7 Spring Fruits and Vegetables

Spring is truly here. With Passover and Easter later this week, it is time to rediscover some of the amazing produce that is at its peak during the months of April, May and June. These 7 spring fruits and vegetables are not only delicious; they are good for you . . . and your vision. Here are some recipes for you to try and enjoy the bounty of spring. Some even include more than one of the seven fruits and vegetables listed below.
apricots - 7 Spring Fruits & Vegetables
Apricots – Apricots should be firm, but not hard, with a nice fruit scent when sniffed. They are best purchased locally so they aren’t picked too early and have a tree-ripened sweetness.

Apricot & Orange Breakfast Smoothie from Discovery Eye Foundation’s Eye Cook

Spicy Apricot Wings from Food & Wine

Fresh Apricot Chutney from Cooking Light

Chicken Tagine with Apricots & Almonds from Gourmet
asparagus - 7 Spring Fruits & Vegetables
Asparagus – Look for firm stalks, from the tips down to the base of stalks. Once asparagus are harvested they deteriorate quickly, so place them in cool storage to retain freshness and their nutrition value.

Asparagus and Strawberry Salad from Discovery Eye Foundation’s Eye Cook

Asparagus with Watercress and Brown Butter Potatoes from Food & Wine

Grilled Asparagus with a Caper Vinaigrette from Cooking Light

Asparagus, Tomato & Red Pepper French Bread Pizza from the Mayo Clinic
cherries - 7 Spring Fruits & Vegetables
Sweet Cherries – The best cherries are an inch or more in diameter, plump, firm, and rich in color.

Cherry Pie from Cooking Light

Cherry Tortoni from Gourmet

Cherry Tart from Bon Appétit

Easy Almond & Dried Cherry Cookies from Discovery Eye Foundation’s Eye Cook
fava beans - 7 Spring Fruits & Vegetables
Fava Beans – Young fava beans can be shelled and eaten either raw or cooked, but more mature favas need to be shelled and skinned, since their skins are too tough to eat.

Quinoa Salad with Grilled Scallions, Favas & Dates from Food & Wine

Sliced Filet Mignon with Fava Beans, Radishes & Mustard Dressing from Bon Appétit

Arugula & Fava Bean Crostini from Gourmet
green peas - 7 Spring Fruits & Vegetables
Green Peas – Fresh green peas include sugar snap peas, snow peas, and green peas. Look for bright green pods that are firm.

Fava, Sweet Pea & Sugar Snap Salad from Cooking Light

Salmon with Sweet Chili Glaze, Sugar Snap Peas & Pea Tendrils from Bon Appétit

Strawberry, Almond & Pea Salad from Bon Appétit
strawberries - 7 Spring Fruits & Vegetables
Strawberries – For the best flavor, you are best looking for strawberries grown close to home since they more are likely to be fresh and not be damaged in transit. They should be plump, firm, well-shaped, and uniformly colored.

Carrot & St rawberry Tea Bread from Discovery Eye Foundation’s Eye Cook

Strawberries Romanoff from Cooking Light

Strawberry and Cream Cheese Crepes from the Mayo Clinic

Pink Grapefruit, Strawberry & Champagne Granita from Bon Appétit
watercress - 7 Spring Fruits & Vegetables
Watercress – Look for uniformly dark green leaves and sniff for a fresh, spicy scent. Watercress has a short shelf life and should be kept in a plastic bag in the refrigerator for no more than three days.

Watercress, Orange & Avocado Salad from Gourmet

Watercress Salad with Verjus Vinaigrette from Food & Wine

Watercress Salad with Pan-Seared Mahimahi from Cooking Light

These are some great ways to enjoy  what spring has to offer.  Do you have any spring recipes you want to share?


Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

10 Tips For Healthy Eyes

In honor of Save Your Sight Week, here are 10 tips for healthy eyes. There are some simple things you can begin to do today to help your retain your vision. Also there are no warning signs for many of the leading eye diseases (age-related macular degeneration, glaucoma, cataracts), yet most people don’t see an eye doctor until they have a problem seeing. Unfortunately, by that time, irreparable damage has been done.
10 Tips For Healthy Eyes


Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

GMO and the Nutritional Content of Food

Genetically Modified Organisms (GMO)

GMO OrangeHow do advances in biotechnology affect the nutritional quality of our food? Historically, humans have realized that the tastiest and most abundant fruit could be selected and replanted the next season. Food crop’s genes change continuously by natural mutation and recombination. Today, advances in our understanding of genetics and molecular biology are permitting scientists to find specific genes that can be moved from one species to another. Genetic material can be transferred from viruses, bacteria, plants, and animals to produce significant changes in the original species. Unlike traditional breeding, gene transfer allows the transfer of genes between organisms of different species. It also permits the transfer of only specifically selected genes to produce the desired outcome in a controlled laboratory setting. Terms frequently used to describe the gene transfer and modification of plants and animals include: Genetically Modified Organisms (GMO), Genetically Engineered (GE) and Biotechnology-Derived (BD).

