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Potential Health Problems
May Show Up First In Your Eyes
By Melissa Lowenstein Book Review
Save Your Sight!
Henry Collins is very worried about his eyes. When he looks out his window at the fence that surrounds his yard, the posts he knows are straight look bent. It's especially bad when he covers his left eye and just looks with his right. He also notices a troublesome blurry spot that only covers the central area of his vision. It has been getting so bad that sometimes he doesn't recognize faces unless he purposely looks past them-he can see details better with his peripheral vision. Colors look different when he looks with only his right eye than when he looks with only his left. Anytime he goes indoors from bright sunshine, he is temporarily blinded, and has had to feel his way through the foyer of his house many times. He doesn't want to unnecessarily worry his wife, but she's beginning to catch on that he is reluctant to drive.
Finally he goes to see Marc Rose, M.D. for a checkup. Dr. Rose examines his eyes and has him look at something called an Amsler grid. The diagnosis is early age-related macular degeneration (ARMD), a disease Henry has never heard of. Henry finds that the symptoms he has been experiencing are experienced by fifteen million other Americans with the early signs of this disease. His heart falls when Dr. Rose tells him there is no cure, and he is skeptical when told that he would be getting a complete nutritional plan to slow the progression of the disease, and perhaps even reverse it. "All this, just for my eyes? Can't we just do something to fix the eye problem?" asks Henry.
Dr. Rose explains to him that when the average eye doctor uses his instruments to look into his eyes, he or she is only looking for specific signs of eye disease. "When I give an eye exam, I'm looking for important clues about the health of your entire body," he tells Henry. "When I look at the tiny blood vessels in your eyes, I know that their condition reflects the health of blood vessels throughout your body. The vessels in your eyes look weakened and leaky, as they often are in patients with degenerative eye diseases, so I can practically guarantee that they are weakened and leaky throughout the body."
Dr. Rose also explains that there are age spots, or drusen, on Henry's retinas. "Those are caused by sun damage over the years, and from those I know that there is probably a significant amount of sun damage to your skin." Surprised, Henry tells him that he has had a few small skin cancers removed recently. He's finally convinced to try the nutritional program when Dr. Rose accurately guesses that he also has high blood pressure and occasional bouts of heart pain (angina). After a few months on the program, he finds not only that his eyes don't get worse, but that he also can stop taking his high blood pressure medicine and has fewer bouts of angina.
Dr. Rose, ophthalmologist, anti-aging physician and author of Save Your Sight (Warner Books, New York, 1998), has found that certain nutrients can make a significant difference in preventing and slowing the progression of eye diseases such as macular degeneration, glaucoma and diabetic retinopathy.
His methods for treating these diseases are based on a holistic view: The health of the eyes reflects the health of the whole body, and when we bring the body into balance and slow the aging process, we can stop the progression of degenerative eye diseases. Save Your Sight gives readers nutrient prescriptions for specific eye diseases, as well as a comprehensive lifestyle plan that supports the health of our other parts. Based on existing clinical research, he concludes that nutrients found in leafy green vegetables, garlic, colorful fruits and fresh fish can help prevent or slow the progression of eye disease. Dr. Rose tells readers how to use these nutrient-rich foods and specific supplements to nourish the eyes. Best of all, his approach to treating blinding diseases like macular degeneration, glaucoma and diabetic retinopathy offer a simple yet comprehensive lifestyle plan to slow the aging process and prevent other kinds of disease.
With macular degeneration, is there a light at the end of the tunnel?
Imagine that when you look at this page, you can see only the edges, with a dark blur covering the center of your view. Imagine that the dark blur is always at the center of your vision-no matter which way you look, you can see only the edges, as though you were looking through a video camera with a dark screen taped over the center of the lens. Imagine being unable to make out the faces of loved ones, drive a car, or cross the street without assistance. That's what the sixteen thousand people who have the most advanced form of age-related macular degeneration (ARMD) experience every day. Fifteen million others are in the early stages, with progression to legal blindness a very real threat.
Age-related macular degeneration is the most common cause of blindness in Americans over the age of fifty. ARMD is the fastest growing cause of legal blindness in the U.S. Almost everyone over the age of sixty-five has some degenerative changes in the macula. There is no known medical cure, but Dr. Rose maintains that you can prevent macular degeneration and halt its progress with nutrition and lifestyle changes.
