IN MY MOTHER’S EYE

There is an old Irish ditty I often heard as a little boy.  It goes something like this:

“One bright and guiding light that taught me wrong from right I found in my mother’s eyes. Those baby tales she told of roads all paved with gold I found in my mother’s eyes”.

As a blind child there was so much I found in my mother’s eyes.  From as early as I can remember, she read me stories that spanned from Robert Lewis Stephenson’s adventures like “Treasure Island” to the book that always made both of us cry – “Black Beauty.”

As a teenager and young adult, her eyes made it possible for me to venture into the world knowing as she liked to say…”dressed to the nines.” And then, when I married my wife, Patty, my mother had strong opinions about the choice of tuxedo I should wear on our wedding day.  I can still remember hearing her talk about how much she loved to see the first smiles on the faces of our children, Blythe & Tom. 

As she grew older, it was her eyes that kept her connected to the world.  Every morning, she read her Boston Globe from cover to cover, and on afternoon television she never missed her Soap Operas – “The Guiding Light,” and “Search for Tomorrow.” And then, there was the NBC Nightly News with her on-going crush on Tom Brokaw.

April is Women’s Eye Health Month along with celebrating the need for Sports Eye Safety.  I can still remember my mother crying when she watched Cleveland Indian’s left-handed pitcher Herb Score hit with a line-drive costing him his sight.  Research goes hand in hand with eye-safety to preserve vision.  The Discovery Eye Foundation is committed to finding the answers that will preserve vision and allow women and mothers the blessing of seeing the smiles on the faces of the children they love.

 

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

LUTEIN AND ZEAXANTHIN

Why Lutein & Zeaxanthin are vital for healthy vision.

Good nutrition is important to keep your eyes healthy.  Researchers have linked two very important eye nutrients that play a key role in healthy vision.  Lutein (LOO-teen) and Zeaxanthin (zee-ah-ZAN-thin), both are potent antioxidants and are best known for protecting your eyes and may reduce your risk for macular degeneration and cataracts.

Lutein and zeaxanthin are two types of carotenoids (kuh-RAH-teh-noids), which are yellow to red pigments found widely in vegetables and other plants and lutein is a yellow pigment, in high concentrations it appears orange-red.

Both lutein and zeaxanthin can also be found in high concentrations in the macula of the human eye.  The macula is essential for vision. Lutein and zeaxanthin work as important antioxidants in this area by protecting your eyes from harmful free radicals. It’s thought that a reduction of these antioxidants over time can impair eye health.  Along with other natural antioxidants, including vitamin C, beta-carotene (vitamin A) and vitamin E, these important pigments guard the body from damaging effects of free radicals, which are reactive molecules that can destroy cells and play a role in many diseases.  It is also believed that lutein and zeaxanthin in the macula block blue light from reaching the underlying structures in the retina, thereby reducing the risk of light-induced oxidative damage that could lead to macular degeneration (AMD).

Unfortunately, the human body does not naturally make the lutein and zeaxanthin it needs. This is why getting daily amounts of lutein and zeaxanthin through your diet or nutritional supplements can help maintain good eye health.

 

Foods that Contain Lutein and Zeaxanthin

Diets rich in these two nutrients may help hold off age-related eye diseases. The best natural food sources of lutein and zeaxanthin are green leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list.

Key sources of these carotenoids include kale, parsley, spinach, broccoli and peas. Orange juice, honeydew melon, kiwis, red peppers, squash and grapes are also good sources of lutein and zeaxanthin.

In addition, egg yolk may be an important source of lutein and zeaxanthin, as the high fat content of the yolk may improve the absorption of these nutrients.

For eye healthy recipes visit Eye Cook

Lutein and Zeaxanthin Supplements

Because of the benefits of lutein and zeaxanthin, many nutritional companies have added these carotenoids to their multiple vitamin formulas. Others have introduced special eye vitamins that are predominantly lutein and zeaxanthin supplements.

