Healthy Habits Slow Macular Degeneration

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I can't see.

Blindness is the disability Americans dread more than any other, according to the American Macular Degeneration Foundation.

Ten million Americans experience a loss of central vision called "macular degeneration" or AMD, according to a 2002 poll by the National Eye Institute.

Complaints such as ‘I can't see your features' and ‘the trees are bending inward' are common among those who lack central, but still have peripheral sight.

AMD is now the leading cause of blindness in those over 55.

A loss of independence goes hand-in-hand with a loss of vision.

There are two basic types of AMD: wet and dry. Although dry afflicts more people, wet macular degeneration, specifically "classic," is the one that is treatable.

The macula of the eye is located near the center of the retina. This area of the eye is where humans derive their ability to see fine, sharp, straight-ahead detail used in driving, reading and facial recognition. Healthy maculae are 100 times more sensitive than the peripheral retina.

Of the 10 million people who suffer from the disease, 1.5 million have bleeding blood vessels and the lesions that characterize wet macular.

If one gets a bad hemorrhage with wet type, "you can go from 20/20 to 20/200 legally blind vision in a day," said Dr. Christian Risser, an ophthalmologist.

"The wet type is due to hemorrhage and leaking in blood vessels and there are things we can do to stop the bleeding if it has not done too much damage," said Risser.

A retinal specialist can treat but not reverse wet macular if it is not too far advanced with special medication and Photodynamic laser therapy.

Locally, Risser-Thomas Eye Care refers clients who may be helped by this treatment to Dr. Scott Sneed of Mesa. Sneed comes to Payson once a month for scheduled appointments.

According to the AMDF, "At present Medicare/Medicaid covers Photodynamic Therapy with Visudyne for those with "classic " lesions only. It does NOT cover "occult" lesions."

The other 85 to 90 percent of the 10 million have dry macular.

There is no hemorrhaging and no cure.

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Macular degeneration causes a lack of central vision that leads to blindness. One study by the National Eye Institute recommends a preventative vitamin formulation to help reduce vision loss that includes: 500 milligrams of vitamin C; 400 International Units of vitamin E; 15 milligrams of beta-carotene; 80 milligrams of zinc as zinc oxide; and 2 milligrams of copper as cupric oxide.

Risser said, "The retinal pigment which is normally present just starts disappearing, or it starts clumping up .... We don't know why it does that .... If we knew the cause, we might be able to do something to prevent it."

Doctors like Optometrist Troy Ford of Payson Eye Care test for AMD by checking visual acuity and administrating drops to dilate the pupil of the eye to look for those scattered deposits.

"The retina is very active tissue," Ford said. "When we are young, the small blood vessels of the retina are very efficient at flushing the waste chemicals away. The older we get, they become less efficient. The accumulations of these waste deposits, or ‘scattered drusen,' are the start of dry macular degeneration that accumulate in the macula."

A study by the University of Utah Medical School, Ophthalmology Department, shows that people with dry AMD who are on supplemental vitamins did not experience degeneration as rapidly as those given a placebo, according to Risser.

"Basically, these are the vitamins that are associated with preventing oxidation," he said.

Some of these include blueberries and carrots.

"And green vegetables in particular -- kale, spinach -- help prevent aging changes," Risser said. "In general the dry type does not progress as fast and tends to be less severe. People will often retain 20/40 or 20/50 vision which may be even legal for driving for some."

The age-related eye disease study found that taking "high levels of antioxidants and zinc" could reduce the risk of developing age-related macular degeneration by about 25 percent.

Bilberry and lutein are two other antioxidants that are currently undergoing scientific study.

Not smoking, a diet of green leafy vegetables and plants that are orange in color (high in lutein and zeaxanthin) are thought by many doctors to slow the progress of AMD.

Depending on how severe the degeneration is, items like a strong magnifying glass, jewelers' helmets and low-vision machines can help a person retain independence in reading a cookbook, writing a letter and shopping. Low-vision monitors that attach to a computer or television are priced new at around $1,000. They can be found on eBay for somewhat less.

A printable Amsler grid and directions for its use in detecting changes in vision is available from www.macular.org/chart.html

Arizona provides services for the blind and visually impaired through their vocational rehabilitation instructional services (RIS), independent living rehabilitation services (ILRS) and business enterprise (BEP) programs.

Rehab Specialist, Kathy Carlise serves the Rim Country and can be contacted by phone, (602) 266-9286, or e-mail KCarlise@ azdes.gov.

Books on tape are available, postage-free, from the National Library Service through Arizona State Braille and Talking Book Library in Phoenix. To apply for the program, call (800) 255-5578 (in-state, toll-free), or e-mail btbl@lib.az.us, or visit www.lib.az.us/braille.

Friends and family members of someone losing their sight can provide both practical and emotional support. The most valuable help is: encouraging self-reliance, building self-confidence, recognizing progress and avoiding over-protectiveness.

It is easier for a blind person to take your offered arm, rather than you taking theirs. Identify yourself, call the blind person by name and speak clearly. Give verbal clues that you are interested in their side of a conversation.

The American Foundation for the Blind provides more specific etiquette at www.afb.org, or by calling toll-free, (800) 232-5463.

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