Leading cause of blindness in people over 65 can be prevented.

The leading cause of blindness in people over age 65 in western nations occurs when the macular region of the eye is destroyed.

ARMD (Age Related Macular Degeneration) is a condition that normally affects people as they get older. However, poor nutrition, excessive sunlight and environmental factors have meant that ARMD is now affecting people as young as 20.

Macular Degeneration is the slow deterioration of the cells in the macula, a tiny yellowish area near the centre of the retina where vision is the most precise. This deterioration therefore affects central vision which is used for reading, writing and driving. Your peripheral vision is not affected.

There are two types of macular degeneration: Ninety percent of people with macular degeneration have the dry type, in which small, yellow spots called drusens form underneath the macular.

In the dry type of macular degeneration, the retina deteriorates, while small yellow pigment-like deposits, called drusen, are formed under the macula. The formation of these deposits leads to a thinning and drying out of the macula. Vision loss is related to the location and amount of retinal thinning caused by the drusen.

Drusens are believed to be waste products that accumulate because of lack of antioxidants to clear the waste from the eyes The drusen slowly break down the cells in the macular, causing distorted vision. Dry macular degeneration can progress to the second, more severe type, called wet macular degeneration.

In the wet type of macular degeneration, abnormal subretinal blood vessels grow under the retina and macula: this is known as angiogenesis. These newly formed blood vessels will bleed or leak. Central vision will thus become distorted. Vision loss may be rapid and severe under these circumstances. Individuals with wet macular degeneration may see a dark spot or spots within their central vision due to the blood leakage under the retina.

Causes of macular degeneration

•    Free radical damage from ultraviolet and blue light from sunlight passing through the crystalline lens. Free radicals are also natural by-products of metabolism. These highly reactive chemicals cause oxidation (hence the need for ‘anti-oxidants’) and can destabilize healthy cells in the back of the eyes. Free radical damage is accelerated by smoking, fried foods, refined vegetable and nut oils, most margerines, and compromised immune systems.
•    Nutritional Deficiencies and Poor Digestion. Often people with macular degeneration are deficient in some or many of the important nutrients including essential fatty acids, lutein, zeaxanthin, taurine, antioxidants, bioflavenoids, zinc, selenium, vitamin B-complex.
•    Family History of macular degeneration.

Drugs that can damage the retina:

•    Plaquenil (hydroxchloriquine sulfate) is a drug routinely prescribed for rheumatoid arthritis. It has caused irreversible retinal damage.
•    Chloridine (brand name catapres) – is used to lower blood pressure
•    NSAIDS (non-steroidal anti-inflammatory drugs) can cause visual side effects such as cataracts, dry eyes, and retinal haemorrhages that may result from long-term use. These include aspirin, ibuprofen, flurbiprofen, ketoprofen and naproxen sodium. Tylenol (acetaminophen), though not an NSAID, can also be harmful.

Macular Density may be an important marker to measure vision level.

The scientists measured macular pigment and visual sensitivity of 27 healthy older subjects, ages 60 to 84, and compared them with 10 younger healthy subjects, ages 24 to 36.

The researchers measured macular pigment density (how much light the pigment absorbs) by flashing blue and green lights in an alternate pattern so the lights appeared to flicker.

The blue light is absorbed by macular pigment, but not green. The amount of blue light required being equally as effective as the green yield the pigment density.

As expected, visual sensitivity declined significantly with age.

Subjects over age 60 with high macular pigment density had the same visual sensitivity as the younger subjects.

Older subjects with low macular pigment density had lower visual sensitivity than the younger subjects.

The results show that high macular pigment density (the accumulation of yellow compounds derived from fruits and vegetables) was associated with the retention of youthful visual sensitivity.

Are you at increased risk of age-related macular degeneration?

The following are risk-factors:

•    cataracts
•    smoking
•    being female
•    high blood pressure
•    type II diabetes
•    blue irises of the eye
•    don’t eat enough green and yellow fruits and vegetables
•    family history of macular degeneration
•    poor ability to absorb nutrients from foods

Are you at less risk?

•    you eat lots of green and yellow fruits and vegetables
•    you are able to absorb sufficient lutein from these foods
•    you take lutein in the form of a supplement every day
•    you have high macular pigment density

Foods that contain lutein and zeaxanthin

The foods containing most lutein are shown first, so, when it comes to eye health, the first half of the list is more important than the second half of the list.

•    Kale
•    Collard Greens
•    Spinach
•    Cress
•    Swiss Chard
•    Parsley
•    Mustard Greens
•    Beet Greens
•    Okra
•    Red Pepper
•    Dark Green Lettuce
•    Leeks
•    Broccoli (very important for a variety of reasons, so in some respects deserves to be top of the list)
•    Green Peas
•    Pumpkin
•    Summer Squash
•    Yellow and Green Peppers
•    Avocado
•    Tomato Puree
•    Orange Fruits

Increasing macular pigment density by eating plenty of dark green and orange fruits and vegetables might prevent people who are mildly impaired from advancing to the worst stages of the diease.

“It is possible that, by improving protection, retinal or retinal pigment cells that may be damaged, but still viable, could recover.

It appears that people lose visual sensitivity before the worst stages of disease. But with the right treatment in the best cases even recover some of the lost function,” Dr Snodderly said.

Some people have difficulty in absorbing enough of the right carotenoids (lutein and zeaxanthin) from fruits and vegetables. These people should also take extra supplements.

Recent reports suggest that vision loss associated with ageing may be preventable – even reversible – through improved nutrition, according to scientists at ‘The Schepens Eye Research Institute’.

The traditional thinking is that as age increases, visual sensitivity decreases. But according to Dr Max Snodderly, Ph.D., Head of the laboratory at ‘The Schepens Eye Research Institute’ in Boston, that is perhaps not inevitable.

Many studies are now finding that macular pigment in the retina – an accumulation of yellow compounds derived from fruits and vegetables – may prevent age-related vision loss.

This yellow pigment is made of two phyto-chemicals, lutein and zeaxanthin, that are part of the family of carotenoids. Particularly high concentrations are found in dark green and orange plants and fruits, like spinach, broccoli, green beans, corn and peaches.

“If you eat a lot of fruits and vegetables, you will be getting a lot of carotenoids”, Dr Snodderly said. “This already fits in with public health recommendations for a wide range of health issues – increase intake of vegetables and fruits.”

And if we do not consume, or absorb, sufficient amounts from our diet then supplements containing carotenoids are imperative.