Some popular lutein and zeaxanthin supplements include:

  • MacuHealth with LMZ3 (MacuHealth LLC)
  • EyePromise Zeaxanthin (Zeavision)
  • ICaps Eye Vitamin Lutein & Zeaxanthin Formula (Alcon)
  • Macula Complete (Biosyntrx)
  • MacularProtect Complete (ScienceBased Health)
  • MaxiVision Ocular Formula (MedOp)
  • OcuGuard Plus (TwinLab)
  • Ocuvite (Bausch + Lomb

The source of lutein in many lutein supplements is marigold flowers, while for zeaxanthin it is often red peppers. If you choose a lutein and zeaxanthin supplement, make sure it’s a high quality product from a reputable dietary supplement company.

Be sure to keep in mind that individuals sometimes react differently to certain supplements, which can have unintended effects such as adverse reactions with medications. Consult with your physician or eye doctor before trying any vision supplements.

For Eye Healthy Recipes visit Eye Cook

Remember that taking dietary supplements does not replace a healthy diet. Eating a well-balanced diet that includes plenty of fruits and vegetables usually is the best way to get the important eye nutrients you need.

Too Much Screen Time:  Is it bad for kids?

Children and their phones, iPads and gaming devices are inseparable today. Most are growing up with a wide selection of electronic devices at their fingertips. They can’t imagine a world without the internet, smartphones and tablets.  Although, all that reading and playing games on their handheld devices may be harmful.  But it’s not just kids who are getting too much screen time. Many parents struggle with over use of screen time themselves.  So it’s important to understand how too much screen time could be harming everyone in the family.

Children can experience at least one of the following symptoms after being exposed to more than two hours of screen time per day:

  • Headaches
  • Neck/shoulder pain
  • Eye strain, dry or irritated eyes
  • Reduced attention span
  • Poor behavior
  • Irritability

Any of these symptoms could potentially affect academic performance and social interactions.

The worldwide rapid rise of nearsightedness has been linked to increased use of and exposure to electronic devices. However, spending more time outdoors, especially in early childhood, can decrease the progression of nearsightedness.

Blue Light can be harmful

The LED screens of computers and portable digital devices emit a broad spectrum of visible light. Most of these light rays are harmless, but a portion of the light emitted by these screens is relatively high-energy visible light called “blue light.”

Blue light has shorter wavelengths and higher energy than other visible light rays. Some laboratory research suggests certain bands of blue light may be harmful to the light-sensitive retina of the eye over time.

Blue light also plays an important role in regulating our body’s circadian rhythm. This basically is an internal clock that’s running in our brain and cycles between alertness and sleepiness at regular intervals over a 24-hour period.

Too much exposure to blue light at the wrong time of day can disrupt a person’s normal sleep/wake cycle, which can have serious health consequences.  Sleep disruption can be especially problematic for children, leading to daytime drowsiness and poor performance in school. Some authorities feel that disruption of the sleep/wake cycle also can eventually lead to weight gain and obesity-related health problems.

Research has shown that people who experience disrupted 24-hour cycles of sleep and activity also are more likely to have mood disorders, lower levels of happiness and greater feelings of loneliness.

How to cut back on screen time

  • Set a limit on daily screen time. Make it clear to your kids and stick to it.
  • Encourage your child to spend some of that screen-free time outdoors while it is still light.
  • Establish screen-free zones: For example, no smartphone use for anyone in the family in the car,  at restaurants, or at the dinner table.
  • No screens in the bedroom when it is time for bed. No exceptions.
  • As parents you can be a model for moderate screen use. Show your children, with your own behavior, how to live a rich, varied and healthy life where all habits are practiced in moderation.

It is also very important to teach your child good eye habits, below are few tips from experts:

  • You can set a kitchen timer or a smart device timer to remind them.
  • Alternate reading an e-book with a real book and encourage kids to look up and out the window every two chapters.
  • After completing a level in a video game, look out the window for 20 seconds.
  • Pre-mark books with a paperclip every few chapters to remind your child to look up. On an e-book, use the “bookmark” function for the same effect.
  • Avoid using a computer outside or in brightly lit areas, as the glare on the screen can create eye strain.
  • Adjust the brightness and contrast of your computer screen so that it feels comfortable to you.
  • Use good posture when using a computer and when reading.
  • Encourage your child to hold digital media farther away, 18 to 24 inches is ideal.
  • Create a distraction that causes your child to look up every now and then.
  • Remind them to blink when watching a screen.