Nutritional Content of Food

Ways the nutrient profile and density of a food can be altered include: gene modification, agricultural growing and feeding practices, conventional plant breeding and selection, and vitamin biofortification. A gene selected for modification can increase or decrease the vitamin, mineral or fatty acid content found in the modified food. For example, golden rice is genetically altered to increase its beta carotene content. Sometimes when one nutrient is increased another will decrease as an unintended consequence. For example, canola oil genetically engineered to contain vitamin A has reduced vitamin E levels. Growing and feeding practices such as grass-fed versus corn-based animal husbandry, and wild versus farm-raised fish, alters the animal’s fatty acid profile. The amount of omega-3 fatty acids found in eggs varies depending upon the chicken’s diet. Conventional plant breeding and selection can also change the nutritional profile, and has been practiced for a very long time. Finally, grains and cereals are frequently fortified with iron and vitamins before being marketed without the need for genetic modification.

There are intended and unintended consequences of gene modification. Some of the intended goals driving the genetic modification of food include an altered nutritional profile, longer shelf life, and better texture and flavor. Other goals include improved agronomic characteristics such as insect and disease resistance, and herbicide and climate tolerance. For example, plant geneticists can isolate a gene responsible for drought tolerance and insert that gene into a different plant. The new genetically modified plant will then be drought tolerant as well. As the world population grows, perhaps genetic modification can increase crop yields.

GMO AppleThe unintended consequences of genetic modification include an increased potential for new allergens in the food supply, antibiotic resistance, toxicity and environmental challenges. Genetic modification ultimately results in the introduction of new proteins into the food supply. True antibody mediated food allergies are an important health issue occurring in approximately 2% of adults and nearly 5% of children. Protecting people with food allergies from unwanted exposure to these new proteins represents a major public health challenge for genetically modified sources of food. Additionally, consumption of foods genetically modified by using “antibiotic resistance markers” may reduce the effectiveness of antibiotics to fight bacterial diseases. Antibiotic-resistant genes produce enzymes that degrade antibiotics and might be transferred to human or animal pathogens, also making them resistant to antibiotics. Finally, a gene selected for modification may have two functions, one with the desired effect and one that has an undesired effect like enhancing natural plant toxins. This occurs in legumes (protease inhibitors), lima beans (cyanogens) and canola species (goitrogens).

Environmental Risks

The unintended environmental risks of genetically modified crops include herbicide and insecticide resistance, gene transfer to wild and conventionally grown plants through cross pollination, crops that are too genetically uniform and thus susceptible to being wiped out by disease, farmer’s limited access to seeds due to patenting of genetically modified food plants, and hard to eradicate “super weeds.”As just one example of the unintended environmental consequences of genetically modified food, Bt corn has been genetically modified to create a toxin in the pollen which kills the European Corn Borer. However, when the pollen is disbursed by the wind, it can land on milkweed, the food plant of the Monarch butterfly, killing the caterpillars that feed on the milkweed. This is one of the reasons the Monarch butterfly population has decreased in recent years.

Lableing of GMO Foods

National and state organic certification rules do not allow genetically engineered foods to be labeled “organic.” Organic products cannot be grown from GMO seeds; an organic animal product like beef, chicken or eggs must not have fed on genetically modified food. Common sources of genetically modified food include sugar made from beets; corn, corn syrup and corn tortillas; papayas; tomatoes; rice; potatoes; soy, including tofu, soymilk, soy nuts, soy sauce; milk produced with rBGH ; zucchini and summer squash; and oils such as vegetable, canola, soybean, cottonseed and corn.

Read the labels and know your ingredients. It is a challenge to avoid genetically altered food. The PLU code on the sticker reveals if the fruit or vegetable was genetically modified, conventionally or organically grown. Bananas labeled with the four digit PLU code 4011 were conventionally grown with the use of pesticides. Bananas labeled with a five digit code beginning with ‘9’ are organically produced without genetic modification (eg. 94011). Genetically engineered produce has a five digit PLU code beginning with the number ‘8.’ For bananas, that code would be 84011.

While genetic modification can alter the nutritional profile of the foods we eat… are we ready to open Pandora’s Refrigerator?


Sandra Young, OD - GMOSandra Young, OD
Author: Visionary Kitchen: A Cookbook for Eye Health

The Best Nutrition for Older Adults

Our bodies change as we age. Our metabolism slows down and we lose lean body mass. Changes occur in the kidneys, lungs, and liver. Total body fat typically increases. The digestive system slows down and changes, producing less of the fluids it needs to process food, thereby making it harder for the body to absorb important nutrients. We lose bone density, which can cause osteoporosis, fractures, and vertebral compression. Many of us lose some sense of taste and smell and our medications interfere with many vitamins. Because of these changes, older adults have very different nutritional needs than those who are younger. What is the best nutrition for older adults?
food pyramid - best nutrition for older adults
The basic challenge when one gets older is to meet the same nutrient needs as when we were younger, but doing it while consuming fewer calories. Extra weight and health issues may be the result if we don’t. We can meet the challenge by eating a healthy diet that provides the necessary nutrients and variables for good digestion and absorption of nutrients. A nutrient-dense (meaning foods high in nutrients in relation to their calories), fiber-filled, colorful and varied diet is key.

