February is National Age-related Macular Degeneration (AMD) Awareness Month
Apparently the mother of George HW Bush used to tell the future president to eat his broccoli. My mother used to tell me to eat my carrots. Now my wife tells me to eat many things, among them the salads and vegetables.
Well, the mothers are right. Wives even more so. It turns out that broccoli, carrots and other leafy vegetables, especially the ones with red, yellow and green colors are good for you, and particularly for the retina.
The retina is really an extension of the brain, situated in the back of our “camera” or our eyes, and works like a “film”. All the images we see are formed there and transmitted to the brain. Consequently, the retina is one of the most active parts of our body. Even when we are relaxing and watching TV, for example, our retina is working hard, imaging and sending signals to our brains. As long as we have our eyes open, it is working full time.
As we get older, sometimes, the waste products from all this high metabolism accumulate under the central part of the retina (called macula). These little white or yellow deposits are called drusen, and are the first signs of “macular degeneration”. When I was in medical school many years ago, we used to call it SMD (senile macular degeneration). For obvious reasons, it is no longer called that, but ARMD (age related macular degeneration) or simply AMD.
There are mainly two types of ARMD. The more serious type is called “wet” because there is blood leaking from the abnormal blood vessels in the affected part of the retina. Again, in the old days of my medical school years, almost everyone lost the central vision. Nowadays though, there is a much better chance of maintaining good vision with various types of intraocular medications.
The other type is called “dry” because there is no bleeding. Fortunately, this is a more common type. However, as the “dry” type can convert into “wet” kind at any time, there are several precautions to take. If applicable, one should stop smoking as soon as possible . The smoking and its related toxins cause tremendous amount of stress in the retina, and “age” it faster.
One of the first symptoms of ARMD is a distorted vision (metamorphopsia). It happens because the image falls on the retina distorted by the drusen or hemorrhage . This distortion can most easily be perceived when looking at a straight line. Therefore, a patient should monitor his or her vision with a chart called Amsler grid. It has multiple lines running vertically and horizontally, centered around a dot. I recommend checking each eye separately, with reading glasses on, at least once a week, and to report to me ASAP if the patient notices any sudden change or distortion.
Thirdly, I recommend eye vitamins. There are many good products out in the market, all can be obtained over the counter without the prescriptions. However, the only products that have actually gone through the scientific trials (AREDS=Age Related Eye Disease Study) and to have shown efficacy are made by Bausch and Lomb, called Preser Vision AREDS or AREDS 2 formula. For current or former smokers, I recommend AREDS with lutein or AREDS 2.
As the life expectancy increases and as the visual demands of our modern world increase, it is so important to take good care of our eyes. As any mother or loved one may say, we should stop smoking, eat right, wear sun protection and get regular eye check ups.
-Dr. Steve Park