Finally, it is very important to make sure your child gets a regular eye exam by a pediatric ophthalmologist or optometrist.  This will help monitor your child’s vision and eye health.

September is Healthy Aging Month

 

Today, people are living longer than ever before so it’s important to be proactive and take responsibility for your health as you age.  

Like any other organ in your body, your eyes do not stay the same as you get older. Vision changes are normal with age but vision loss and blindness are not.  Older adults are at higher risk for certain eye diseases and conditions, including age-related macular degeneration, cataract, diabetic retinopathy, glaucoma, dry eye, and low vision.  To continue to enjoy healthy vision as you advance in years, it’s important to have a comprehensive dilated eye examination with an ophthalmologist or optometrist on a regular basis.

Here are some other tips to maintain healthy vision now and as you age:

  • Eat a healthy, balanced diet. Fruits and vegetables can help keep your eyes healthy. Visit our website for healthy eye recipes, click here Eye Cook.

 

 

  • Maintain a healthy weight. Being overweight increases your risk for diabetes. By exercising regularly, you can help keep your body healthy and prevent vision loss. 

 

 

 

  • Don’t smoke. Smoking increases your risk for age-related macular degeneration, cataract, and other eye diseases and conditions that can damage the optic nerve.

 

 

 

  • Wear protective eyewear when outdoors. Protecting your eyes from the sun’s ultraviolet rays when you are outdoors is vital for your eye health.  Wearing sunglasses that block 99 to 100 percent of both UV-A and UV-B radiation.

 

 

  • Know your family history.  Talk to your family members about their eye health history. It’s important to know if anyone has been diagnosed with a disease or condition since many are hereditary, such as glaucoma, macular degeneration, and diabetes . This will help determine if you are at higher risk for developing an eye disease or condition.

 

  • Consider a multivitamin. Vitamins C, E and the mineral zinc have been shown to promote eye health.  Vitamins with Lutein and Zeaxanthin have been known to help patients with moderate to severe age-related macular degeneration.

 

  • Give your eyes a rest.  If you spend a lot of time at the computer or focusing at any one distance, you sometimes forget to blink, resulting in dryness and eye fatigue.  Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain. Consider using a lubricant eye drop during long periods of intense eye use and rest your eyes for 5 minutes.

 

You can’t stop time, but you can take care of your eyes so that they remain healthy as you age. Having a healthy vision can be possible at any age! 

Get Fit for Your Vision

It’s no secret that exercise is the best way to get in shape and to prevent serious health conditions. But did you know that you can actually exercise your way to healthy eyes too!?

Like your heart, brain, and lungs, your eyes are impacted by how you care for your body. By eating a healthy diet and exercising regularly, you can help prevent eye conditions linked to obesity and being out of shape.

Studies have found connections between regular exercise and reducing risks for several common eye ailments such as cataracts, age-related macular degeneration and glaucoma. Vision problems and eye disease also stem from high blood pressure and high cholesterol. A healthy diet and regular exercise are two of the most important steps you can take to lower both.

 

What you should know about the common eye diseases and exercise

Cataracts – Studies have found that a lack of physical activity may be associated with an increased risk of getting cataracts. Whether it’s a brisk walk around your block or a run through the park, both activities may be associated with decreased risk of age-related cataract.

Age-related Macular Degeneration (AMD)– Studies found that that those who were active and exercised three or more times a week were less likely to develop AMD.

Glaucoma – Doctors treat glaucoma by lowering high intraocular (eye) pressure. Research that focused on young adults found that moderate intensity, low-impact exercise led to significant reduction in eye pressure. Regular, ongoing exercise, such as walking or jogging, will help reduce eye pressure.