First, let’s look at some of the important vitamins and nutrients we need to insure healthy bodies:

WATER – of all the nutrients, this the most important. Drinking enough water reduces stress on kidney function, which can decline with age. It also eases constipation. Be aware that the ability to detect thirst declines with age. Instead of waiting to feel thirsty, drink water and other healthy fluids throughout the day. The goal should be about 8 glasses of water per day.

CALCIUM – Calcium’s most important role is for building and maintaining strong bones. Unfortunately, as we age, we tend to consume less in our diets. If you don’t get enough, your body will leach it out of your bones. If your diet includes dairy, three low-fat servings per day are recommended. But also consider plant alternatives such as collard greens, kale, and broccoli. In addition, tofu, almonds, sesame and chia seeds are other great non-dairy sources for calcium.

VITAMIN D – This vitamin helps the body absorb calcium, maintain bone density and prevent osteoporosis. Recent studies suggest it may also protect against some chronic diseases and vitamin D deficiency has been linked to an increased risk of falling in seniors. Vitamin D can be found in salmon, tuna, and eggs. You can also look for vitamin D fortified foods, including cereals, milk, some yogurts, and juices. Because aging skin becomes less efficient at producing the vitamin from sunlight, some experts believe seniors may need vitamin D supplements. You may want to discuss your vitamin D needs with your health care provider.

FIBER – Getting enough fiber in the diet will promote healthy digestion by moving foods though the digestive tract. It will also not interfere with the absorption of nutrients, which occurs with laxative use. Eating foods rich in fiber have additional benefits, including protecting against heart disease. So eat more whole grains, nuts, beans, fruits and vegetables.

POTASSIUM – Potassium is an essential mineral vital for cell function. It has been shown to reduce high blood pressure and the risk of kidney stones. It may also help keep bones strong. Older people can get the recommended daily amount by including fruits and/or vegetables in their diet at every meal. Banana, prunes, plums and potatoes with their skin are particularly potassium rich.

MAGNESIUM – Magnesium is important to many different physiological processes and keeps the immune system in good order. It also keeps the heart healthy and your bones strong. Absorption of magnesium decreases with age and some age-related medications, such as diuretics, may also reduce absorption levels. Eating as many unprocessed foods as possible, including fresh fruits, vegetables, nuts, seeds, grains, and beans will provide you a great source of magnesium.

VITAMIN B12 – Vitamin B12 is important in creating red blood cells and maintaining a healthy nerve function. Getting enough is the challenge for older people because of the decrease in absorption from food. The solution is to eat more food rich in B12 which includes fish, meat, poultry, eggs, and low-fat dairy. Also check with your health care provider about whether a supplement is in order.

FOLATE/FOLIC ACID – Anemia is the result of not enough of this essential B vitamin, which is related to B12 absorption and may improve hearing. Eat plenty of fruits and vegetables and/or make sure your breakfast cereals are fortified to ensure you are getting enough.

OMEGA-3 FATS – Primarily found in fish, these unsaturated fats have a wide range of benefits, including possibly reducing symptoms in rheumatoid arthritis and slowing the progression of age-related macular degeneration. They may also reduce the risk of Alzheimer’s disease and may even keep the brain sharper as we age. Strive toward at least two servings of fish a week and choose salmon, tuna, sardines, and mackerel which are especially high in omega-3. Plant sources of omega-3 include soybeans, walnuts, flaxseed, chia, hemp and sesame seeds, and cauliflower.

IRON – Iron intake sometimes appears to be low in many older adults. To improve absorption, include vitamin C-rich fruits and vegetables with iron-rich foods such as red meats, fish, and poultry.

ZINC – Along with vitamins C and E, lutein and zeaxanthin, it may help slow the progression of age-related macular degeneration. Eat lots of fruits and vegetables, especially those that are dark green, orange or yellow in color, such as kale, spinach, broccoli, peas, oranges, and cantaloupes.

VITAMIN E – This vitamin may have a potential role in the prevention of Alzheimer’s disease. Including whole grains, peanuts, nuts and seeds in your diet may help reduce the risk of this disease.

Now, how do we get these into our diet to ensure optimal nutrition? Strive to have your diet look like this:

  • Colorful and varied. Have three to five different colors of food on your plate at each meal. This will translate into getting the most variety of nutrients. Eat more veggies than fruit.
  • More natural and unprocessed. This will give you more fiber. Choose whole fruit over juice; whole grains over processed flours; include seeds, nuts, whole grains and beans in your salads and soups. Look at labels – choose foods with five or fewer ingredients you can pronounce.
  • The majority of your food should be complex carbohydrate foods – vegetables, fruits, grain products, seeds, legumes and nuts. Choose more vegetables to keep the calorie count down.
  • High-quality protein – eat less processed and high-fat choices and go for fish, lean meats, skinless poultry, low-fat dairy and plant-based protein sources.
  • Less sodium, sugar, and “bad” carbs (such as white flour, refined sugars, and white rice). Too much of these things can lead to many age-related health issues and diseases.
  • More steaming and sautéing and less battering and/or frying.
  • Use of good fats such as olive oil, avocados, salmon, walnuts, flaxseed, and other monounsaturated fats to protect your body against heart disease.
  • Try not to skip meals (it slows down your metabolism), eat smaller portions (we don’t need the extra calories), and exchange unhealthy snacks with healthier choices (raw veggies instead of potato chips, piece of fruit instead of a candy bar, etc).
  • Lastly, don’t forget to drink your water!


