To Your Health

Q: I am watching my grandfather fade away because he is losing his eyesight to macular degeneration. He was always the healthiest of my grandparents, but now he can't drive or read, and he is too proud to take advantage of the services available for the blind. Is there any hope for a cure?

A: Macular degeneration (usually called age-onset macular degeneration, or AMD) is the deterioration of that part of the retina where we focus our vision. A person with macular degeneration is unable to see the objects he is looking directly at, though he can detect them in his peripheral vision.

I am sad to say that at this time there is no real hope for your grandfather to regain his sight. However, there is always the possibility that he can adjust his attitude and lifestyle so that the loss of this faculty does not blind him to his other abilities and blessings, such as having a grandchild who cares for him. You may find a book by Bruce and Kate Rosenthal helpful, called Living Well With Macular Degeneration: Practical Tips and Essential Information. Yes, you will need to read it to him, but not only will you gain some information that will help you, it will provide him with tips to make his life easier.

It is all the more important to prevent the onset or progression of AMD, since it cannot be reversed to any significant degree. The two primary means of preventing AMD are to maintain circulation to the retina and furnish it with an abundance of antioxidants.

The habit that most compromises both of these methods is smoking. Smoking is not the only explanation for AMD, but there is no doubt that it both depletes antioxidants and, at the same time, constricts blood vessels.

In addition to not smoking, emphasize the deeply colored fruits and vegetables in your diet, since these provide many antioxidants as well as lutein and zeaxanthin, a couple of the "non-beta carotenoids." A really good diet can provide 5-10 mg of these non-beta carotenoids, and supplements are available that provide an additional 10 mg/day.

Non-beta carotenoids, different from beta-carotene in that most cannot be made into vitamin A or retinol, were virtually ignored for decades. Retinol is the form of vitamin A that we are most familiar with; beta-carotene is often called "pro-vitamin A," indicating it can be made into vitamin A. Now it appears non-beta carotenoids are every bit as important as retinol for eye health because they absorb the ultraviolet light that can be most damaging to the retina.

Some are apprehensive about supplementing with vitamin A because of a concern over toxicity, and indeed the retinol form of vitamin A can be toxic when supplemented at high levels for a long period of time. Furthermore, even modest retinol supplements carry the risk of birth defects in pregnant women. Carotenoids are safer than retinol because they contain large amounts of transporter protein, which makes them easier to move out of the liver and to the skin. The orange color that develops in your skin when you drink a lot of carrot or beet juice is carotene, and carotene is safer because it can be excreted by this route. The benefits of supplementing the non-beta carotenoids are enhanced by using an antioxidant blend, especially one rich in vitamin C, with reduced risk of cancer and heart disease as a bonus.

Our eyesight is precious, and well worth preserving, especially considering the small investment the dietary changes and supplements above represent.