 

How to kick off your exercise routine

  • Start simple and set realistic goals. Keep a log of your goals and daily exercise routine, this will help you stick to your plan and track your progress.
  • Keep it fun.
  • Mix up your fitness routine with combinations of strength and cardio.
  • Not feeling all that motivated? Try jump-starting your fitness routine with a little Zumba or ballroom dancing; these are super fun ways to get in shape.
  • Head outside and roller skate, bike, or go on a hike—all are great calorie burners too.
  • If it’s too cold to go outdoors, pick up the latest yoga fitness DVD and create a calming atmosphere in your living room. Or you could try a circuit training fitness DVD for a more upbeat cardio workout.
  • Don’t get stuck in a rut: change up your routine frequently to get the biggest bang out of your exercise time!

No time for exercise? You can squeeze it in between everyday tasks such as:

  • Taking the stairs at work instead of the elevator.
  • Walking to your co-worker’s desk instead of sending an e-mail.
  • Doing lunges or squats while brushing your teeth.
  • Contracting and holding your abs while working on your computer – try for 10 contractions every hour.
  • Taking the dog for a long walk or jog—try doing a few lunges on the trail.

Stay active, get plenty of exercise and keep a healthy diet. When you’re tempted to slack off, or quit exercising all together, just remember how terrific you’ll look and feel when you keep moving. You’ll probably agree it’s worth working out a few minutes each day to reap the rewards of good health and great vision!

Click here for Eye Healthy Recipes.

AMD and a Healthy Diet: How they Relate

While there is still no concrete answer as to why some do not develop age-related macular degeneration (AMD) and other’s do, significant studies have proven the importance of a healthy diet and the mitochondria.

AMD is the leading cause of vision loss for those over 60 years of age in the developing countries. For decades we have studies that show the genetics and environmental factors associated with AMD. There have been over 20 genetics modification associated with AMD but there is no single gene that “causes AMD in all cases.” The genes most highly associated with AMD are found in the complement system, an important system related to controlling the inflammation in our body. A change in the complement factor H (CFH) gene from a low risk gene to a high risk gene has been associated with 43% of those developing AMD.

However, some people who have this high risk CFH gene but never develop AMD. This leads us to believe that the genetics are not the entire answer. The other factor has to do with the environment. Smoking is the leading risk factor, along with aging, exposure to sunlight and higher body mass index (obesity). But again there are obese people that smoke and never develop AMD. So, while the environmental risk factors are important, they do not answer the entire question of “why do some people get AMD but others do not?”

Recently, researchers have recognized that a major factor in the dry form of AMD is that the retinal cells begin to die off. Therefore, they have looked at important factors that keep cells alive. The mitochondria are one of the most important elements that protect the cells in the body. These subunits or organelles, produce energy for the cells, acting like batteries for the cells. And just like the batteries in a flashlight – if the batteries are not working then the flashlight dies. The same thing happens with cells – when the mitochondria are not healthy, then the cells eventually will die. Therefore to protect ourselves, it is important to keep the mitochondria healthy. One way to do this is to eat healthy foods. Over the past 20 years, the National Eye Institute (NEI) has conducted a series of studies that have identified foods and supplements that are good for the retinal cells and also the mitochondria.

 

super greens, spinachThe National Eye Institute has recommended that people who are high-risk for developing AMD eat diets rich in green leafy vegetables, whole fruits, any type of nuts and omega 3 fatty acids. Many of these foods have anti-oxidant properties that help to “turn off” genes involved with inflammation, an important factor of retinal diseases. Salmon, mackerel and sardines have the highest levels of omega-3 fatty acids. An analysis that combined the data from 9 different studies showed that fish intake at least twice a week was associated with reduced risk of early and late AMD. Other studies show that Omega-3 fatty acids improve mitochondrial function, decreases production of reactive oxygen species (free radicals that damage cells) and leads to less fat accumulation in the body. The green leafy vegetables contain important protective macular pigments (carotenoids) called lutein and zeaxanthin that reduce the risk of AMD by 43%. High levels of lipid or fat deposits in the body (obesity) can “soak-up” the lutein and zeaxanthin so that they are not available to protect the retina.