Michelle MooreMichelle Moore, CHHC
Natural Style Health

Adding Healthy Eating To Your Exercise Plan


Last week, as we helped you prepare for a healthy 2015, we discussed exercise and physical activity. We gave you pointers on how to select and set-up a personalized healthy plan of action. But healthy eating plans along with being physically active are what lead to a healthy lifestyle. Today we will look at adding healthy eating to your exercise plan.
Healthy Living
But first let’s review the three main points you need to keep in mind as you engage in any physical activity.

Include physical activity in your everyday life

• That means making it a priority, even if you have to schedule it on your calendar.
• Make it easy to do. Don’t forget that taking the stairs or walking up and down all the isles at the grocery store can be considered physical activity.
• Make it a social experience by finding an exercise buddy to help encourage you.
• Be sure it is interesting and fun. You may find it more fun if you listen to a book or music on your iPod.
• Make it an active decision to include physical activity throughout your daily routine and think of new ways to be active such as parking your car at the far end of the parking lot to make the walk to the store longer (and probably easier to find a parking space).

Try all of the four different types of exercise
We discussed endurance, strength, balance and flexibility training as your options. But there is no reason to stick with just one, think about mixing it up to reduce boredom and risk of injury while you increase your overall fitness.

Plan for breaks in your exercise plan
Life happens and there will be times, such as illness, injury or travel that will interfere with your normal physical activities.

• Don’t be too hard on yourself and don’t worry about the time you have missed.
• If you have stopped because of illness or injury, check with your doctor about when you can safely resume your regular routine.
• Remember why you started exercising.
• Contact your exercise buddy and have them help you get back on track.
• Try something new if you can’t get motivated to get back to the old routine. Be creative in thinking of new ways to exercise.
• If you are starting the same routine, start again at a comfortable level. Depending on how long you have not been exercising regularly, you may need to start at a slightly lower level than where you left off.

Healthy eating emphasizes:

• A diet of vegetables, fruits, whole grains and fat-free or low-fat dairy products.
• It can include lean meats, poultry, fish, beans, eggs and nuts.
• It is low in saturated fats, trans fats, cholesterol, sugars and added salt.
• It is a balance of the calories you get from foods and beverages vs. the physical activities you engage in to keep you at a consistent weight.

To help keep those healthy foods healthy here are some tips to keep in mind:

• Eating vegetables and fruits in a wide range of bright colors give your body a wider range of nutrients. Leaving the skins on, when possible, gives the nutrients and extra boost. Remember to wash all vegetables and fruits before eating.
• Fiber is a very important to your diet. Breakfast is a great time to enjoy whole-grained foods along with fruits.
• Cut the butter and salt by seasoning your foods with lemon juice, balsamic vinegar and herbs.
• While fresh food are much better for you, if you do use packaged foods, read the labels and chose items that are low in salt, saturated fat and trans fat.
• Use lean meat with excess fat removed and poultry with the skin removed. Do not sauté in butter or fry.
• Control your portion size to limit calorie intake. Also eat more slowly to give your system time to recognized when you are full. Here is a link to picture how large portions should be.
• Drink enough fluids to keep your body working properly. This is especially true in older adults because they don’t necessarily feel thirsty even if their body needs hydration. This liquids should not have added sugars and should be low-fat if dairy and low-sodium if broths.
• When eating out look for low-fat options, have dressings, sauces and butter served on the side so you can control how much you use.
• Select tomato-based sauce over cream-based or white sauce.
• Ask for small portions. If they are still large ask for a container to take part of it home BEFORE you start to eat.
• Ask to substitute low calorie options for sides like French fries.

Even with a well-planned diet you may think you need dietary supplements. However, combinations of supplements with any prescription or over-the-counter medicine could be harmful. Also so supplements can have unwanted or harmful effects before, during or after surgery. The best way to find out if you need any supplement is to talk with your doctor.

Hopeful this has helped you get a healthy start on 2015. The next thing to do – make an appointment with your eye doctor professional for your yearly comprehensive eye exam!

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

7 Healthy Eating Tips for the Holidays


Every year the holidays come around to tempt us with a variety of wonderful foods. It doesn’t make any difference if its Christmas or Hanukah, food is an integral part of the celebration. And the celebrations are pretty non-stop from Thanksgiving through New Year’s. Here are seven healthy eating tips for the holidays to help you handle all the delicious temptations of the season (the average person says they gain around five pounds).
healthy eating tips for the holidays
1. Eat before you go – Have a small healthy snack before you go to the party, to help control your appetite once you get there. Some great snacks include, cut up fresh vegetables, small handful of nuts (remember to make it small as they have quite a few calories, but they are healthy and filling), low-fat string cheese, etc.

2. Select wisely – When confronted with an open bar ask for club soda, tonic water or even tomato juice. Still want that glass of wine? Add some club soda to make it a wine spritzer and cut some of the calories. Once you have your drink, walk as far away from the bar as possible. Another good reason beside calories to cut down on alcohol – you will be able to drive home safely.

