The leading causes of blindness in the U.S are diabetic related eye complications, glaucoma, and macular degeneration. Cataracts are generally listed as the number one cause but this is somewhat misleading.
Cataracts effect in excess of 20 million people but most cataracts are treatable with modern surgical techniques and artificial lens implants. The complication rate is low. While some cataracts may be inoperable due to other health problems, most can be successfully removed. Many cases of blindness attributed to cataracts are actually due to preexisting retinal problems such as macular degeneration and advanced glaucoma. If the retina is not healthy to start with, removing the cataract will not restore vision, and the low level of vision categorized as blindness is actually not due to cataracts. The cost of cataract surgery is a barrier to treatment to the uninsured and can account for some of the large numbers of blindness attributed to cataracts.
Next to cataracts, diabetic complications in the eye do result in blindness in over 4 million people. With the current increase in obesity in our culture, especially in youth, this is a serious concern for the future. Most diabetes related blindness is due to changes in the blood vessels in the retina that causes microanuysms, bleeding, proliferation of fragile new blood vessels, and detachments of the retinal tissue. There is a correlation with how many years the diabetes has been present and how well the blood sugar has been controlled. Early treatment of retinal complications is a proven method of greatly lowering the incidence of blindness.
Glaucoma also is responsible for several million cases of blindness. Glaucoma has traditionally been thought of as high pressure in the eye. Today it is gradually becoming viewed as a circulatory problems to the optic nerve and a neurodegenerative disease, where the death of the nerves are a vital part of the disease. This will greatly alter our treatment regimins at some point in the future as we transition to using drugs to protect the nerve health and increase blood circulation.
All three of these conditions are primarily a condition of aging and as the population ages the incidence is increasing. All three are also highly likely to prove amendable to lifestlye and nutritional intervetion at early stages.
Protection of the lens in the eye from UV exposure and enrichment of the diet with food and nutriional supplements containing lutein and zeaxanthin appears to show promise. Eating a diet with a low glycemic index (limiting refined sugars, eating complex carbohydrates like whole grains, and lost of vegetables) also will probably be shown to reduce cataracts. Finally, like the other leading causes of blindness, reducing obesity will reduce cataract fomration. While vitaimin E and C have been shown in recent studies not to reduce cataract formation. I do not beleive this will prove to be true with repeated studies. I do beleive antioxidants will be shown over time to be useful but it may be true in the context of whole foods and balanced diets, not in the form of supplementation.
Macualr degeneration has it’s proven formula manufactured by Bausc & Lomb under the name of Preservision which was shown in the initial Age Related Eye Disease Study (A.R.E.D.S.) to slow the progression of the mild form of macualr degeneration to the severe form. The supplements in the original formula are:
Vitamin A (beta-carotene)
Vitamin C (ascorbic acid )
Vitamin E (dl-Alpha Tocopheryl Acetate)
copper cupric oxide
While a studies have shown an increase in lung cancer in smokers taking Vitamin A (beta-carotene) supplements, this is not a clear cut finding and may be proven wrong in the future. Currently supplements are being made both with and without Vitamin A. The exciting new news on the macular degeneration front is Age Related Eye Disease Study 2 -, which is testing the addition of lutein and zeaxanthin. Omega 3 fatty acids are also currently being looked at as a preventative supllements for macualr degeneration. Oxidative damage is presumably a major factor in macualr degeneration but it, like every other disease is usually not a simple one fix all type of propostition. Focusing on lifestlye prevention and nutrition and not late miracle cures should be a large part of our research expenditures.
It is still incredibly important to remember that many cases of all three of these conditions are due to genetic, environmental,coexisting health conditions, social, and mental health conditions out of our hands; and to place the blame or burden on an individual for their own illness is one of the cruelest and narcissistic attitudes we can take. On the other hand, we are enterning a new era where we can offer new forms of advice and interventions at an early age.
Glaucoma is at an earlier stage where we know less. While we will address individuals supplements and conditions in laters articles, for now a few peices of the clue. Vitamin C loweres eye pressure in some people due to osmotic pressure. Ginko may increase blood flow to the optice nerve. Forskolin comes from a plant named Coleus forskohlii and it has been used to lower intraocular pressure.
You can alter your lifestlye and nutrition and in conjunction with your prevetative eye exams from your family eye doctor thier is a good chance you can expect a lifetime of healthy eyesight. Fortunatly, most vision insurance plans, including Vision Service Plan and Medicare are recognizing the need for annual eye check ups for theses diseases.
As a final note, we feel so strongly about preventing blindness, if you have lost your job the last 12 months and are unisured we will work with you to manage your glaucoama for free for the remaider of the year if we feel we can help your case.