The goal is to increase the omega-3 fatty acid and carotenoid levels to protect the eye. Below is a list of foods that are eye healthy:

Foods that have lutein or zeaxanthin:

– 6mg/d of lutein and zeaxanthin – decreased

– Lutein/zeaxanthin content – ug/100g wet weight

– Kale, cooked – 15,798

– Spinach, raw – 11,935

– Spinach, cooked – 7,053

– Lettuce, raw – 2,635

– Broccoli, cooked – 2,226

– Green peas, cooked – 1350

Source: Johnson, et al 2005 Nutr Rev 63:9

 

To help kickstart an eye healthy diet, here is a list of “eye-healthy recipes” that provide nutritional support for the mitochondria and retinal cells.

Asparagus Soup
Kale Chips
Quinoa Collard Green Wraps with Summer Vegetables
Smoked Salmon Rillettes

Sources:
Geoffrey K. Broadhead, John R. Grigg, Andrew A. Chang, and Peter McCluskey Nutrition Reviews. Dietary modification and supplementation for the treatment of age-related macular degeneration VR Vol. 73(7):448–462

Chong et al., Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol 2008;126:826–33.

5/19/16

courtesy of the
SFCulinaryAcademyLogoWEB

 

 

Increased Awareness for Saving Vision

The following is a survey done by Essilor (a French company that produces ophthalmic lenses along with ophthalmic optical equipment) and a large marketing research firm in the UK, YouGov. While the focus in on people living in the UK, the results would probably be similar to the US population. Even with increased access to the Internet, many people are still not aware of the risks associated with eye disease and what they can do to help retain their vision. Increased awareness of informational resources are important for saving vision.
saving vision
There are a number of websites with easy to understand information about taking care of your vision that I have listed under Resources to Help Save Vision at the bottom of this article. And while there are eye diseases that are hereditary, you can slow the onset and progression by making good lifestyle choices about smoking, diet and exercise. Your eye care specialist is also an excellent source of information about what you can to do reduce your risk of vision loss, at any age.

Increased Awareness for Saving Vision

A YouGov poll conducted with Essilor reveals that most Britons are unaware of damage to their eyes by surrounding objects, activities, and devices. This widespread lack of awareness means fewer people seeking methods of prevention and avoidance, and for those that are aware of risks, most are not informed of existing preventative measures.

The poll has shown* that many British people remain uninformed about the various ways in which eyes are damaged by common daily factors, despite evidence that eye health is affected by blue light, UV rays (reflected from common surfaces), diet, obesity, and smoking.
Of the 2,096 people polled, the percentage of respondents aware of the link between known factors affecting and eye health were:

  • Poor diet – 59%
  • Obesity – 35%
  • Smoking tobacco – 36%
  • UV light, not just direct from the sun but reflected off shiny surfaces – 54%
  • Blue light from low energy lightbulbs and electronic screens – 29%

More than one in ten people were completely unaware that any of these factors could affect your eyesight at all.
saving vision
72% of respondents own or wear prescription glasses but only 28% knew that there were lenses available (for both prescription and non-prescription glasses) to protect against some of these factors; specifically, blue light from electronic devices and low energy light bulbs, and UV light from direct sunlight and reflective surfaces.

76% admitted they haven’t heard of E-SPF ratings – the grade given to lenses to show the level of protection they offer against UV.

Just 13% have lenses with protection from direct and reflected UV light, and only 2% have protection from blue light (from screens, devices, and low energy bulbs).

Poll results showed that younger people were most aware of the dangers of UV and blue light, yet least aware of how smoking tobacco and obesity can affect your eye health. Within economic sectors, middle to high income people are more aware of the effects of smoking & obesity on eyesight than those with low income –

  • 39% of people with middle to high income compared to 33% of people with low income are aware of the impact of smoking tobacco.
  • 38% of people with middle to high income compared to 31% of people with low income are aware of the impact of obesity.

Awareness of the impacts of smoking and obesity on eye health is significantly higher in Scotland (47% & 49% respectively) than anywhere else in the UK (35% & 33% in England and 40% & 38% in Wales).
Essilor’s Professional Relations Manager, Andy Hepworth, has commented: “The lack of awareness about these common risks to people’s eyes is concerning. Not only would many more glasses wearers be better protected, but also many people who do not wear glasses would likely take precautions too, if made aware of the dangers and the existence of non-prescription protective lenses.”