3. Strive to be the last in line – This works well in two ways, first being that once the food is picked over it doesn’t have the visual impact of the buffet when everything is presented in its perfection, making your mind go into overload as you try to decide what all to pile on your plate. Second, by the time you go through not everything might be available, and what’s left might not let you take too large of a helping.

4. How to use your plate – If you have more than one size plate to choose from, select the smallest one. Also know that filling your plate does not mean you have to cover every square inch with food, nor do you have see how high you can layer food. You are better off making more than one trip. On the first trip start with vegetables and salads while you scan what else is available. Then you can go back for small portions of what you think are the three best offerings.

5. Lend a helping hand – If the pull of the buffet becomes too strong, help out your hosts by pouring drinks, taking dirty dishes to the kitchen, even helping clean dishes.

6. Leave the party empty-handed – No matter how grateful your hosts are for you attending, do not take home any of the leftovers. No matter where you hide them in the refrigerator, you will still know they are there.

7. Elastic is not your friend – As you socialize and catch up with old friends you can get distracted, making it hard to watch what you eat. You are better off wearing something fitted, or at least with a regular waistband, to remind you that you might be eating too much. Belts are great as long as you don’t adjust them after getting to the party.

Just because a food is healthy, it doesn’t mean that it is low in calories. As you fill your plate, select foods that “bright and colorful.” These will generally be healthier options with a lower calorie count, such as fresh fruits and vegetables. But remember that fruits, because of their higher sugar content, will have more calories. Also the “bright and colorful” approach won’t work at the dessert table with brightly-decorated cookies, cakes and pies.

Here is a color palate to get you started:

RED – tomatoes, red peppers, kidney beans, strawberries, cranberries

ORANGE/YELLOW – pumpkin, butternut squash, yellow peppers, citrus fruit

GREEN – kale, spinach and other green leafy produce, broccoli, asparagus, apples, green peppers

BLUE/PURPLE – purple cabbage, eggplant, blueberries, plums, blackberries

Two bonus tips:

1. Shopping is stressful – Even when you are shopping you will be surrounded by food, especially at the mall where food courts and food kiosks offer a variety of “quick” snacks and meals. Plan ahead. You know what your shopping area has for you to eat. Find a healthy option that offers you good fiber and protein and plan to go there for lunch. Taking a lunch break will keep you from snacking all day and help you power through an afternoon of shopping. If you need snacks, pack something healthy in your purse.

2. Moms and baking go together – There is something about the holidays that brings out the baker in every mom. So when you go home, or even if mom arrives at your house, you will be presented with baked goods filled with love . . . and calories. Here is where avoidance won’t work, you need to rely on strategic moderation. Choose just a few samples to keep and enjoy, then either take the rest to the office, or make goodie gift bags for the mail or UPS delivery person, your manicurist, paperboy, etc. Mom will be pleased that you want to share her baking expertise.

And if you are the mom making these baked goods – try making fewer in December and spread them throughout the year. Less stress for you, and whom wouldn’t want to eat a spritz cookie in July?

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Diabetes And The Potential For Diabetic Retinopathy


Defining Diabetes

Diabetes mellitus is a group of metabolic disorders in which a person has high blood sugar levels. It occurs either because the pancreas does not produce enough insulin, or because the body does not respond appropriately to the insulin that is produced. Insulin is the hormone that converts sugar into energy for the body. There are several forms of diabetes.

Type 1 diabetes occurs when the pancreas does not produce adequate levels of insulin. It usually develops during childhood or adolescence; however, it can also occur in adults. Those with type 1 diabetes must take insulin injections. About 10 percent of those with diabetes have type 1.

Type 2 diabetes is the most common type of diabetes, affecting about 90 percent of those with diabetes. It is caused by the combination of the body’s resistance to insulin (not using its own insulin efficiently) and the pancreas not producing enough insulin. As a result, there is an increase in the level of sugar, or glucose, in the blood.

Gestational diabetes occurs in pregnant woman who have not previously had diabetes but whose blood sugars become elevated during pregnancy. In many patients, their blood sugars will return to normal after the pregnancy is over. Placental hormones make the mother resistant to insulin, causing a buildup of blood sugars. These women are at high risk for type 2 diabetes later on in their lives.

Diabetic Retinopathy: An Overview

diabetic retinopathy
Anyone with uncontrolled diabetes is at risk for developing diabetic retinopathy. According to the National Eye Institute, between 40 to 45 percent of Americans with diabetes have some form of diabetic retinopathy, the most common eye condition associated with diabetes.

In the United States, the Centers for Disease Control and Prevention reports between 12,000 and 24,000 new cases of blindness each year due to diabetic retinopathy, making it the leading cause of vision loss among American adults, ages twenty to seventy-four. The Center also projects that by 2050, the number of Americans age forty and older with diabetic retinopathy will grow from a current 5 million individuals to about 16 million. Although these statistics are alarming, you can prevent or delay damage to your vision by controlling your diabetes, along with obtaining regular eye evaluations and treatment.