The macula is a part of the retina, which lines most of the inside surface of the eyeball. Each of the several layers of the retina has its own role in maintaining vision. There are the photoreceptors, the cells responsible for translating light energy into impulses that travel along the optic nerve into the brain; the retinal pigment epithelium, or RPE, which brings nutrients into and wastes out of the retina; and the choroid layer, a network of blood vessels that nourishes the retinal tissues. Near the rear center of the retina, beside the optic nerve, lies the macula, measuring only two millimeters across, a little bit larger than the letter "o" in this text. The macula contains specialized photoreceptors needed for central vision and for perception of colors and printed words.
Macular degeneration is just that-degeneration of the macula. In the majority of cases, this happens over a span of many years. Slowly, the cells of the macula age and die off. The RPE becomes clogged with wastes and calcium deposits, and the blood vessels of the choroid become leaky or stopped up and unable to nourish the macula. Age spots called drusen, a sign of sun damage similar to age spots on the skin, form on the retina. This is as far as things progress in the dry form of macular degeneration, which makes up about 90% of cases. Dry ARMD often leads to significant visual impairment, making everyday tasks like reading, writing, and driving difficult, if not impossible.
In about ten percent of those with the disease, it progresses to the wet form. Wet ARMD is characterized by the development of new blood vessels in the retina. These vessels grow across the macula and block central vision. Hemorrhages increase the fluid pressure within the eye and destroy the delicate tissues of the macula. Drusen can grow larger and coalesce, and cause detachment of the RPE. Wet (also called "exudative") ARMD eventually blocks central vision completely, causing legal blindness. Mainstream medicine is baffled by this disease, and so far hasn't been able to pinpoint a cause or a cure. There isn't any mainstream treatment for the dry form, and the therapies for the wet form are last-ditch attempts to preserve sight. Laser surgery can be used to seal up hemorrhaging blood vessels and temporarily stave off blindness, but it's a stopgap measure at best. Drugs that inhibit the growth of new blood vessels have not proven effective either.
Retinal tissues are rich in fats that are vulnerable to the assault of free radicals. Eyes that are lighter in color have less protective melanin pigment than dark eyes. Melanin acts as a natural sun shield, and more ultraviolet and blue light rays from sunshine can pass through to the macula when there is less of this pigment. These wavelengths of light cause the fats in the retina to become oxidized. Over years of unprotected sun exposure, this can cause significant damage to the retina. This is especially true if antioxidants are deficient. In a study published in the Journal of Experi- mental Eye Research, when rats were supplemented with antioxidants, they became less vulnerable to retinal damage from ultraviolet and blue light. Other studies on humans have shown that high blood levels or high intakes of antioxidant nutrients both correlate with much lower incidence of ARMD.
Carotenoids are nutrients found plentifully in orange, yellow and dark green vegetables. Beta carotene is the best known of these, but there are many others that have important roles in the body-particularly in the eyes. A recent study in the Journal of the American Medical Association showed that adults who eat leafy greens like spinach, kale and collards often have far lower risk of macular degeneration. These greens are rich in the carotenoids lutein and zeaxanthin. Lutein and zeaxanthin are yellow pigments found abundantly in the retina. They protect the retina from oxidative damage, most notably from ultraviolet and blue light rays. Adults with light-colored eyes, smokers and post-menopausal women-all high risk groups for ARMD-have significantly fewer of these pigments in their retinas. A review of studies on macular degeneration and nutrition in the American Journal of Clinical Nutrition showed that the lower the concentration of carotenoids in the eye, the higher the risk of ARMD. This review also described lab studies where carotenoids were shown to actually protect the retina from oxidative damage.
Bioflavonoids are super-nutrients found in vitamin C-rich foods like berries, grapes, lemons, plums, black currants, grapefruit, cherries and apricots. Ginkgo and grape-seed extracts are also rich in bioflavonoids, and bilberry extract is especially nourishing to the eyes. These nutrients are essential for maintaining the health of blood vessels and should be a part of any preventive or healing supplement program for ARMD. Save Your Sight also includes nutritional prescriptions for glaucoma, diabetic eye disease, cataract and retinitis pigmentosa.
Now, imagine that your field of vision begins to narrow-the opposite of what happens with ARMD. It's really hardly noticeable at first. You only notice it when it's progressed so far that you are experiencing tunnel vision. Blackness surrounds your visual field. Painlessly, your optic nerve is dying from the outside in.
Three out of every one hundred Americans over the age of 65 have glaucoma, which can lead to complete blindness. Once diagnosed, glaucoma is usually treated with a barrage of drugs, none of which can cure the disease. At best they slow it down, and at worst they exacerbate the problem or cause others.
