Age-Related Macular Degeneration. Is it preventable?

Philip J. Goscienski, M.D.

April 2008

Vision problems are nothing new to the senior segment of our population but they hide it well. Contact lenses, laser surgery and cataract removal often eliminate the need for eyeglasses as well as the progressively poor vision that our grandparents put up with. Unfortunately, eye surgeons can't reverse Age-Related Macular Degeneration (AMD) as easily.

AMD (also known as age-related maculopathy) leads to blurring and loss of central vision, straight lines appearing wavy and dimming of vision when reading. There are no symptoms at all in the early stages. Everyone over the age of 60 should have an eye exam every year in order to catch the early findings of AMD as well as other diseases, such as diabetes, glaucoma and cataracts.

Some family groups have a high incidence of AMD but the genetic pattern is only partly understood. It appears that about half the cases of this major cause of blindness are highly influenced by heredity. Even so, those who have one of the genes that increase the risk of AMD can slow it down even if they cannot eliminate it.

Our Stone Age ancestors, even the 10 percent who lived beyond the age of 60, had a lifestyle that helped them to avoid AMD. They didn't smoke, a habit that magnifies the risk among certain genetic groups by a whopping factor of more than a hundred! Another offsetting factor was their nutrient-rich diet. Unlike the vast majority of us, those who lived before farmers started raising grain ate plenty of plant foods. A diet rich in antioxidants, vitamins C and E, carotenoids (think green leafy vegetables, tomatoes, carrots and apricots) zinc, copper and omega-3 fish oil can lower the risk of AMD by about 25 percent. Natural foods are best; antioxidant and vitamin supplements aren't as effective.

Other factors that were absent from the Stone Age lifestyle add to the risk of AMD as well as other eye diseases. They had no type 2 diabetes, which may soon become the leading cause of blindness among the elderly, adding to the burden of AMD. An active lifestyle that includes walking and muscle-strengthening activities 3 or 4 times a week helps to avoid both of these vision-destroyers.

Losing most of your visual acuity is demoralizing and to make that worse it raises the risk of falls and other accidents. Poor vision predisposes to hip fractures in a population whose bones have been weakened by osteoporosis.

In the past two decades the pharmaceutical industry has developed medications for the treatment of AMD that offer real hope to the victims of this disease but they are not as convenient as taking a pill. Laser treatment and new surgical procedures slow down the progress of the disease. No treatment method will restore vision completely.

Lifestyle makes a difference even for those diseases that have strong genetic influences such as type 2 diabetes and Alzheimer's disease. Even if you don't have a family history of AMD it's a good idea to keep that in mind.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.