Defining Diabetic Retinopathy
Diabetic retinopathy is a disease affecting the retina, caused by elevated blood sugar levels. It usually affects both eyes and occurs when uncontrolled blood sugar levels damage the small vessels of the retina, the light-sensitive tissue in the back of your eye. The retina is responsible for processing images that make vision possible. To produce clear, distortion-free vision, the retina must lie completely flat. If the delicate retinal tissue is damaged, images that you see may be blurred or distorted.

Diabetic retinopathy is a progressive disease, and thus worsens over time. Although some effects, such as blurriness and distortions, may be mild or subtle, the long-term consequences can cause severe vision loss.

Symptoms of Diabetic Retinopathy

Because diabetic retinopathy rarely causes pain, symptoms are not always apparent in the earliest stages. In fact, damage to your retina could be occurring long before you have noticeable signs. When symptoms do occur, they’re often caused by retinopathy affecting the macula, the area at the center of the retina. Symptoms may include the following:

• blurred vision

• seeing dark spots or “floaters” (small specs in your field of vision)

• decreased night vision

• vision loss

• problems seeing colors

It’s important that you see your eye specialist immediately if you have any such symptoms. Diabetic retinopathy cannot be cured, but with careful monitoring, it can be diagnosed and treated, before your vision is impaired. The treatment is typically less invasive and more effective when diagnosed at an earlier stage, before permanent damage has occurred.

How the Retina Works

The retina is made up of specialized nerve tissue that contain microscopic receptors (called cones and rods) and other nerve cells that line the back of the eyeball.

These cells carry signals (images that we see) along the optic nerve to a special area of the brain, where they’re interpreted into what we perceive as sight. You might compare the retina to film in a camera—the film delivers the photo image that the camera captures.

There are two main areas of the retina that can be damaged by diabetic retinopathy:

• The macula, the center of the retina. The macula allows you to read and see fine details and recognize colors. At the very center of the macula is a dimple known as the fovea. It is the most sensitive portion of the macula and makes sharp vision possible.

• The peripheral retina, which is the portion of the retina that is outside the macula. It’s responsible for your side vision and also makes night vision possible.

The retina lies on a nutrient-rich flat “carpet” of vessels that nourish it with necessary oxygen and nutrients. To reach the retina, however, nutrients must pass through two buffers—a thin membrane called Bruch’s membrane and a single layer of specialized cells called the retinal pigment epithelium. Waste products are also transported away from the retina through these two membranes. Diabetic retinopathy can interfere with this constant import of necessary nutrients and export of waste products.

Risk Factors for Diabetic Retinopathy

There are many factors that can raise your risk for diabetic retinopathy. However, you’ll note that many of these risk factors can be controlled.

Duration of Diabetes and Glucose Control

The longer you’ve had poorly controlled blood glucose levels, the higher your risk for diabetic retinopathy. Most diabetic individuals develop eye problems overtime, making duration of their diabetes one of the strongest predictors that they will develop this eye disease. Research has shown that nearly all type 1 diabetics and 60 percent of type 2 diabetics develop the condition within the first two decades of their diabetes diagnosis.

The American Diabetes Association (ADA) recommends fasting glucose levels between 70 and 120 mg/dL and less than 180 mg/dL two hours after meals. They also recommend a hemoglobin A1c of 7 percent of less. Hemoglobin A1c is a protein in red blood cells that bonds with blood sugars. Since red blood cells can live from 90 to 120 days, the hemoglobin A1c stays in the blood for that length of time. Accordingly, it is effective in measuring the average blood sugars over a period of time. This test tells doctors how well your treatment plan is working. You should always know what your hemoglobin A1c values are, as they may affect the interval between your retinal examinations.


The more fatty tissue you have, the more resistant your cells are to insulin. Obesity increases your risk for diabetes as well as other serious conditions such as heart disease. Estimates suggest that 65 percent of Americans may be overweight. Being overweight aggravates high blood pressure and cholesterol. Achieving a healthy weight is important in controlling blood sugars and diabetes related complications.

Lifestyle Choices

A sedentary lifestyle, especially if you are overweight, contributes to many diseases, including diabetes, heart disease, high blood pressure, and high cholesterol levels. On the other hand, physical exercise improves circulation, lowers blood sugars, and improves your body’s use of insulin. This results in improved blood sugar levels. This benefit of increased sensitivity to insulin continues for hours after you stop exercising.

Exercise also promotes weight loss. A sedentary lifestyle contributes to insulin resistance, and makes it more difficult to keep weight off. Even light or moderate physical activity can help lower blood sugars.

Smoking is another major risk factor for developing diabetic retinopathy. Smoking also causes diabetic retinopathy to progress faster. The nicotine in tobacco not only contributes to higher blood pressure and higher cholesterol levels, but it also impairs insulin activity. Even though quitting can be difficult, it is critical to heart health and diabetes control.
Unlike smoking, alcohol consumption doesn’t have a direct influence on diabetic retinopathy. Yet because it can affect diabetes control, drinking in excess can affect the health of your eyes. Your doctor can tell you what constitutes drinking in moderation for you.

High Cholesterol Levels

Diabetes puts you at risk for chronically high cholesterol or blood fats that promote the buildup of plaque in your arteries. Although the tiniest vessels of the retina are too small for such build-up, uncontrolled cholesterol can contribute to macular edema and the development of hard exudates, the small yellow spots or lipid deposits that may form in the macula. Both conditions are associated with a higher risk of vision loss.

