Macular Degeneration Can Be Wet Or Dry


DEAR DR. DONOHUE: Everything I read or hear about macular degeneration is always about dry macular degeneration. I happen to have the wet kind, and would like to know what its treatments are. I’ve heard that vitamins work. Do they? Thank you. — T.R.

ANSWER: In the well-off countries of the world, macular degeneration is the leading cause of blindness in people over 50.

There are two varieties, wet and dry.

The dry kind is the more common of the two, accounting for 85 percent to 90 percent of all macular degeneration cases. Both involve deterioration of the macula, a small circle on the retina, jam-packed with vision cells necessary for high-resolution sight like reading, watching TV, distinguishing faces and driving.

Wet macular degeneration comes from a sudden proliferation of fragile blood vessels blossoming in and around the macula. Those vessels leak fluid and blood, and disrupt that sensitive area of sight. Wet macular degeneration often comes on quickly and can progress rapidly.

You might have heard of the vitamin-mineral mixture used for slowing the progression of macular degeneration. It consists of vitamins C and E, beta-carotene and the minerals zinc and copper. It is much more useful for dry macular degeneration. For wet macular degeneration, eye doctors can inject the eye with medicines that stop the generation and growth of new, delicate blood vessels. Lucentis and Avastin are two examples.

Photodynamic therapy is another method of handling wet degeneration. Here, a drug that is sensitive to light is injected into a blood vessel. The drug localizes in the newly formed, fragile, troublemaking macular vessels. A laser is flashed on those vessels and they dry up.

I don’t know if your doctor has suggested any treatment. It may be that you’re not at a stage when therapy would provide the most benefit.

The booklet on macular degeneration describes the disease and its treatments. To obtain a copy, write: Dr. Donohue — No. 701W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I crave salt. I sprinkle it heavily on an egg in the morning. At noon I sprinkle it on potatoes, and in the evening on meat, corn or tomatoes. As a snack I eat raw potatoes sprinkled heavily with salt. My mother used lots of salt on her food. She lived to be 96. — B.

ANSWER: Most often, salt craving is a learned hankering. You were conditioned to grab the salt shaker by your mother, and she, probably, by her mother. You should conquer the salt habit. Even though it didn’t hurt your mother and apparently hasn’t hurt you, too much salt can raise blood pressure.

Slowly wean yourself off your high-salt diet. Cook and season with things like lemon juice, lime juice, vinegar, pepper and the large array of herbs and spices found in every grocery store. In a month or so, you’ll wonder how you tolerated so much salt on your food. You’ll experience tastes that salt had been completely obliterating.

DEAR DR. DONOHUE: Are eggs harmful? I’ve been told not to eat more than two a week. I read, however, that eggs are good for us. — M.D.

ANSWER: The daily cholesterol limit has been set at 300 mg. An egg has 212 mg of cholesterol, so a single egg just about polishes off the entire day’s cholesterol allotment. However, the 300 mg limit was set in a time when it was believed that most blood cholesterol comes from foods high in cholesterol. That isn’t true. Most blood cholesterol comes from our liver’s production of it.

Saturated fat and trans fat, not cholesterol, prod the liver into making cholesterol. Diet restrictions to lower cholesterol, therefore, should focus on those fats and not so much on cholesterol. Unless your doctor has you on a very stringent cholesterol-lowering diet, the rule on egg limitation can be relaxed.

A little while ago, a study compared those who ate one or two eggs a day with those who ate fewer than one a week. The egg-eaters were not more likely to die from heart disease than were the abstainers. The only exception was people with diabetes. Diabetics who ate eggs daily were a little bit more at risk of dying from heart disease than were the ones who seldom ate them.

Eggs are a nutritional bargain. One egg has 6 grams of protein and many of the B vitamins. It also has vitamins A and D. Lutein and zeaxanthin are found in eggs. They are important for eye health. All of this, and eggs are cheap.

One egg a day is permissible for most people. If a person wants to eat two, that’s OK. Just skip the next day’s egg.

DEAR DR. DONOHUE: If I don’t take Metamucil every day, I become quite constipated. I know it’s not good to take a daily laxative; many people tell me so. They have me worried about too-frequent use of it. The box says it’s a bulk laxative. Does that mean it’s a laxative that could get me in trouble? — J.R.

ANSWER: Metamucil contains psyllium, a substance like bran. It’s a laxative only in the broadest sense of the word. It doesn’t irritate the colon like some other laxatives do. You can safely use it every day.

The laxative report explains constipation and its treatment in detail. To obtain a copy, write: Dr. Donohue — No 504W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Since he lost his job, my husband has been very depressed and nervous. His doctor put him on an antidepressant. He has taken it for 10 days and says he feels no different. Should he ask for another medication? — S.S.

ANSWER: It takes four to six weeks for an antidepressant to take hold. Ten days is not enough time to consider a medicine ineffective.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

© 2008 North America Synd., Inc. All Rights Reserved


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