is due to an inadequate amount of the water layer of tears. This condition, called keratoconjunctivitis sicca (KCS), is also referred to as dry eye syndrome.

People with dry eyes may experience symptoms of irritated, gritty, scratchy, or burning eyes, a feeling of something in their eyes, excess watering, and blurred vision. Advanced dry eyes may damage the front surface of the eye and impair vision.

Treatments for dry eyes aim to restore or maintain the normal amount of tears in the eye to minimize dryness and related discomfort and to maintain eye health.

What Causes Dry Eyes?

The majority of people over the age of 65 experience some symptoms of dry eyes. The development of dry eyes can have many causes. They include:

Age

Dry eye is a part of the natural aging process. The majority of people over age 65 experience some symptoms of dry eyes.

Gender

Women are more likely to develop dry eyes due to hormonal changes caused by pregnancy, the use of oral contraceptives, and menopause.

Medications

Certain medicines, including antihistamines, decongestants, blood pressure medications and antidepressants, can reduce the amount of tears produced in the eyes.

Medical Conditions

Persons with rheumatoid arthritis, diabetes and thyroid problems are more likely to have symptoms of dry eyes. Also, problems with inflammation of the eyelids (blepharitis), inflammation of the surfaces of the eye, or the inward or outward turning of eyelids can cause dry eyes to develop.

Environmental Conditions

Exposure to smoke, wind and dry climates can increase tear evaporation resulting in dry eye symptoms. Failure to blink regularly, such as when staring at a computer screen for long periods of time, can also contribute to drying of the eyes.

Other Factors

Long term use of contact lenses can be a factor in the development of dry eyes. Refractive eye surgeries, such as LASIK, can cause decreased tear production and dry eyes.

How are Dry Eyes Diagnosed?

Dry eyes can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the evaluation of the quantity and quality of tears produced by the eyes, may include:

Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the dry eye problem.

External examination of the eye, including lid structure and blink dynamics.

Evaluation of the eyelids and cornea using bright light and magnification.

Measurement of the quantity and quality of tears for any abnormalities. Special dyes may be instilled in the eyes to better observe tear flow and to highlight any changes to the outer surface of the eye caused by insufficient tears.

Using the information obtained from testing, your optometrist can determine if you have dry eyes and advise you on treatment options.

How are Dry Eyes Treated?

One of the primary approaches used to manage and treat mild cases of dry eyes is adding tears using over-the-counter artificial tear solutions.

Dry eyes can be a chronic condition, but your optometrist can prescribe treatment to keep your eyes healthy, more comfortable, and prevent your vision from being affected. The primary approaches used to manage and treat dry eyes include adding tears, conserving tears, increasing tear production, and treating the inflammation of the eyelids or eye surface that contributes to the dry eyes.

Adding Tears

Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives that could further irritate the eyes. However, some people may have persistent dry eyes that don’t respond to artificial tears alone. Additional steps need to be taken to treat their dry eyes.

Conserving Tears

An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed, if needed. A surgical procedure to permanently close tear ducts can also be used. In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.

Increasing Tear Production

Prescription eye drops that help to increase production of tears can be recommended by your optometrist, as well as omega-3 fatty acid nutritional supplements.

Treatment of the Contributing Eyelid or Ocular Surface Inflammation

Prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners may be recommended to help decrease inflammation around the surface of the eyes.

Self Care

Steps you can take to reduce symptoms of dry eyes include:
  • Remembering to blink regularly when reading or staring at a computer screen for long periods of time.
  • Increasing the level of humidity in the air at work and at home.
  • Wearing sunglasses outdoors, particularly those with wrap around frame design, to reduce exposure to drying winds and sun.
  • Using nutritional supplements containing essential fatty acids may help decrease dry eye symptoms in some people. Ask your optometrist if the use of dietary supplements could be of help for your dry eye problems.
Avoiding becoming dehydrated by drinking plenty of water (8 to 10 glasses) each day.

Source: The American Optometric Association

ADDING POWERFUL ANTIOXIDANTS TO YOUR DIET CAN IMPROVE YOUR EYE HEALTH.

