Treating macular degeneration: Lifestyle changes

Age-related macular degeneration (AMD) is the leading cause of blindness among Canadians over the age of 50. Although the disease is not yet curable, there are promising new therapies in the research pipeline that may be available soon.

No one knows what causes age-related macular degeneration (AMD), but by some estimates it accounts for one-third of all cases of vision loss in Canada. Close to 80,000 Canadians are diagnosed with AMD annually. Nearly 90% of those with AMD have what’s called the dry (or nonexudative or atrophic) form, in which the light-sensitive cells in the macula slowly decay and yellow spots of fatty deposits called drusen appear on the macula.

• Dry AMD. This is the less severe of the two forms of AMD. It progresses slowly and sometimes stabilizing temporarily. You might not even notice symptoms of vision loss, especially if it is restricted to one eye and your "good" eye compensates. About 15 percent of people with the more common dry AMD go on to develop wet AMD.
• Wet AMD. In the less common form, called wet (or exudative or neovascular) AMD, fine blood vessels grow beneath the retina, leaking and damaging the macula. Wet AMD progresses more quickly than dry AMD and it causes more severe vision loss, sometimes within days or weeks. If left untreated, wet AMD can lead to legal blindness , defined as vision of 20/200 or worse, although not to total blindness.

Even though effective treatments for AMD are scarce, there is much you can do on the lifestyle front to preserve the vision you have:

1. Monitor your eyes. Your best defense is to act promptly. See your eye doctor regularly and monitor your eyes at home with an Amsler chart, a piece of paper with a grid of black lines. Ask your doctor for one. Cover one eye at a time so you can test each eye individually. If straight lines look wavy or there is a gap in the lines, call your eye doctor at once.
2. Eat your fruits and vegetables. Studies have shown that a balanced diet rich in fruits and vegetables — especially those containing carotenoids such as beta-carotene and lutein — can help preserve eye health. This means eating foods of green, red, orange or yellow hue — tomatoes, corn, squash, kiwi, and oranges — as well as green leafy vegetables.
3. Cut down on fat. A high total fat intake is associated with increased risk of AMD. This is especially true of animal fats but also includes the omega-6 fatty acids found in vegetable oils. There’s one exception: the omega-3 fatty acids in salmon, mackerel, tuna and other fish may help preserve your vision.
4. Keep up your health. High blood pressure is associated with AMD, so this gives you another reason to control your blood pressure and cholesterol levels. If you have diabetes, which can also affect eye health, continue your efforts to keep your blood sugar levels under tight control.
5. Don't smoke. People who smoke are at a greater risk for AMD, and are more likely to respond poorly to laser surgery.
6. Avoid bright sunlight. When you go outdoors, wear sunglasses that absorb all UVA and UVB radiation, and also shade your eyes with a wide-brimmed hat.