Doctors advise keeping “bad” or low density cholesterol (LDLs) less than 70 mg/dL. Good cholesterol or high density lipoproteins (HDLs) should be greater than 40 mg/dL in men and 50 mg/dL in women. Both men and women should strive for triglycerides, another type of fat, at levels less than 150.

High Blood Pressure

If you have both diabetes and high blood pressure (also called hypertension), you may be at higher risk for a number of eye-related problems, including retinopathy, glaucoma and optic nerve damage. Seriously elevated blood pressure not only stresses your heart, it also raises the risk for eye problems, particularly macular edema and bleeding. Chronic hypertension combined with long-term diabetes also increases the chance that your retinopathy will be more destructive and progress more rapidly. Research has consistently shown that keeping your blood pressure below 130/80 mmHg is important in minimizing the risk of hypertension related complications.


Diabetic retinopathy is more common in some ethnic and racial groups than others. African Americans, Asian Americans, Hispanic/Latino Americans, American Indians and Alaskan Natives are at higher risk for type 2 diabetes than non-Hispanic whites.

African Americans and Mexicans are almost twice as likely as whites to have eye problems, according to the American Diabetes Association. Native Americans also have an increased for diabetic retinopathy. Researchers aren’t sure why some ethnic groups have higher rates of diabetes, which increase the risk for retinopathy and other problems.

Age and Gender

As mentioned earlier, the longer you have diabetes, the greater your risk for diabetic retinopathy. Not surprisingly, this complication is rare among children but common among older diabetic adults. A recent study by Prevent Blindness America and the National Eye Institute, demonstrated that older adult Americans are facing a bigger threat of all age-related eye diseases (diabetic retinopathy, age-related macular degeneration, cataracts and open angle glaucoma) today than at any other time.


Our genetic make up has an important effect on our predisposition for many health issues such as diabetes. Scientists believe that many genes or combinations of genes either promote diabetes in certain individuals or protect them from developing it.

Scientists have yet to identify every gene involved in type 1 and type 2 diabetes, but they have shown that genetics are a factor. Research studies of identical twins, for instance, have demonstrated that if one twin has type 1 diabetes, the other twin has a 50 percent change of developing the disease. If one twin has type 2 diabetes, the other twin has a 75 percent chance of developing it.


Gestational diabetes is a type of diabetes linked to pregnancy; however, diabetic retinopathy is usually not a complication in these women. However, if you’re already a diabetic and become pregnant, you are at an increased risk of developing diabetic retinopathy. This is a result of the hormonal and metabolic changes that occur during pregnancy, making the disease and its complications progress more rapidly. It is recommended that you see a retinal specialist for evaluation and monitoring.

In Summary

• Diabetic retinopathy is a serious complication of diabetes that results from high glucose levels damaging the retinal blood vessels. This can cause loss of vision.

• Between 40 and 45 percent of diabetic Americans have some form of diabetic retinopathy.

• The earliest form of the disease is called background diabetic retinopathy. With time it progresses to mild, moderate, or severe nonproliferative diabetic retinopathy.

• Without proper diagnosis and treatment of nonproliferative diabetic retinopathy, the condition can advance to proliferative diabetic retinopathy, which is a serious sight-threatening stage of the disease.

• Macular edema is due to build up of fluid and thickening of the macula and can occur with any type of diabetic retinopathy. It is the most common cause of vision loss in those with diabetes.

• The duration of your diabetes and how well blood glucose is controlled are major risk factors for the development and progression of diabetic retinopathy.

• Other risk factors that play a significant role in the development of retinopathy, include high blood pressure, high cholesterol, and smoking.

• As an individual with diabetes, you’re also at increased risk for other eye diseases, especially glaucoma, cataracts, retinal vein occlusion and optic nerve damage.

• Good blood sugar control, regular eye examination, and timely treatment are the key factors in reducing the damage to the eye and keeping your vision.

Pouya Dayani - Diabetic RetinopathyPouya N. Dayani, MD
Retina-Vitreous Associates Medical Group

Night Blindness


As the number of daylight hours decrease and daylight savings time is about to end, many of us feel that the days are getting much shorter. If you suffer from night blindness, your days are shorter, because getting around or driving at night, are sometimes impossible.

Night blindness is a condition that makes it difficult for a person to see in low-light situations or at night. Some types are treatable, while others are not. You will need to consult your eye doctor to determine the underlying cause of your night blindness to determine what can or cannot be done.

night blindness
Courtesy of wikipedia

There are several things that could cause night blindness:
•Genetic eye disease
•Vitamin A deficiency
•Aging eye
•Sunlight exposure

Here is a brief look at each.
Cataracts – This is when the lens of the eye becomes gradually becomes clouded, reducing vision. Besides reducing vision at night you may also experience halos around lights. This is a treatable condition requiring cataract surgery and replacing your clouded lens with a clear artificial lens. Your vision should improve considerably.

Genetic Eye Disease – Both retinitis pigmentosa or Usher syndrome are progressive genetic eye diseases where the rods that regulate light, and cones that control color perception and detail die. Progressive night blindness is one of the first visual symptoms of these two diseases. Currently there is no treatment for them as there is no way to treat or replace the dying rods.

