RETINA
DIABETES AND THE EYE
Diabetes is a disease that interferes with the body's ability to absorb sugar. It causes various health problems and affects the eyes in the form of diabetic retinopathy, a condition in which blood vessels in the eye bleed and damage the retina, the lining in the back of the eye. In the early stages of diabetic retinopathy, these blood vessels may swell and leak fluid. In more advanced stages, oxygen to the retina becomes constrained causing new abnormal blood vessels to grow and cause further leakage and bleeding. There may be no symptoms early in the disease; however, in later stages, symptoms include seeing spots or floaters, difficulty with night vision, seeing shadows, having blurred vision, and eventually blindness. The longer a person has diabetes, and the less managed the disease, the more likely it is that he or she will develop diabetic retinopathy. To minimize your risk, ensure that you maintain a healthy diet, exercise and lifestyle regimen, adhere to any prescribed medication, and comply with regular doctor visits and annual eye examinations.
MACULAR DEGENERATION
Age related macular degeneration (AMD) is a condition in which damage occurs to the macula, the part of the retina responsible for sharp central vision. There are two forms of AMD – the “dry” form and the “wet” form. Dry AMD is more common, but wet AMD is more severe, causing irreversible and rapid vision loss due to abnormal blood vessel growth and leakage inside the eye. Treatment of wet AMD involves the injection of medication in the eye to prevent such blood vessels from growing.
While no medical or surgical treatment is available for dry AMD, the role of nutritional intervention in slowing or preventing its progression continues to be explored. A landmark study for AMD known as the Age-Related Eye Disease Study (AREDS) showed that high amounts of certain antioxidants and zinc can reduce the risk of advanced AMD by as much as 25% for those with intermediate macular degeneration in both eyes or advanced macular degeneration in one eye. The study did not show that such antioxidants and zinc prevented the development of macular degeneration, and did not have any bearing on the development or progression of cataracts. Still, many eye care professionals advocate the use of nutritional supplements (vitamins A, C and E, and certain other minerals) to help manage or lower risk of AMD, and most do not oppose their patients taking supplements or foods containing these antioxidants. Phase two of the AREDS study is presently in its late stages, and seeks to evaluate whether similar protective benefits may be associated with other nutrients such as omega-3 fatty acids, lutein and zeaxanthin.
By a retina exam, it is possible to detect early signs of AMD before symptoms occur. Risk factors for AMD include aging, smoking, lighter skin and eye color, obesity, and heredity and family history. No conclusive evidence has shown that sun exposure contributes to the risk of AMD, although some eye care providers may recommend protection from UV light. Your eye doctor may also send you home with an Amsler grid, a chart of straight black lines, to monitor development to wet AMD; someone progressing to wet AMD may see some of the lines as wavy or blurred around darkened spots.
