Your changing vision

A pharmacist’s view on eye health, and how you can protect your vision

Ienjoy seeing things: trees, flowers, the sky, my paycheque and my daughter are all things I enjoy gazing upon (I won’t bore you with which one I like the best). What if one day you couldn’t see, or even worse, what if the vision loss was gradual so you knew it was coming? This is the reality of macular degeneration, the progressive damage of the part of the eye which is responsible for sharp, central vision. This month, we will look at the early warning signs, prevention and treatments for this sight-robbing condition.

The bodily function known as sight is fascinating, complicated and fragile. Light passes into our eye and is focused onto the thin tissue on the back of the eye called the retina. The central portion of the retina is called the macula, and it is this area that is responsible for sharp, central vision.

An early symptom of macular degeneration is the gradual blurring in the central area of vision. Another symptom may be when straight lines begin to appear wavy. Macular degeneration may only occur in one eye; in this case, no vision changes may be noticed. This is why regular visits to your optometrist are important.

There are two forms of macular degeneration (MD) – wet and dry. About 85 per cent of cases are the dry form. Dry MD occurs when cells of the macula break down and cause yellow deposits to form under the retina. As the deposits increase in number, there is a greater risk of developing the other form of MD referred to as ‘wet MD’. This occurs when small fragile blood vessels form under the retina. These fragile blood vessels tend to leak blood and fluid and can rapidly damage the retina and macula.

While both types of MD can cause significant vision loss or blindness, the risk associated with wet MD is greater. In general, both forms of this disease are referred to as age-related macular degeneration (AMD). The degeneration can be caused by other factors such as a genetic predisposition, but these types are rare.

There are many things a person can do to protect their eyes from AMD and other eye conditions. Seeing that it is summertime, the first thing you can do is protect your eyes from sunlight – wear your sunglasses. While sunlight has not been proven to worsen AMD, many people still believe that it can cause damage and is an easily avoidable risk factor.

I think everyone should wear sunglasses – especially young children and infants. Their sensitive eyes need protection from the sun’s harmful rays. Smoking can also increase your risk of developing MD and other eye diseases. High cholesterol may also play a part in the development of macular degeneration. “Be good to your eyes and use them often. There are so many wonderful things to see in our lovely city.”

A supplement has been shown to help prevent AMD. This high potency multivitamin was shown to help AMD in the National Eye Institute’s Age-Related Eye Disease Study (AREDS). In this large study, people with and without AMD took a multivitamin containing zinc, beta-carotene, vitamin C and vitamin E. What researchers found was that there was a risk reduction of 27 per cent for vision loss in people who had advanced AMD, and a risk reduction of 25 per cent for the progression of AMD to a more advanced stage of this disease. For people without, or with early AMD, there appeared to be no benefit.

The AREDS vitamin formula consists of 500 milligrams of vitamin C, 400 international units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc, and two milligrams of copper. Some vitamin manufacturers are making this formulation; look for the word

AREDS in the name of the product. There are few contra-indications for taking this product; ask your Heart Pharmacist if this vitamin is right for you. There is some concern that people who smoke and take beta-carotene increase their risk of developing lung and prostate cancer. One way to reduce this risk is to quit smoking. This risk is not seen in non-smokers. It has also been reported that DHA (Docosahexaenoic acid), a fatty acid found in fish oil, may help to prevent AMD. This was determined by a prospective study of dietary fat intake. The researchers found that the amount of all dietary fat intake was directly related to an increased risk of developing AMD.

Upon looking deeper, they also found that those who ate fish more that four times a week had a 35 per cent lower risk of developing AMD. DHA is a fatty acid that is unique to fish, so it was thought that it was the fatty acid that was associated with the reduced risk.

With many of my articles warning of the dangers of sun exposure, you might think I’m some sort of vampire. Far from it – exposure to sunlight is very important for our health and mood. Just be wary of over exposure. Be good to your eyes and use them often. There are so many wonderful things to see in our lovely city.