Vitamin A Deficiency – While rare in the US, it can be a result of other diseases or conditions such as Crohn’s disease, celiac disease, cystic fibrosis or problems with the pancreas. Options to help with the deficiency include vitamin supplements suggested by your doctor, or increasing your intake of orange, yellow or green leafy vegetables.

Diabetes – People with diabetes are at higher risk for night vision problems because of the damage to the blood vessels and nerves in the resulting in diabetic retinopathy. Not only can it cause poor night vision, it may also take longer to see normally after coming indoors from bright light outside. There is no cure, but controlling blood sugar levels with medicine and diet can help prevent developing retinopathy or help slow the progression.

Aging Eye – As we age several things happen to our eyes. Our iris, which regulates the amount of light going into the eye, gets weaker and less responsive. This can make adapting from light to dark more difficult and slower. Our pupils shrink slightly allowing less light into the eye. The lens of the eye becomes cloudier, as explained above in cataracts, limiting the amount of light into the eye. We also have fewer rods for light perception. Aside from cataract surgery there is no treatment for age-related night blindness. However, eating a diet rich in fruits and vegetables and low in saturated fat is the best way to slow the progression. Here is more information on how the aging eye is affected.

Sunlight Exposure – If your night vision seems temporarily worse after a trip to the beach or a day on the ski slopes, it probably is. Sustained bright sunlight can impair your vision, especially if you fail to wear sunglasses or goggles.

Night blindness due to genetic conditions or aging cannot be prevented. However if you protect your eyes from extreme sunlight, eat a healthy diet, and monitor blood sugar levels if needed, you can reduce your chances for night blindness.

As we head into the holiday season, you should know that some great sources of vitamin A include sweet potatoes, butternut squash and … pumpkins!

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development

Our Thanks to Guest Bloggers Continues


More Amazing Guest Bloggers

Last week I took the opportunity to thank our very first guest bloggers for helping us launch the Discovery Eye Foundation Blog. We are pleased that so many people appreciate the wide range of eye-related information from eye care professionals, as well as the stories from people that live with eye disease on a daily basis.
Thank you part 2
Here is a round-up of guest bloggers since June 2014 that shared their time, experience and/or expertise to provide you with the best eye-related information.

Sumit “Sam“ Garg, MDwhat you should know about cataracts

Randall V. Wong, MDfloaters, causes and treatments

Roy Kennedyhis personal experiences with the miniature telescope implant

Sandra Young, ODthe importance of getting vitamins and minerals from your food and not just supplements

Jeanette Hassemanliving with keratoconus

Greg Shanetheater for the blind

Caitlin Hernandezblind actress and playwright

Jullia A. Rosdahl, MD, PhDlasers for glaucoma and genetics and glaucoma

Maureen A. Duffy, CVRTways to reduce harmful effects of sun glare

Kooshay Malekwhat is it like to lose your vision and being a blind therapist

Jeffrey J. Walline, OD PhDchildren and contact lenses

Robert Mahoneychoosing a home care agency

Robert W. Lingua, MDnystagmus in children

Buddy Russell, FCLSA, COMTcommon pediatric eye diseases, treatment options for children and pediatric contact lenses

NIH (National Institute of Health)telemedicine for ROP diagnosis

Harriet A. Hall, MDevaluating online treatment claims

Patty Gadjewskithe life-changing effects of a telescopic implant

Michael A. Ward, MMSc, FAAOproper contact lens care and wearing contacts and using cosmetics

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Our First Three Months Of Eye Care


Discovery Eye Foundation Blog’s First Three Months

It is hard to believe, but this blog has been providing information and insights into eye disease, treatment options, personal experiences of living with vision loss, and other eye-related information for seven months.

All of this would not have been possible without the expertise of remarkable eye care professionals who took time out of their busy schedules to share information to help you cope with vision loss through a better understanding of your eye condition and practical tips. Since so much information was shared in the seven months, here is a look at the first three months, with the additional four months to be reviewed next Tuesday.
Thank You - first three months
I am very thankful to these caring eye professionals and those with vision loss who were willing to share their stories:

Marjan Farid, MDcorneal transplants and new hope for corneal scarring

Bill Takeshita, OD, FAAO, FCOVDproper lighting to get the most out of your vision and reduce eyestrain

Maureen A. Duffy, CVRTlow vision resources

M. Cristina Kenney, MD, PhDthe differences in the immune system of a person with age-related macular degeneration

Bezalel Schendowich, ODblinking and dealing with eyestrain

Jason Marsack, PhDusing wavefront technology with custom contact lenses

S. Barry Eiden, OD, FAAOcontact lens fitting for keratoconus

Arthur B. Epstein, OD, FAAOdry eye and tear dysfunction

Jeffrey Sonsino, OD, FAAOusing OCT to evaluate contact lenses

Lylas G. Mogk, MDCharles Bonnet Syndrome

Dean Lloyd, Esqliving with the Argus II

Gil Johnsonemployment for seniors with aging eyes

We would like to extend our thanks to these eye care professionals, and to you, the reader, for helping to make this blog a success. Please subscribe to the blog and share it with your family, friends and doctors.

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation