and Vision: Eating Right and Seeing Better
proper nutrition for optimum general health is
something that we’ve all heard for many years.
It makes sense that what we eat affects how our
bodies function and survive. However, until recently
little has been said about how nutrition affects
our eyes and visual system.
that the eyes are as much a part of the body as
any other organ. There are literally millions
of nerve endings that serve as a part of the visual
process. The eye really is an extension of the
brain, and while the eye and brain only make up
2% of body weight, they require about 25% of the
nutritional input. So proper nutrition of the
eyes is important to not only maintain proper
vision but also eye health as well.
article excerpts Dr. Anshel’s book, “Smart Medicine
For Your Eyes” and will discuss various eye conditions
that occur and how to deal with them, both conventionally
and with nutritional support. Please realize that
diagnosing vision conditions requires the expertise
of qualified eyecare professionals, so this information
is to be used in conjunction with your eye doctor’s
efforts. Be sure to work closely with your doctor
to assure that all of the steps you are taking
are toward achieving the proper goal.
macula is the area of the retina that is the most
sensitive and is used for direct, central vision.
For one in four people over the age of sixty-five
and one in three over the age of eighty, the macula
begins to degenerate (deteriorate), therefore
this condition is known as age-related macular
degeneration (AMD, or AMD). Very often the
macular area of one eye shows this degenerative
change while the other eye is perfectly normal.
In this circumstance, you may not notice that
the change is taking place because the good eye
will dominate your vision.
are two types of AMD: the wet and dry
forms. The wet form accounts for only 10% of the
cases. It occurs when tiny, new abnormal blood
vessels begin to grow behind the retina toward
the macula. Here they often leak blood and fluid
that damage the macula, causing rapid and severe
vision loss. The dry form constitutes the other
90% of cases and occurs when small yellowish deposits
called drusen (DROO-zin) start to accumulate
beneath the macula. These deposits gradually break
down the light-sensing cells in the macula, normally
causing distorted vision in the eye.
blindness doesn't occur with macular degeneration.
Since the macular area is only responsible for
central vision, only this area will be affected.
However, a person afflicted with macular degeneration
can feel very helpless and frustrated due to the
loss of detail vision. Peripheral vision usually
remains intact and therefore allows a person to
function almost normally, especially if only one
eye is involved.
are certain risk factors that can make one more
susceptible to AMD. Those are:
it is estimated that about 14% of people aged
55-64 have some form of AMD. This rises to about
25% of 65 to75 year-olds and up to 37% of those
and Nutrition- the macula’s fragile cells
are highly susceptible to damage from oxygen-charged
molecules called free radicals. Early research
has shown that people with a low dietary intake
of antioxidants may be at risk of developing AMD.
Alcohol may also deplete the body of antioxidants.
High levels of saturated fats and low –density
(LDL) cholesterol harm blood vessels and are also
involved in producing free radicals reactions
that can damage the macula.
The cells of the macula are highly sensitive to
sunlight. Cell damage from the sun can lead, over
time, to deterioration of the macula. People with
light colored eyes may be more prone to damage
from sunlight, as are those who have prolonged
exposure to ultraviolet light.
A recent study showed that smoking, which reduces
protective antioxidants in the eye, more than
doubles the risk of AMD. The study found
that AMD is more than twice as common in people
who smoke more than one pack of cigarettes a day,
compared with people who do not smoke, and the
risk remains high even up to 15 years after quitting.
Some studies show that AMD may be in part inherited.
This means that if you have one or more immediate
relatives with AMD, you may be at higher risk
to develop the condition.
and Race- Being a women over age 75 doubles
your chances of developing AMD compared to a man
of the same age. Low levels of estrogen in post-menopausal
women may also increase risk for the condition.
There is some suggestion that post-menopausal
estrogen therapy may be protective or AMD, but
more research is needed in that area. Women also
live longer than men. Caucasians are much more
likely than African Americans to lose vision to
Disease- If you have high blood pressure or
another form of heart disease, you may also have
a greater chance of getting AMD because of poor
blood circulation to the eyes.
have been used in the treatment of the “wet” form
of macular degeneration. In this procedure, the
laser can be used to coagulate (clot) the tiny
blood vessels that have grown near the macula.