There are several kinds of glaucoma, all of which result in the destruction of the optic nerve-the passageway visual messages need to get to the brain. The eyeballs are filled with a fluid, the aqueous humor, that undergoes changes in pressure just like the blood in the blood vessels. Blood and eye fluid pressures both vary in response to exercise, stress and bad nutrition. When eye fluid pressure stays too high-a condition known as ocular hypertension-the optic nerve is crushed. Cells begin to die off from the outside in, which is what causes the gradual tunnel-vision effect in this most common form of glaucoma.
"It is possible to have glaucoma and have normal eye pressure, and it's also possible to have ocular hypertension and not have glaucoma," says Dr. Rose. "It's a difficult disease to diagnose and treat because it's so variable. Many ophthalmologists, when they find high ocular pressure, immediately start barraging the patient with powerful drugs that have all kinds of side effects, when there may not be any optic nerve damage going on. Even in cases where there is optic nerve damage from high eye pressure, the drugs can do more harm than good."
Glaucoma can be caused by partly or completely plugged fluid drains in the eyes (the most common cause). Steroid drugs or toxins like cigarette smoke, monosodium glutamate (MSG) and aspartame (NutraSweetTM) are to blame in some cases. One variety, known as circulatory glaucoma, often goes undetected until it's very advanced because eye fluid pressure doesn't rise and may even be abnormally low. This form of glaucoma kills the optic nerve because of poor circulation in the eyes. An eye exam that reveals a pale optic nerve that's not getting enough blood flow is another good indication of poor blood vessel health throughout the body.
The earliest detectable sign of optic nerve fiber loss in glaucoma is diminishing levels of carotenoids on the retina. Dr. Rose's supplement program for glaucoma includes carotenoids, as well as coenzyme Q10 and carnitine (which are useful for improving circulation to the optic nerve). Also recommended is forskolin, an ages-old natural remedy from India. In a study published in the journal Lancet, researchers found that forskolin to be a safe and effective alternative to powerful drugs usually prescribed for ocular hypertension. Magnesium is also recommended to open up eye blood vessels. It works through a mechanism similar to the calcium channel blocking drugs often prescribed for this purpose, without the side effects. Dr. Rose also recommends sublingual vitamin B12, the bioflavonoids rutin and quercetin, and plenty of antioxidants to prevent or slow the progression of glaucoma.
Eleven million Americans have diabetes, and almost half of diabetes sufferers have some related eye disease. Diabetics are at higher risk of cataract, but this isn't a sentence of blindness anymore because of the surgeries now performed to replace clouded lenses with clear artificial lenses. More dangerous for diabetics is a disease known as diabetic retinopathy (DR). Adult-onset diabetes, by far the most common kind of diabetes, is characterized by high levels of sugar and insulin in the bloodstream. This is a toxic state of affairs throughout the body, raising risk of heart disease, high blood pressure, kidney disease, blood vessel disease in the legs and nerve damage. In diabetic retinopathy, the blood vessels of the eyes deteriorate and the macula actually becomes swollen. New blood vessels begin to spring up, and hemorrhages leak blood into the fluid that fills the eyeball. Left unchecked, diabetic retinopathy will cause blindness.
Diabetic retinopathy is a good example of the eyes' health reflecting the health of the entire body. When diabetes is well-controlled with the right diet, supplements and exercise, diabetics can often avoid taking medication and are much less likely to suffer from retinal disease. Careful monitoring of blood sugars is one of the most important measures a diabetic can take to prevent complications like DR. Supplements helpful for diabetic eye disease include any that keep blood sugar levels down, such as chromium, vanadyl sulfate, and alpha lipoic acid. Supplements that support blood vessel health, including magnesium, garlic, omega-3 oils, and quercetin, are also part of Dr. Rose's prescription.
Save Your Sight also includes chapters on the importance of maintaining good digestion and assimilation and on how exercise helps keep vision clear. There's a chapter about the circulatory system with guidelines on how to keep blood vessels throughout the body clear and strong. Other chapters address threats to our vision posed by many commonly prescribed drugs and commonly encountered chemical toxins. You'll find tips for choosing the right kind of sunglasses for optimal protection. There are also chapters on coping with vision loss and resources for the blind and partially sighted. It's surprising how many low vision aids are out there for people who need some help seeing clearly, and Dr. Rose's book lists dozens of organizations that specialize in this area. Purchase Books and Other Media Online |