To see the full results of the poll, please visit the Essilor website.

For more information on the protection offered from blue light and UV through specialist lens coatings, for both prescriptions and non-prescription glasses, please see here for UV & Blue Light Protection options.

*All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,096 adults. Fieldwork was undertaken between 21st and 24th August 2015. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Resources To Help Save Vision
All About Vision
Macular Degeneration Partnership
National Eye Institute (NEI)
Prevent Blindness

10/16/15


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

Cataract Prevention

The more you know about cataracts, the easier it is to focus on cataract prevention.

What is a cataract?

At birth, with rare exceptions, most of us arrive in the world with a clear crystalline lens within each eye. The pathway of our visual images start with light passing through the cornea (the clear front window of the eye), through the pupil (the opening in the center of the iris, or colored portion of the eye) and through crystalline lens which functions to focus light onto the center of the retina (the film of the eye). cataract preventionThe retina, via the optic nerve, will then transmit visual images to the brain. When the crystalline lens becomes opacified (cloudy), this system becomes disrupted, and vision becomes impaired. Opacification of the crystalline lens is called “cataract”, and there are many variations in appearance and type and many causes and can present at any age. The word cataract originates from the Greek word “cataracta”, which means waterfall. The ancient Greeks used this term as they noticed a similarity in the appearance of the white opaque rushing water of a waterfall and the appearance of a white mature cataract.

To understand the different types of cataracts and causes, it is important to understand the anatomy of the lens. Using a metaphor, the lens anatomy can be compared to a Peanut M&M candy™. There is an outer candy coating (the lens capsule), a chocolate layer inside (the lens cortex), and a peanut in the center (the lens nucleus).

The most common cause of a cataract is an age related nuclear clouding which is due to long term accumulation of metabolic and oxidative waste products within the lens and possibly UV-B/Sunlight light exposure. Cortical clouding (within the cortex of the lens), due to similar causes, is also a common cause of an age related cataract.

Cataracts can occur earlier in life with poorly controlled diabetes resulting in cortical and nuclear cataract. Patients who are exposed to steroid medications in any form (orally, topically as eye drops, skin creams etc.) are at an increased risk to develop a posterior subcapsular (PSC) cataract which occurs on the posterior lens capsule. PSC cataracts can have a much more abrupt and earlier onset in life than nuclear or cortical cataract. Smoking has also been known to predispose patients to formation of a PSC cataract. Other less common varieties of cataract can occur with any trauma to the eye or even present at birth as a congenital cataract with a large variety of causes.

What can be done to prevent cataracts?

I often joke with patients that a cataract is such a common occurrence that just like birth, death, and taxes, it is an issue we must all face at some juncture in life (hopefully later than earlier). I am often asked if there are any dietary measures or vitamin supplementation to reduce the formation of a cataract, however this is not as well studied as the use of vitamins in the prevention of macular degeneration. Several scientific epidemiological studies following populations over many decades have shown some merit however that using multivitamins regularly (Vitamin B6 and B12, Vitamin C, beta carotene, antioxidants and possibly lutein and zeaxathin) can reduce the degree of lens opacification over time. As with all medications, you should consult with your physician before deciding to use any vitamin supplementation to clarify if you have any contraindication to using them.

There is conflicting evidence regarding the role of UV-B exposure in sunlight as a causative agent for cataracts. There is some support that using sunglasses on a regular basis to block UV-B light may help to reduce cortical cataract formation. Smoking cessation can also help to reduce the formation of cataract. If a patient is diabetic, strict blood sugar control is also an important measure to reduce the formation of a cataract. If possible, reducing or avoiding the use of steroid medication can reduce the formation of a PSC cataract.

What can be done if a cataract is worsenening and glasses cannot help improve vision significantly?

