With Macular Degeneration Awareness Week coming up from the 27th of May to 2nd of June, eyecare professionals are focusing strongly on spreading the message of prevention. That’s because, while the common saying may be ‘prevention is better than cure’, in the case of macular degeneration – the leading cause of major vision loss and blindness in Australia – prevention is the only cure.
“Once you develop macular degeneration, it’s simply a case of managing and treating the symptoms and making the lifestyle changes necessary to slow down its progression,” advises Dr Jan Coetzee of Insight Optometrists in Indooroopilly, Brisbane. “The tragedy is that all of the lifestyle adaptations you would need to make after developing this condition may well have prevented it developing had they been started sooner.”
A little black dot
Macular degeneration is a collective of diseases of the macula, a small (3-5mm) portion of the retina with a big purpose: central vision. “As the macula progressively degenerates, your central vision will first appear blurry, greyish or distorted and it will gradually worsen until you see nothing but a black spot in your central vision, with only peripheral vision remaining,” says Dr Coetzee. “Activities you may have taken for granted before, such as reading, driving, needlework and other fine-detail work, will no longer be possible. You will eventually no longer be able to see and recognise the faces of the people around you – which is obviously especially distressing.”
As the condition commonly affects older people, it is also referred to as Age Related Macular Degeneration (AMD). According to the Macular Degeneration Foundation, about one in seven people over 50 suffer with AMD and it gets worse the older you get. Recently, in the face of persistent media speculation that she was going blind, the famous 77-year old English actress Judi Dench publicly announced that she suffers from AMD and struggles to see people in front of her or read her film scripts, with someone having to read them to her “like a story”.
Forms of MD
Dr Coetzee advises: “There are various forms of macular degeneration, including wet (atrophic) and dry (exudative), with the dry form being more common, slower to progress and less severe than the wet form. Both wet and dry forms take hold in the retinal pigment epithelium (RPE), the layer of cells at the back of the eye underneath the retina. The RPE moves oxygen, sugar and other products to the retina and takes garbage back down to the blood vessels underneath. When this process breaks down, the waste builds up under the RPE and ‘drusen’ (small yellow spots) are formed. This is the first stage of macular degeneration.”
Regular eye exams
In the first phase of macular degeneration, only your optometrist would notice the drusen – and this early stage is the best time to diagnose, treat and markedly slow down progression of the disease. Dr Coetzee stresses that with the optical technology available today, such as a digital retinal imaging, where a digital photograph of your eye is produced, it is easy to pick up macular degeneration, glaucoma and other eye problems early – but only if you book that appointment!
Self-testing with the Amsler Grid
The Amsler Grid, developed by Swiss ophthalmologist Marc Amsler in 1945, is a simple yet highly valuable diagnostic tool used to monitor the field of central vision. The grid is simply a chart with ‘crisscrossing’ lines and a dot in the middle and it is ideal for regular eye tests at home. Cover one eye at a time and look at the small dot in the centre of the grid. Should you see the lines as wavy, distorted or missing through any eye, you should immediately book an eye exam.
The Amsler Grid
Example of distorted Amslyer Grid
Images courtesy of the National Eye Institute (NEI)
Lifestyle tips for optimal eye health
If you are serious about your vision, book a thorough eye health assessment with your optometrist and then consult your GP to discuss these suggested diet and lifestyle changes in order to ‘insure’ your eyesight:
- Wear high-quality, UV-blocking eyewear from an early age
- Ensure you go for regular eye tests, including macular exams
- Stop smoking (even better, don’t start!)
- Exercise regularly – about half an hour of vigorous, aerobic exercise three to five times a week
- De-stress regularly – spend time in nature, take up yoga or other calming activities
- Control your weight so that it does not ‘see-saw’
- Drink plenty of fresh, filtered water
- Limit processed and fatty foods, sugar and dairy (especially cheese)
- Eat plenty of leafy, dark green vegetables (broccoli, spinach)
- Eat a variety of orange and yellow veggies
- Eat a variety of fresh fruit each day (especially citrus, black/blueberries and cherries)
- Eat fresh, oily fish (Omega 3 and 6) a few times a week
- Opt for healthy snacks like nuts, seeds and dried fruit
- Consider zinc, beta carotene and antioxidant supplements.
“Not only will wise diet and lifestyle changes decrease your chances of contracting macular degeneration, they will slow down progression of the disease to a manageable level, plus they will impact positively on every other area of your life”, advises Dr Coetzee.
“Your vision is a precious gift that cannot be replaced once gone. By arming yourself with the simple combination of knowledge about the health of your eyes, a balanced diet and lifestyle and regular eye check-ups could mean the difference between crisp, clear vision and that little black dot that gets bigger every day.”
Dr Coetzee holds a doctorate in optometry and is dedicated to raising awareness of eye health issues and providing high quality, protective eyewear. His practice, Insight Optometrists in Indooroopilly, western Brisbane, is also an accredited member of the Eyecare Plus group, a select collective of clinically-driven optometry practices across Australia.