Unfortunately, most forms of the problem cannot
yet be reliably treated either medically or surgically.
Special low-vision aids can be of great help to
those with macular degeneration. These aids serve
to magnify images so they are spread over a larger
portion of the retina.
doctors will administer a test called an “Amsler
Grid”. This test will be valuable in following
the course of the disease process but certainly
does nothing to resolve the condition.
recently there has been the development of certain
light-enhanced treatment for AMD, called Photo-Dynamic
Therapy (PDT). This process involves injection
a solution into the veins, then shining a light
into the eyes that will allow this solution to
block the development of new blood vessels. This
procedure is designed for the “wet” form of AMD.
New studies are continuing to look at several
other forms of PDT, but little is on the horizon
for the “dry” form of the disease.
you cannot change your age, your sex or your family
tree, there are some lifestyle changes you should
adopt to help protect your eyes. First, wear sunglasses
or a brimmed hat when exposed to large amounts
of ultraviolet light. Moderate amounts of ultraviolet
light are good for the human body but overexposure
can cause damage to some parts of the eye.
that prevents the clogging of your arteries may
help prevent macular degeneration (as well as
the degeneration of the rest of your body). Therefore,
watching your dietary fat and cholesterol, exercising
regularly, not smoking and watching your weight
and blood pressure are wise moves. Limit your
intake of alcohol to a maximum of six drinks
per week for men and three for women.
most doctors are finally recommending that their
older patients take antioxidant supplements to
prevent or halt the progress of macular degeneration.
Recent studies indicate that a well-rounded combination
of antioxidants has shown to slow macular degenerative
changes. Several research studies on AMD are focusing
on the role of a group of antioxidants called
carotenoids (care-OTT-ten-oyds). Two of these,
lutein (LOO-teen) and zeaxanthin (zee-ah-ZAN-thin),
are the only pigments found in the macula. By
contrast, beta carotene is virtually absent in
the eye (although it’s cousin, Vitamin A, is plentiful
in the retina). Lutein and zeaxanthin can be found
in almost all fruits and vegetables, but are most
likely to be in dark green, leafy vegetables such
as spinach and collard greens. Another study among
male veterans showed that increasing antioxidants
could slow the progression of vision loss from
dry AMD. For more specific information, consider
the formulations by Biosyntrx (www.biosyntrx.com).
2,500-5,000 IU per day
antioxidant. Use emulsion form for easier
assimilation and greater safety
C with bioflavonoids
mg (250 mg/4 times daily)
300-400 IU daily
important antioxidant and free radical destroyer
25-30 mg daily
has been linked to eye problems. Use zinc
400 mcg. daily
1 mg daily (if using Zinc Oxide)
to balance the zinc concentration.
10 mg daily
4 mg daily
cataract (CAT-ah-rackt) is a clouding of the lens
within the eye. This clouding can be partial or
complete, so not all cataracts interfere very
much with vision. However, the type of cataract
that occurs with advancing age is generally progressive,
so that a small cataract that doesn’t cause much
of a problem will probably become a large cataract
that obscures vision at some point, perhaps a
few years down the road.
Cataracts are not limited to the aged, although
so-called ‘senile’ cataracts are the most common
type of cataract. The National Eye Institute estimates
that by age 80, more than half of all Americans
either have a cataract or have had cataract surgery.
It also estimates that cataracts affect more than
20.5 million Americans age 40 and over, or about
one in every six people in this age range.
You may have heard that cataracts can also be
present at birth. They can happen, though it’s
pretty rare. They’re called ‘congenital’ and are
sometimes caused by the mother’s having contracted
German measles, mumps, chickenpox or certain other
infectious diseases during her pregnancy; they
can also be inherited.
Some diseases, injuries and a class of anti-inflammatory
drugs called steroids can also cause cataracts
at any time of life. You can also develop a cataract
after being exposed to radiation (from many X
rays, for example), from constant exposure to
infrared light (called “glassblower’s cataract”
because this profession used to work with infrared
light without eye protection) or from being hit
with a high-voltage current (lightning or electrocution)
through the head. (Of course, if you’re struck
by lightning or electrocuted, cataracts would
probably be the least of your concerns!) Recent
research suggests that many years of extreme exposure
to ultraviolet light (UV), which is part of sunlight
but is beyond the human visible spectrum, can
also play a part in the development of cataracts.
This is because the lens is a UV filter and absorbs
most of the UV light entering the eye so that
none of it reaches the retina. Another study suggests
that cigarette smoking may be linked to the formation
of cataracts; the eye damage seems to be from
the effect of certain chemicals being transported
internally to the lens when the person smokes,
not from smoke in the environment.
So, you may wonder, are cataracts an inevitable
consequence of advancing age, or are they the
result of some action that can be changed?
Researchers in the field of aging are asking this
question about many conditions previously thought
to be the unavoidable price of living a long life.
The answer with cataracts, as with most conditions,
is that they are probably a combination of the
aging process and the environment in which the
person has been living for many years. Years of
exposure to ultraviolet light, radiation and various
as-yet-unidentified environmental “insults,” such
as smoking, eventually catch up with us as we
age; at the same time, the eye’s lens fibers begin
to break down and are more vulnerable to stresses
from the outside world. You may be able to prevent
or postpone the development of a cataract by protecting
your eyes against ultraviolet light with a good
pair of sunglasses, eating a nutritious and balanced
diet, limiting your exposure to infrared light
and radiation from X-rays and other sources, and
by not smoking.
When the cataract is interfering significantly
with your vision and your life, it’s usually time
to consider surgery (not every cataract gets to
this point). Cataract surgery currently is the
most frequently performed surgical procedure in
the United States, with more than 1.5 million
people having cataract surgery each year. Worldwide,
an estimated 8.7 million cataract procedures are
performed annually. You may have heard that you
have to wait until a cataract is “ripe” before
it can be surgically removed. This was true years
ago, but new surgical techniques have made it
possible to remove a cataract at any time as long
as your doctor feels you are in good enough shape
to undergo surgery. A few different surgical techniques
can be used, and you and your surgeon can decide
which one is best for you. Sometimes, cataract
surgery can be done as an outpatient procedure.
recent study by a group in Spain found a relationship
between estrogen and cataracts. It found that
women who had been taking estrogen for more than
four years had a reduced number of opacities in
the lenses of their eyes. Although this is only
one study, it might be worth a look at why this
If you do develop a cataract, you won’t necessarily
need surgery, at least not right away. What you’ll
notice with your cataract is that light is refracted
differently now and doesn’t look the same as it
did before. You may see just a general sort of
cloudy haze in your visual field, or you may see
a “dazzling” effect of scattered light as it bounces
off your cataract. Changes in how you see are
almost always due to changes in the lighting around
Outdoors on a sunny day, you will probably want
to wear a hat with a brim to reduce this dazzle
effect of bright sunlight; sunglasses will help
this too. Indoors, experiment with the best lighting
for you. You’ll find reading easier if you have
a small reading lamp that can be moved around
and adjusted for your comfort instead of a bright,
immovable ceiling fixture. You may want to keep
the room lighting low (but not off) when you watch
have been many reports of nutritional support
to fend off cataracts. It has been experimentally
shown that diets low in vitamin B-2 can produce
cataracts in animals. Cataracts in horses, a common
cause of blindness in these animals, can be reduced
when large amounts of vitamin B-2 are added to
the diet. Galactose or milk sugar increases the
need for vitamin B-2. In infants who cannot utilize
galactose normally, blindness from cataracts has
been corrected when milk sugar has been withdrawn
from their diet and vitamin B-2 added. A 1997
study found a significant reduction in cataracts
in a group of nurses who took vitamin C supplements.