There’s no substitute for the quality of life good vision offers. Adding certain nutrients to your diet every day – either through foods or supplements – can help save your vision. Researchers have linked eye-friendly nutrients such as lutein/zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration and cataract formation.

Lutein & Zeaxanthin

Lutein and zeaxanthin are important nutrients found in green leafy vegetables, as well as other foods, such as eggs. Many studies have shown that lutein and zeaxanthin reduce the risk of chronic eye diseases, including age-related macular degeneration and cataracts.

Vitamin C

Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. Scientific evidence suggests vitamin C lowers the risk of developing cataracts, and when taken in combination with other essential nutrients, can slow the progression of age-related macular degeneration and visual acuity loss.

Vitamin E

Vitamin E in its most biologically active form is a powerful antioxidant found in nuts, fortified cereals and sweet potatoes. It is thought to protect cells of the eyes from damage caused by unstable molecules called free radicals which break down healthy tissue.

Essential Fatty Acids

Fats are a necessary part of the human diet. They maintain the integrity of the nervous system, fuel cells and boost the immune system. Two omega-3 fatty acids have been shown to be important for proper visual development and retinal function.

Zinc

Zinc is an essential trace mineral or ‘helper molecule.’ It plays a vital role in bringing vitamin A from the liver to the retina in order to produce melanin, a protective pigment in the eyes. Zinc is highly concentrated in the eye, mostly in the retina and choroid, the vascular tissue layer lying under the retina.

Emerging Research

In the last 20 years, eye health research has linked diet and nutrition with a decreased risk of age-related macular degeneration (AMD).

Source: The American Optometric Association

Infant Vision

Babies learn to see over a period of time, much like they learn to walk and talk. They are not born with all the visual abilities they need in life. The ability to focus their eyes, move them accurately, and use them together as a team must be learned. Also, they need to learn how to use the visual information the eyes send to their brain in order to understand the world around them and interact with it appropriately.

Vision, and how the brain uses visual information, are learned skills. From birth, babies begin exploring the wonders in the world with their eyes. Even before they learn to reach and grab with their hands or crawl and sit-up, their eyes are providing information and stimulation important for their development.

Healthy eyes and good vision play a critical role in how infants and children learn to see. Eye and vision problems in infants can cause developmental delays. It is important to detect any problems early to ensure babies have the opportunity to develop the visual abilities they need to grow and learn.

Parents play an important role in helping to assure their child's eyes and vision can develop properly. Steps that any parent should take include:

  • Watching for signs of eye and vision problems.
  • Seeking professional eye care starting with the first comprehensive vision assessment at about 6 months of age.
  • Helping their child develop his or her vision by engaging in age-appropriate activities.

Steps in Infant Vision Development

At birth, babies can't see as well as older children or adults. Their eyes and visual system aren't fully developed. But significant improvement occurs during the first few months of life.

The following are some milestones to watch for in vision and child development. It is important to remember that not every child is the same and some may reach certain milestones at different ages.

Birth to Four Months

Up to about 3 months of age, babies' eyes do not focus on objects more than 8 to 10 inches from their faces.
  • At birth, babies' vision is abuzz with all kinds of visual stimulation. While they may look intently at a highly contrasted target, babies have not yet developed the ability to easily tell the difference between two targets or move their eyes between the two images. Their primary focus is on objects 8 to 10 inches from their face or the distance to parent's face.
  • During the first months of life, the eyes start working together and vision rapidly improves. Eye-hand coordination begins to develop as the infant starts tracking moving objects with his or her eyes and reaching for them. By eight weeks, babies begin to more easily focus their eyes on the faces of a parent or other person near them.
  • For the first two months of life, an infant's eyes are not well coordinated and may appear to wander or to be crossed. This is usually normal. However, if an eye appears to turn in or out constantly, an evaluation is warranted.
  • Babies should begin to follow moving objects with their eyes and reach for things at around three months of age.

Five to Eight Months

  • During these months, control of eye movements and eye-body coordination skills continue to improve.
  • Depth perception, which is the ability to judge if objects are nearer or farther away than other objects, is not present at birth. It is not until around the fifth month that the eyes are capable of working together to form a three-dimensional view of the world and begin to see in depth.
  • Although an infant's color vision is not as sensitive as an adult's, it is generally believed that babies have good color vision by five months of age.
  • Most babies start crawling at about 8 months old, which helps further develop eye-hand-foot-body coordination. Early walkers who did minimal crawling may not learn to use their eyes together as well as babies who crawl a lot.

Nine to Twelve Months

By the age of nine to twelve months, babies should be using their eyes and hands together.
  • At around 9 months of age, babies begin to pull themselves up to a standing position. By 10 months of age, a baby should be able to grasp objects with thumb and forefinger.
  • By twelve months of age, most babies will be crawling and trying to walk. Parents should encourage crawling rather than early walking to help the child develop better eye-hand coordination.
  • Babies can now judge distances fairly well and throw things with precision.

One to Two Years Old

  • By two years of age, a child's eye-hand coordination and depth perception should be well developed.
  • Children this age are highly interested in exploring their environment and in looking and listening. They recognize familiar objects and pictures in books and can scribble with crayon or pencil.

Signs of Eye and Vision Problems

The presence of eye and vision problems in infants is rare. Most babies begin life with healthy eyes and start to develop the visual abilities they will need throughout life without difficulty. But occasionally, eye health and vision problems can develop. Parents need to look for the following signs that may be indications of eye and vision problems:

Excessive tearing - this may indicate blocked tear ducts

Red or encrusted eye lids - this could be a sign of an eye infection

Constant eye turning - this may signal a problem with eye muscle control

Extreme sensitivity to light - this may indicate an elevated pressure in the eye

Appearance of a white pupil - this may indicate the presence of an eye cancer

The appearance of any of these signs should require immediate attention by your pediatrician or optometrist.

What Parents Can do to Help With Visual Development

There are many things parents can do to help their baby's vision develop properly. The following are some examples of age-appropriate activities that can assist an infant's visual development.

Birth to Four Months

  • Use a nightlight or other dim lamp in your baby's room.
  • Change the crib's position frequently and change your child's position in it.
  • Keep reach-and-touch toys within your baby's focus, about eight to twelve inches.
  • Talk to your baby as you walk around the room.
  • Alternate right and left sides with each feeding.

Toys like building blocks can help boost fine motor skills and small muscle development.

Five to Eight Months

  • Hang a mobile, crib gym or various objects across the crib for the baby to grab, pull and kick.
  • Give the baby plenty of time to play and explore on the floor.
  • Provide plastic or wooden blocks that can be held in the hands.
  • Play patty cake and other games, moving the baby's hands through the motions while saying the words aloud.

Nine to Twelve Months

  • Play hide and seek games with toys or your face to help the baby develop visual memory.
  • Name objects when talking to encourage the baby's word association and vocabulary development skills.
  • Encourage crawling and creeping.

One to Two Years

  • Roll a ball back and forth to help the child track objects with the eyes visually.
  • Give the child building blocks and balls of all shapes and sizes to play with to boost fine motor skills and small muscle development.
  • Read or tell stories to stimulate the child's ability to visualize and pave the way for learning and reading skills.

Baby's First Eye Exam

An infant should receive his or her first eye exam between the ages of 6 and 12 months.

Even if no eye or vision problems are apparent, at about age 6 months, you should take your baby to your doctor of optometry for his or her first thorough eye examination.

Things that the optometrist will test for include:
  • excessive or unequal amounts of nearsightedness, farsightedness, or astigmatism
  • eye movement ability
  • eye health problems.

These problems are not common, but it is important to identify children who have them at this young age. Vision development and eye health problems are easier to correct if treatment begins early.

InfantSEE® is the American Optometric Association's public health program designed to ensure that eye and vision care becomes an integral part of infant wellness care to improve a child's quality of life. Under this program, participating optometrists provide a comprehensive infant eye assessment between 6 and 12 months of age as a no-cost public service. Click here to learn more and locate a doctor in your area who can provide the free infant assessment.

source: The American Optometric Association

Glaucoma

Glaucoma is a group of eye disorders leading to progressive damage to the optic nerve, and is characterized by loss of nerve tissue resulting in loss of vision. The optic nerve is a bundle of about one million individual nerve fibers and transmits the visual signals from the eye to the brain. The most common form of glaucoma, primary open-angle glaucoma, is associated with an increase in the fluid pressure inside the eye. This increase in pressure may cause progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Advanced glaucoma may even cause blindness. Not everyone with high eye pressure will develop glaucoma, and many people with normal eye pressure will develop glaucoma. When the pressure inside an eye is too high for that particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.

Glaucoma is the second leading cause of blindness in the U.S. It most often occurs in people over age 40, although a congenital or infantile form of glaucoma exists. People with a family history of glaucoma, African Americans over the age of 40, and Hispanics over the age of 60 are at an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation, and using medications that increase the pressure in the eyes.

The most common form of glaucoma, primary open-angle glaucoma, develops slowly and usually without any symptoms. Many people do not become aware they have the condition until significant vision loss has occurred. It initially affects peripheral or side vision, but can advance to central vision loss. If left untreated, glaucoma can lead to significant loss of vision in both eyes, and may even lead to blindness.

A less common type of glaucoma, acute angle closure glaucoma, usually occurs abruptly due to a rapid increase of pressure in the eye. Its symptoms may include severe eye pain, nausea, redness in the eye, seeing colored rings around lights, and blurred vision. This condition is an ocular emergency, and medical attention should be sought immediately, as severe vision loss can occur quickly.

Glaucoma cannot currently be prevented, but if diagnosed and treated early it can usually be controlled. Medication or surgery can slow or prevent further vision loss. However, vision already lost to glaucoma cannot be restored. That is why the American Optometric Association recommends an annual dilated eye examination for people at risk for glaucoma as a preventive eye care measure. Depending on your specific condition, your doctor may recommend more frequent examinations.

What Causes Glaucoma?

Glaucoma is the leading cause of blindness among Hispanics.
There are many types of glaucoma and many theories about the causes of glaucoma. The exact cause is unknown. Although the disease is usually associated with an increase in the fluid pressure inside the eye, other theories include lack of adequate blood supply to the nerve.

Primary Open-Angle Glaucoma

This is the most common form of glaucoma. One theory is that glaucoma is thought to develop when the eye’s drainage system becomes inefficient over time. This leads to an increased amount of fluid and a gradual buildup of pressure within the eye. Other theories of the cause of the optic nerve damage include poor perfusion, or blood flow, to the optic nerve. Damage to the optic nerve is slow and painless and a large portion of vision can be lost before vision problems are noticed. Other theories also exist.

Angle-Closure Glaucoma

This type of glaucoma, also called closed-angle glaucoma or narrow angle glaucoma, is a less common form of the disease. It is a medical emergency that can cause vision loss within a day of its onset.

It occurs when the drainage angle in the eye (formed by the cornea and the iris) closes or becomes blocked. Many people who develop this type of glaucoma have a very narrow drainage angle. With age, the lens in the eye becomes larger, pushing the iris forward and narrowing the space between the iris and the cornea. As this angle narrows, the aqueous fluid is blocked from exiting through the drainage system, resulting in a buildup of fluid and an increase in eye pressure.

Angle-closure glaucoma can be chronic (progressing gradually) or acute (appearing suddenly). The acute form occurs when the iris completely blocks the drainage of the aqueous fluid. In people with a narrow drainage angle, if their pupils become dilated, the angle may close and cause a sudden increase in eye pressure. Although an acute attack often affects only one eye, the other eye may be at risk of an attack as well.

Secondary Glaucoma

This type of glaucoma occurs as a result of an injury or other eye disease. It may be caused by a variety of medical conditions, medications, physical injuries, and eye abnormalities. Infrequently, eye surgery can be associated with secondary glaucoma.

Normal-Tension Glaucoma

In this form of glaucoma, eye pressure remains within what is considered to be the “normal” range, but the optic nerve is damaged nevertheless. Why this happens is unknown.

It is possible that people with low-tension glaucoma may have an abnormally sensitive optic nerve or a reduced blood supply to the optic nerve caused by a condition such as atherosclerosis, a hardening of the arteries. Under these circumstances even normal pressure on the optic nerve may be enough to cause damage.

Risk Ffactors

Certain factors can increase the risk for developing glaucoma. They include:

Age

People over age 60 are at increased risk for the disease. For African Americans, however, the increase in risk begins after age 40. The risk of developing glaucoma increases slightly with each year of age.

Race

African Americans are significantly more likely to get glaucoma than are Caucasians, and they are much more likely to suffer permanent vision loss as a result. People of Asian descent are at higher risk of angle-closure glaucoma and those of Japanese descent are more prone to low-tension glaucoma.

Family History of Glaucoma

Having a family history of glaucoma increases the risk of developing glaucoma.

Medical Conditions

Some studies indicate that diabetes may increases the risk of developing glaucoma, as do high blood pressure and heart disease.

Physical Injuries to the Eye

Severe trauma, such as being hit in the eye, can result in immediate increased eye pressure and future increases in pressure due to internal damage. Injury can also dislocate the lens, closing the drainage angle, and increasing pressure.

Other Eye-Related Risk Factors

Eye anatomy, namely corneal thickness and optic nerve appearance indicate risk for development of glaucoma. Conditions such as retinal detachment, eye tumors, and eye inflammations may also induce glaucoma. Some studies suggest that high amounts of nearsightedness may also be a risk factor for the development of glaucoma.

Corticosteroid Use

Using corticosteroids for prolonged periods of time appears to put some people at risk of getting secondary glaucoma.

How is Glaucoma Diagnosed?

Glaucoma is diagnosed through a comprehensive eye examination. To establish a diagnosis of glaucoma, several factors must be present: Because glaucoma is a progressive disease, meaning it worsens over time, a change in the appearance of the optic nerve, a loss of nerve tissue, and a corresponding loss of vision confirm the diagnosis. Some optic nerves have a suspicious appearance, resembling nerves with glaucoma, but the patients may have no other risk factors or signs of glaucoma. These patients should be closely followed with routine comprehensive exams to monitor for change.

Testing Includes:
  • Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems and family history that may be contributing to the problem.
  • Visual acuity measurements to determine the extent to which vision may be affected.
  • Tonometry to measure the pressure inside the eye to detect increased risk factors for glaucoma.
  • Pachymetry to measure corneal thickness. People with thinner corneas are at an increased risk of developing glaucoma.
  • Visual field testing, also called perimetry, to check if the field of vision has been affected by glaucoma. This test measures your side (peripheral) vision and central vision by either determining the dimmest amount of light that can be detected in various locations of vision, or by determining sensitivity to targets other than light, and comparing it to others of similar age.
  • Evaluation of the retina of the eye, which may include photographs of the optic nerve, in order to monitor any changes that might occur over time.
  • Supplemental testing may include gonioscopy, a procedure allowing views of the angle anatomy, the area in the eye where fluid drainage occurs. Serial tonometry may be performed. This is a procedure acquiring several pressure measurements over time, looking for changes in the eye pressure throughout the day. Other tests include using devices to measure nerve fiber thickness, and look for specific areas of the nerve fiber layer for loss of tissue.

How is Glaucoma Treated?

The treatment of glaucoma is aimed at reducing intraocular pressure. The most common first line treatment of glaucoma is usually prescription eye drops that must be taken regularly. In some cases, systemic medications, laser treatment, or other surgery may be required. While there is no cure as yet for glaucoma, early diagnosis and continuing treatment can preserve eyesight.

Medications

A number of medications are currently available to treat glaucoma. Typically medications are intended to reduce elevated intraocular pressure. One may be prescribed a single medication or a combination of medications. The type of medication may change if it is not providing enough pressure reduction or if the patient is experiencing side-effects from the drops.

Surgery

Surgery involves either laser treatment, making a drainage flap in the eye, inserting a drainage valve, or destroying the tissue that creates the fluid in the eye. All procedures aim to reduce the pressure inside the eye. Surgery may help lower pressure when medication is not sufficient, however it cannot reverse vision loss.
  • Laser surgery - Laser trabeculoplasty helps fluid drain out of the eye. A high-energy laser beam is used to stimulate the trabecular meshwork to work more efficiently at fluid drainage. The results may be somewhat temporary, and the procedure may need to be repeated in the future.
  • Conventional surgery - If eye drops and laser surgery aren't effective in controlling eye pressure, you may need a filtering procedure called a trabeculectomy. Filtering microsurgery involves creating a drainage flap, allowing fluid to percolate into and later drain into the vascular system.
  • Drainage implants - Another type of surgery, called drainage valve implant surgery, may be an option for people with uncontrolled glaucoma, secondary glaucoma or for children with glaucoma. A small silicone tube is inserted in the eye to help drain aqueous fluid.

