Q: By middle age, many of us wear reading glasses - what happens to our vision as we age? 

A: Every tissue in the eye is aging, as well as the supporting systems in the body, including the vascular circulation supplying nutrients to the eye. The big three eye diseases that occur around age 70 are age-related cataracts, macular degeneration, and glaucoma. Cataracts are the number one issue for people as they age, then macular degeneration, and then glaucoma. In the United States, cataracts are usually removed surgically and quite successfully in an outpatient procedure called implant surgery. We also have well-established protocols for identifying, managing and treating patients who develop glaucoma, a disease that can affect vision at the moderately advanced and advanced stages. More problematic is age-related macular degeneration which can affect vision at seemingly early stages of the disease. For example, one could have 20/25 visual acuity during an eye examination, yet have difficulty driving a car safely at night or reading newspaper size print in low light situations. In that sense, almost 90 % of patients with visual difficulty from macular degeneration go undetected. This is a problem for aging high tech visual-based societies like ours.

Q: Is there anything a person can do to avert macular degeneration or slow it down?

A: In my opinion, there's plenty a person can do. You can't affect your chronological age, but you can control whether or not you smoke and your cardiovascular risk factors including proper weight maintenance, exercise and nutritional choices. Many people who are not eating plant-based foods are substituting them with other foods that are less healthy and have high levels of starch, fat, trans fats, high fructose corn syrup, and things of that nature - which increase body mass weight. These are the factors that are driving the obesity epidemic, which to a large extent is also associated with macular degeneration. We have remarkable documented success in improving the vision of older veterans with nutrition modification.

Q: Why would your weight affect your vision?

A: Because obesity is linked to cardiovascular disease, which in turn is associated with macular degeneration. Studies demonstrate that obesity doubles the risk of developing macular degeneration, via various specific physiological mechanisms. 

Q: What other advice do you have for people who want to maintain healthy eyes?

A: In addition to smoking cessation, weight control and exercise to maintain good cardiovascular status, the daily diet should include plenty of fruits, vegetables (particularly dark green leafy vegetables) and what is known as Omega 3 fatty acids (i.e. cold water fish or supplements). As well, the AREDS (Age Related Eye Disease/National Institute of Health) study has shown certain supplements can prevent or slow vision loss from macular degeneration in patients with very high-risk retinal findings.   

Q: What supplements are most advantageous?