If you are experiencing gradual painless loss of vision, you should consult with your ophthalmologist as cataract can be a common cause. If you are found to have cataract formation, there is generally a shift in the glasses prescription in the early stage. Having your glasses prescription checked to see if your vision can be improved with glasses is the first step in determining how significant your cataract has become. If glasses are not able to sufficiently improve your vision and your daily activities are affected by the decrease in vision your experience, you may be a candidate to have cataract surgery.

Modern cataract surgery has improved a tremendous degree compared to decades earlier. It is the most common and successful surgery in the world, and is typically performed on an outpatient basis with topical anesthetic and often without any sutures or eye patch. Prior to surgery the pupil is dilated, and once in the operating room, a small self-sealing incision is made on the side of the cornea. The surgeon then makes a circular opening in the anterior lens capsule (the candy coating of the peanut M&M), and uses an ultrasound instrument to emulsify and vacuum out the nucleus (the central peanut), and remove the cortex (the chocolate layer). The inside of the lens capsule is polished and an intraocular lens is folded and introduced into the eye through the corneal incision and seated into the remaining lens capsule to conclude the surgery.

Prior to surgery, measurements are taken to determine the power of lens necessary to achieve the best vision after surgery based on the curvature of the cornea and anterior-posterior length of the eye. Intraocular lenses (IOLs) can potentially have several features depending on a patient’s needs. The most common IOL used is a monofocal lens, which does not typically require an additional out of pocket expense. This lens is chosen to have a point of focus either for distance vision (driving, TV) or near vision (reading), but not both. Typically patients who have the monofocal lens will choose to have distance focus and use reading glasses for near vision. There are multifocal/accommodating IOLs available for patients who are appropriate candidates, to allow the patient a larger range of vision at far, near and intermediate (computer) distance and may allow great independence from glasses. There are still other IOLs which can correct astigmatism (a special type of glasses prescription) at the time of cataract surgery. After discussion of the patient’s needs and preferences, the surgeon can best advise their patient regarding which type of IOL may best suit them.

6/11/15

Anand Bhatt, MD - cataract preventionAnand B. Bhatt, MD
Assistant Professor of Glaucoma and Cataract Surgery, Gavin Herbert Eye Institute
UC Irvine School of Medicine

Food for Thought . . .

6/26/14

Can dinner really be delicious medicine for our eyes?

Recent studies have shown compelling evidence that specific nutrients support eye health.* When a vitamin or mineral is given as a supplement, are there the supporting micronutrients and enzymes required for optimal utilization of that supplement by our bodies? Is a nutrient more bioavailable and/or more beneficial to our health as a foodstuff than as a supplement? Are there unintended effects from supplements that are not present when the nutrient is derived from a food source?**

Visionary Kitchen - nutrients
Despite the many thought provoking questions, I personally take supplements as I feel it is difficult to acquire the nutrients strictly through food. Dietary preferences and requirements influence our everyday food choices as well as the quality of food available at our local grocery stores. Thoughtfully designed, well-sourced supplements have been shown to enhance eye health and general well being.
Here are some key nutritional principles which should be kept in mind to maximize the nutrient availability to our eyes and bodies from the foods that we eat:

1. Bioavailability: Vitamins A, D, E and K are fat soluble; the vitamin B-complex and vitamin C are water soluble. Dietary fats aid in the transport of fat soluble vitamins. Of particular importance to eye health are the fat soluble carotenoids in the vitamin A family, lutein and zeaxanthin. Carotenoids are the red, orange and yellow pigments found in fruit and vegetables such as kale, spinach, corn, apricots and orange bell peppers. To maximize their nutritional benefit, combine foods rich in carotenoids with a healthy source of fat such as olive oil, avocados or walnuts. Egg yolk contains the most bioavailable source of lutein and zeaxanthin and is preferentially deposited in the macula.

2. Nutrient Synergy: Nutrient synergy is the interaction of two or more nutrients that work together to achieve a greater effect than a single nutrient alone could. Foods have a vast array of micronutrients. We know that spinach contains a high level of lutein; however, we don’t know precisely how all the nutrients in spinach work together to promote eye health. Epidemiological studies show people who eat spinach have a lower risk for developing Age-related Macular Degeneration (AMD). Levels of lutein and zeaxanthin in the macula can be measured and low levels are a predictor for the risk of developing AMD.