Treatment for Acute Angle-Xlosure Glaucoma

Acute angle-closure glaucoma is a medical emergency. Several medications can be used to reduce eye pressure as quickly as possible. A laser procedure called laser peripheral iridotomy will also likely be performed. In this procedure, a laser beam creates a small hole in the iris to allow aqueous fluid to flow more freely into the front chamber of the eye where it then has access to the meshwork for drainage.

Lifelong Treatment

There is no cure for glaucoma. Patients with glaucoma need to continue treatment for the rest of their lives. Because the disease can progress or change silently, compliance with eye medications and eye examinations are essential, as treatment may need to be adjusted periodically.

By keeping eye pressure under control, continued damage to the optic nerve and continued loss of your visual field may slow or stop. The optometrist may focus on lowering the intraocular pressure to a level that is least likely to cause further optic nerve damage. This level is often referred to as the target pressure and will probably be a range rather than a single number. Target pressure differs for each person, depending on the extent of the damage and other factors. Target pressure may change over the course of a lifetime. Newer medications are always being developed to help in the fight against glaucoma.

Early detection, prompt treatment and regular monitoring can help to control glaucoma and therefore reduce the chances of progression vision loss.

Source: The American Optometric Association

Symptoms of AMD

  • Gradual loss of ability to see objects clearly
  • Objects appear distorted in shape. Straight lines look wavy or crooked.
  • Loss of clear color vision
  • A dark or empty area appears in the center of vision.

Diagnosis of AMD

In its early stages, signs of macular degeneration can go unnoticed. Yet, if you experience any signs/symptoms, contact your doctor of optometry immediately. In a comprehensive eye exam, your optometrist will perform a variety of tests to determine if you have macular degeneration, or any other eye health problems.

Treatment of AMD

With “dry” macular degeneration, the tissue of the macula gradually becomes thin and stops functioning properly. There is no cure for dry AMD, and any loss in central vision cannot be restored. However, doctors now believe there is a link between nutrition and the progression of dry AMD. Dietary changes favoring low-fat content and dark green leafy vegetables can slow vision loss. Nutritional supplements also may be beneficial.

Less common, "wet" macular degeneration results when fluids leak from newly formed blood vessels under the macula and blur central vision. Vision loss can be rapid and severe. If detected early, “wet” AMD can be treated with laser treatment, which is often called photocoagulation. A highly focused beam of light seals the leaking blood vessels that damage the macula. Photodynamic Therapy (PDT) uses a medication injected into the bloodstream, which is then activated with a laser shone into the eye. A new therapy available, where a medication is injected into the back of the eye, is showing favorable results. These are not permanent cures but are used to slow the rate of central vision loss.

Nutrition and AMD

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over age 50. The Centers for Disease Control and Prevention estimate that 1.8 million people have AMD and another 7.3 million are at substantial risk for vision loss from AMD. Caucasians are at higher risk for developing AMD than other races. Women also develop AMD at an earlier age than men. This eye disease occurs when there are changes to the macula, a small portion of the retina that is located on the inside back layer of the eye. AMD is a loss of central vision that can occur in two forms: “dry” or atrophic and “wet” or exudative.

Most people with macular degeneration have the dry form, for which there is no known treatment. The less common wet form may respond to laser procedures, if diagnosed and treated early.

Some common symptoms are: a gradual loss of ability to see objects clearly, distorted vision, a gradual loss of color vision, and a dark or empty area appearing in the center of vision. If you experience any of these, contact your doctor of optometry immediately for a comprehensive examination. Central vision that is lost to macular degeneration cannot be restored. However, low vision devices, such as telescopic and microscopic lenses, can be prescribed to maximize existing vision.

Researchers have linked eye-friendly nutrients such as lutein/zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration. For more information on the importance of good nutrition and eye health, please see the diet and nutrition section.

Source: The American Optometric Association