It is apparent that except for those cases of
cataracts that are strictly and totally congenital,
the major factor in the etiology of cataracts
is nutrition. Although the lens can now be replaced
by an artificial one, the best lens to have in
your eye is the one that is already there!
capsule 3 times per day
free radical scavenger
capsules per day
growth of cataract
directed on label
directed on label
in collagen formation- repairs lens
IU per day
for all vision problems
B-complex (extra B1,B2 &
mg each daily
for eye metabolism
mg (500mg 4 times a day)
mg daily (not to exceed 40 mg)
against light-induced damage
directed on label
free radicals- shown to be very effective
in reducing cataract density.
eye syndrome is a problem with either the quantity
or quality of the tear film leading to symptoms
of dry, red, burning, gritty, or watery eyes.
The eyes may be very light sensitive. Dry eye
syndrome is not so much a disease but a group
of symptoms that develop as a result of other
conditions such as eye allergy, medications, arthritis,
and environmental factors such as low humidity.
understand dry eyes, one must first understand
the function and components of the tear film.
There are three layers of tears on the front of
the eye: the oily layer is outermost. It is produced
by glands called meibomian (my-BOHM-ee-an) glands,
primarily located in the eyelids. It reduces tear
evaporation. The second layer is the watery middle
layer, which comprises the majority of the thickness
of the tear film. This tear layer is produced
by the lacrimal (LAK-ri-mal) gland located under
the brow bone. This is the watery type of tear
that is produced in copious amounts when we cut
an onion and our eyes become watery. The innermost
layer, which is called the mucin (MEW-sin) layer,
is produced by the cells in the conjunctiva (the
clear coating over the white of the eyes).
dry eye sufferers have watery eyes and don't understand
how their eyes can be running with moisture and
yet their doctor diagnoses their problem as “dry”
eye. This can be explained as a dry eye where
the tear glands pump extra amounts of watery tears
on the eyes as a protective mechanism to compensate
for the dry condition. Eyes that are constantly
watery may also have a blocked tear duct.
eye is probably the most common of all eye problems.
A recent Harris Poll indicates 33 million U.S.
adults are affected by dry eyes, and 89 percent
of Americans are unfamiliar with what is probably
the most common of all eye disorders.
Adults who have arthritis and other autoimmune
disorders are more likely to have dry eyes. Dry
eyes accompanied by dry mouth (difficulty swallowing)
is called Sjogren’s (SHOW-grins) Syndrome,
a condition that occurs more commonly (90%) among
women past age forty. In Sjogren’s syndrome, the
body’s immune system mistakes its own moisture
producing glands for foreign invaders. The immune
system then attacks and destroys these glands
causing the hallmark symptoms of dry eyes and
dry mouth. Like Lupus, Sjogren’s can also damage
vital organs of the body with symptoms that may
plateau, worsen or go into remission. Some people
may only experience the mild symptoms of dry eyes
and mouth, while others go through cycles of good
health followed by severe disease.
eyes produce about 40 percent less moisture with
advancing age. Certain medications may interfere
with tear production (see below). Droopy lower
eyelids, as well as excessive computer viewing
(decreased blink rate), may expose the surface
of the eyes to the air, increasing evaporation
and dry eye symptoms.
first treatment for dry eyes is artificial tears.
There are many types of eye drop preparations.
It is advisable to avoid artificial tears that
have preservatives. Preservatives eventually make
your dry eye condition worse. Most preservative-free
eye drops come in individual dose vials and you
can conveniently carry them around in your pocket
or purse. Some of the more viscous (thicker) eye
drops last longer on the eye, but your vision
is likely to be a little foggy for the first few
minutes after putting them in your eyes.
is no known cure for Sjogren’s syndrome. Moisture
replacement therapies can ease the symptoms of
dryness. Nonsteroidal anti-inflammatory drugs
(NSAIDs), steroids and disease modifying drugs
are often used to treat Sjogren’s. Studies by
scientists indicate that the male hormone androgen
may restore lacrimal gland function and relieve
chronic dry eye symptoms. There are some side
effects, such as virilism- the growth of facial
hair and the manifestation of other male characteristics-
in women. Further studies are being conducted
to identify an androgen compound that would prevent
these side effects.
of the most practical methods of treating a conventional
dry eye is to plug the hole in the tear “sink.”