3. Growing and Feeding Practices: The growing and feeding practices of the agriculture industry affect the nutrient profile and nutrient density of our food. Grass-fed versus corn-based animal husbandry, and wild versus farm-raised fish, alters the fatty acid profile. The amount of omega-3 fatty acids found in eggs varies depending upon the chicken’s diet. Ketchup from organically grown tomatoes contains nearly 50% more lycopene than from conventionally grown tomatoes. Choose quality ingredients whenever possible.

4. Cooking Techniques: Steaming, sautéing or pureeing will break down the plant cell walls increasing the body’s access to the lutein found in dark leafy greens. Cooking tomatoes will increase the availability of lycopene. Heat, however, diminishes the amount of vitamin C present. To maximize lutein and vitamin C, consume both fresh and cooked vegetable sources. Excessive heat and lengthy cooking times diminish vitamin content (mineral content will remain intact, however).

5. Whole Foods: Whole foods have benefits such as soluble and insoluble fiber which help to regulate blood sugar. Foods high in fiber have been shown to decrease total cholesterol, triglycerides and VLDL levels. Fiber supports gut health which is integral to nutrient absorption.

6. Select Eye Nutrient Dense Foods: Studies have highlighted lutein+zeaxanthin, the omega-3 fatty acids balanced with omega-6 fatty acids, the vitamin A family, the antioxidant vitamins C and E, as well as the mineral zinc. There a number of other nutrients that play a role in eye health including B vitamins, selenium and other plant based antioxidants. Knowing the food sources of these important nutrients will help you to make better food choices for eye health.

How does this sound for dinner tonight? Grilled wild salmon on a bed of lightly sautéed spinach with caramelized onions!

* AREDS 1, 2; LAST: Lutein Antioxidant Supplement Trial; ZVF: Zeaxanthin and Visual Function
** CARET: Carotene and Retinal Efficacy Trial

author-portraitSandra Young, OD
Author of the award winning Visionary Kitchen: A Cookbook for Eye Health
www.visionarykitchen.com

Beyond Eating Green

Beyond Eating Green

Spinach and kale aren’t the only things to watch in your diet. Eating low glycemic foods may slow the development and progression of AMD. The glycemic index measures how quickly carbohydrates get glucose (sugar) into the blood stream. People with diabetes will find this familiar. High glycemic foods like potatoes, white rice, processed foods like cakes and crackers and cereal raise the blood glucose level. Low glycemic foods include vegetables and beans.

from www.crossfithoboken.com
from www.crossfithoboken.com
Several years ago researchers at Tufts University found that mice fed a low glycemic diet developed fewer and less severe age-related lesions in the retina than mice fed the higher GI diet. When lesions like this develop after age 60 in humans, they are the earliest warning sign of age-related macular degeneration. Earlier studies in humans resulted in similar observations.

*Here are some tips from Harvard University for low-glycemic eating.

1. Eat a lot of non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts.

2. Eat grains in the least-processed state possible: “unbroken,” such as whole-kernel bread, brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals.

3. Limit white potatoes and refined-grain products, such as white breads and white pasta, to small side dishes.

4. Limit concentrated sweets – including high-calorie foods with a low glycemic index, such as ice cream – to occasional treats. Reduce fruit juice to no more than one-half cup a day. Completely eliminate sugar-sweetened drinks.

5. Eat a healthful type of protein, such as beans, fish, or skinless chicken, at most meals.

6. Choose foods with healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados, but stick to moderate amounts. Limit saturated fats from dairy and other animal products. Completely eliminate partially hydrogenated fats (trans fats), which are in fast food and many packaged foods.

7. Have three meals and one or two snacks each day, and don’t skip breakfast.

8. Eat slowly and stop when full.

*Adapted from Ending the Food Fight, by David Ludwig with Suzanne Rostler (Houghton Mifflin, 2008)

Judi Delgado headshotJudith Delgado
Executive Director
Macular Degeneration Partnership