Caring For Your Eyes

Regular eye tests that include the retina (back of the eye) should be a regular part of your annual health check-up. The are conditions (such as type 2 diabetes) that could show in the eye many years before you are aware of diabetes and/or damage to your eyes.

It is equally important for anyone with a family history of any eye disease such as macular degeneration to have an annual eye check.

Although Inherited Retinal Degenerations (IRD) may be rare they can occur in any family with no previous history of vision loss. Regular eye examinations are important to ensure that conditions are detected early. If not detected and treated, many of these problems may lead to permanent eye damage.

Even if you are diagnosed with an, as yet untreatable, inherited retinal condition, you still need regular eye examinations. Cataracts and Macular Oedema occur very often in IRD and they are treatable.

Conditions like Glaucoma, retinal degeneration, and cataracts will respond to early intervention.

Children should have an eye test around five years of age. Older patients should see an eye- care practitioner every two to four years and more regularly over the age of forty. Glaucoma for example can be detected in the early stages by having a pressure test. This is a silent and serious disease that may cause irreversible damage to the retina, but is treatable in the early stages.

Age Related Macular Degeneration (AMD) may present as dry or wet. The dry form may also develop into the more aggressive wet form. In AMD any sudden and severe change in vision needs immediate Anti-VEGF treatment from an eye specialist. Daily monitoring with an Amsler grid (free of charge to members) is available from Retina South Africa.

Research has shown that smoking increases the risk of AMD very significantly. 

This risk factor is compounded by genetic risks.

Smoking damages all the blood vessels and the tiny, fragile vessels in the retina are very easily damaged. Smoking also increases oxidative stress and again the retina at the back of the eye is very easily affected.

During deep sleep the inner discs of the photoreceptors in the retina are rejuvenated; short term memories are converted to long term memories and the brain does a deep cleansing of itself to get rid of waste products.

One of the biggest problems in SA today is the alarming increase in the number of people developing obesity and diabetes.

The International Diabetes Federation estimates that 12.8% of our population has diabetes. This means that a staggering 4 million people are at risk for Cardio-vascular disease, limb amputation and blindness. Of these, 20% already have retinal damage at diagnosis and are only aware of vision loss when it is too late.

Often the last sign of trouble is a raised blood glucose level. The earliest sign of problems is tummy fat and anyone who has a waist measurement larger than the hips should take immediate steps to reverse this.

Physical fitness may also positively influence the gene expression- this new science of epi-genetics is now being studied.

Regular exercise is essential for blood flow, the more you exercise the better the blood flows in the body.  Insulin that moves the glucose from the blood vessels to the muscles depends on exercise. Better exercise means better use of glucose in the body, and less risk of insulin build-up that causes damage to nerves, blood vessels and eyes.

Good nutrition has always been recognised as a necessity for good vision.

In Inherited Retinal Degeneration (IRD) this is particularly true.

Our favourite South African brown and white diet can cause damage to the blood vessels. We need a colourful diet rich in vitamins and antioxidants that can neutralise the potential damage from too much red meat and refined carbohydrates. 

The carotenoids Lutein and Zeaxanthin are structural components of the central retina – the Macula. Nutritional studies have shown benefits from increasing the intake of these by regularly eating leafy green vegetables. Spinach, herbs and kale are all good sources of this group of carotenoids and are particularly beneficial to the eyes.

Avoid dangerous fats such as saturated or trans fats. Healthy fats are found in olives, olive oil, fish, avocado, nuts or canola oil. Avoid overheating fat when cooking, fats and oils that have changed colour are dangerous.

A diet low in saturated fats with plenty of fruit and vegetables is recommended. Oily fish, high in Omega 3 Fatty acids has also been advised for AMD patients.

Dietary supplements may also be beneficial but should be discussed with your eye-care practitioner. In AMD the AREDS study showed a slower conversion from dry to wet AMD for patients taking a specific supplement containing vitamins, minerals and carotenoids.

Supplements containing Lutein, Zeaxanthin, Alpha Lipoic Acid and L- Glutathione showed significant retinal protection in animal models of RD.  This supplement is available in South Africa.

Dietary restrictions are just as important. Patients with Stargardt Disease, Cone Rod Dystrophy or a proven ABCA4 mutation should NOT take any supplements containing Vitamin A or beta carotene as this may speed the rate of degeneration.

Other oxidative factors may also negatively influence IRD – pollution, artificial food additives such as colourings, flavourings and artificial sweeteners.

Sunlight protection is important for all IRD, wear sunglasses with good UVa and UVb protection.

Although some sunlight is essential for Vitamin D which is needed by every cell in our bodies, overexposure causes skin and retinal damage. Blue light that is emitted from TVs, Computers and Devices can also damage the eyes. Wear a hat and protective lenses when out in the sun and limit screen time – especially for children. Look away from the screen every 20 minutes to a distance of 20 meters for a least 20 seconds, and then blink 20 times. This changes your focus and lubricates the eyes.

Uncontrolled stress has a major effect on the body affecting blood pressure, sleep and even your gut micro-biome. All of these can affect your vision.

We know that Covid and social distancing is making this very difficult.  For older people discuss any health problems, including vision problems with your friends and family. Reach out to people, do not isolate yourself.

“Dr Google” is not always right. Ignore fake news on social media about any health matters. Covid vaccines do NOT harm your vision, but Covid 19 may.