There are tear drainage canals on the edges of
the upper and lower eyelids near the nose area.
Inside the drainage opening in the lids are tiny
pumps that suck away fluid from the surface of
the eyes. The lacrimal glands behind the eyelids
produce tears. The eyelids spread the tears across
the eye's surface, much like a windshield wiper.
The drain at the bottom permits the fluid to drain
away. If the drain is plugged, more fluid stays
on the surface of the eyes. The main problem with
this procedure is that, if the tears are “faulty”
and lead to inflammation (a major cause of dry
eyes), then allowing the inflammatory tears to
stay in contact with the eyes longer can actually
make the condition worse.
help conserve moisture on the surface of the eyes,
consider some of the following measures:
· Use humidifiers in the home, especially in
dry, desert areas.
· Wear wrap-around sun goggles outdoors: Sunglasses
(or even clear goggles) with side shields help
reduce evaporation by as much as 40 percent.
· Blink your eyes: As you blink you squeeze
tears from the glands in your eyelids. Waiting
20-30 seconds in between blinks may cause the
breakup of tear film and dehydration.
· Stop smoking: When cigarette smoke is introduced
to a room, dry spots on the surface of the eyes
occur 40 percent faster than when the lids are
· Avoid smog and fumes: These eye irritants
inactivate the enzyme that acts as an antibacterial
agent in the tear fluid.
· Check the nose pads on your eyeglasses: If
the nose pads are pushing the lower eyelids down
they may increase the evaporation of tears. Have
an optician adjust the nose pads.
· Tilt the computer monitor: When using a computer
terminal, lower the monitor so that the opening
in the eyes will be narrow when viewing the screen,
thus reducing the surface area of the eyes exposed
to the air. See Computer Vision Syndrome
sections in this web site.
· Reduce, replace or avoid eye makeup: Eye makeup
has been shown to thin the fatty layer on the
outer surface of the tear film that keeps the
eyes from dehydrating quickly. Eye makeup can
harbor bacteria and should be replaced frequently.
Gentle removal of all eye makeup nightly is essential.
for medications that cause eye dryness: A partial
list of these drugs is provided below.
Antihistamines (Benadryl, Coricidin)
Vitamin A analogs (isotretinoin)
Decongestant eye drops (Visine, Murine, Prefrin,
Diazepam, valium, lithium (anti-anxiety agents)
Methotrexate and other cancer drugs
Tranquilizers (Elavil, Valium)
Beta blockers: Timolol, Timoptic, Betoptic, Betagan,
Ocupress (glaucoma eye drops)
on your soft contact lenses: Soft lenses may promote
the evaporation of tears from the surface of the
eyes. In severe dry eye cases, contact lenses
cannot be worn. However, there are new materials
in contact lenses that maintain moisture in the
lens longer, so that even marginal dry eyes can
be comfortable. Check with your eyecare professional
for an evaluation to see if these new lenses can
meet your vision needs.
oils are needed in the diet in order to provide
lubrication for the joints, the eyes, and to restore
normal lubrication to the body. There are good
fats and bad fats. The undesired saturated fats
are found in meats, fried foods, butter, diary
products, and margarine. The good fats are called
polyunsaturated fats, especially Omega-6 (non-hydrogenated)
and Omega-3 fats found in cold-water fish and
flax seeds and walnuts. It is important to maintain
the proper balance between the various Omega fatty
acids. (see another article in this section on
“Fatty Acids- The Good, Bad and Ugly”)
SUPPLEMENTS- the best formula I have
seen is called BioTears and is manufactured by
Biosyntrx (www.biosyntrx.com). This formula contains
all the necessary nutrients to treat dry eye conditions
and usually works within 30 days. It is available
through eyecare professionals or on their web