The eyes are the windows to
our soul—and, sometimes, to the state of our general health. Vision
abnormalities can be harbingers of other problems, including diabetes, brain
tumors, multiple sclerosis, blood disorders, rheumatoid arthritis and lupus.
But trouble seeing can also
indicate serious problems with, well, the eyes.
According to the American
Foundation for the Blind, 6.5 million Americans over the age of 65 experience
severe vision loss. Health officials predict that diseases of the eye, such as
age-related macular degeneration (AMD), glaucoma and diabetic retinopathy will
double as the nation's 78 million baby boomers reach retirement age and
beyond.
One of the leading causes of
impairment of vision in people over 50 is age-related macular degeneration,
which is caused by the hardening of the arteries that nourish the retina. In
2004, the Archives of Ophthalmology
estimated that 1.75 million U.S. residents
show significant symptoms associated with AMD, with that number expected to grow
to almost three million by 2020. Although AMD doesn’t often cause total
blindness (peripheral vision is usually not affected), it can cause severe
vision loss.
Sarasota resident Furman Arthur knows all about this
devastating condition. Three years ago, he noticed that the vision in his right
eye was more blurry than usual. In his early 80s, he chalked it up to old age.
When it started seriously interfering with his reading and writing, Arthur, a
former public relations director at New College and a journalist who still
practices his craft, knew it was time to see his eye doctor. That doctor sent
him to a retina specialist.
By the time Arthur saw the
specialist, he had lost most of his central vision in his right eye. He still
had peripheral vision, but anything in the center of his vision was blurred and
mostly unrecognizable. The specialist told him what he feared: The macula in his
right eye was showing signs of deterioration.
But let’s back up a minute.
What the heck is the macula, anyway?
The macula is located in the
center of the retina, says Dr. Harry Grabow, founder, medical director and chief
surgeon of the Sarasota Cataract & Laser Institute, “and is the part of the
eye used for focusing on detailed vision, especially reading and driving. One of
the first symptoms of macular degeneration is difficulty reading very small
print, especially newspaper print.” Patients complain, he says, of seeing a
blank hole in the center of their vision.
“Macular degeneration
happens when the arteries that nourish the retina begin to harden,” says Grabow.
“The tissue of the retina becomes deprived of the oxygen and nutrients that keep
it healthy. As a result, the central vision deteriorates.”
There are two types of
macular degeneration. The wet type is the most aggressive form and occurs when
new blood vessels grow under the macula in an attempt to carry much-needed
oxygen to the area. “These vessels break easily, causing bleeding and damage to
the surrounding tissue,” says Grabow. Statistics show that about 10 percent of
patients who suffer from macular degeneration have the wet type. Arthur happens
to be one of these people.
The dry type of AMD is more
common and generally results in less severe loss of vision. It can progress to
wet, so if you’re diagnosed with dry AMD, you’ll be advised to have your eyes
examined at least twice a year.
What causes this unpleasant
condition and how can we prevent it? While scientists still haven’t come up with
one determining cause, the condition is aggravated by a variety of factors,
including age, dietary habits and overexposure to sunlight. Smokers are found to
have higher incidences of it. Recent research by Duke University and other research facilities
shows that genetics play a role. If you have a family member with AMD, it’s a
good idea to have your eyes checked at least once a year after 50. Obesity,
lighter eye color, and high blood pressure are also seen as factors that point
to a predisposition to AMD.
As for symptoms, says
Grabow, the disease takes its time, and the process is usually slow and
relatively painless. Most commonly, patients complain of experiencing fuzzy or
distorted vision. They also report difficulty in reading. One way to tell if
you’re experiencing AMD is to take an Amsler grid test. This is a chart of black
lines arranged in a graph pattern that’s used to monitor vision
loss.
We all want to be able to
read and drive well into our 80s. If we can’t prevent the condition, what can we
do to cure it?
There is still no outright
treatment that cures either type of AMD. That said, there is a new FDA-approved drug being used to stop abnormal
blood vessel growth for patients suffering from the wet type of macular
degeneration, says Dr. Keye L. Wong of the Sarasota Retina Institute.
“Up until only a few
years ago, treatment of AMD was not very satisfactory,” Wong says. “At the very
best we could halt the progression. Then, last summer, a new drug called
Lucentis was approved by the FDA. This drug has completely changed our
perception of how we treat AMD. One out of three patients we’re treating with
Lucentis can see significantly better. Some are actually driving
again!”
Wong explains that the
drug, which is injected directly into the eye, significantly reduces vascular
growth. “I’m talking about a real ‘wow’ factor,” he says. “The difference for
some of our patients has been the difference between being able to maintain
independence and having to go into assisted living.”
There’s one downside to
Lucentis: the cost. Wong explains that the drug costs $2,000 a pop—far out of
the reach of most people, since it’s often administered on a monthly basis.
Another drug, Avastin, is currently being tested for use in AMD but is not yet
FDA-approved. (The Retina Institute has been chosen by the FDA as a testing
facility for Avastin.) Wong says that thus far results are encouraging. Even
better? If it’s approved, the cost will be around $50 a treatment. “Avastin
could potentially save the health care system $4 billion a year,” he
says.
Nutrition also plays a
part in AMD. Research is indicating that certain nutrients such as zinc, lutein,
zeaxanthin and vitamins A, C and E can lower the risk for AMD and slow down the
progression of dry macular degeneration. Other studies show that consumption of
omega-3 fatty acids may also protect against developing AMD.
Arthur, for one, is
grateful for all of the new research being conducted to fight AMD. By the time
his left eye started showing signs of AMD last year, his retina specialist, Dr.
John H. Niffenegger of the Sarasota Retina Institute, started him on Lucentis,
which has greatly helped slow the progression of the degeneration. “I check in
with Dr. Niffenegger once every six weeks or so,” says Arthur. “If he sees that
the vessels are leaking again, he’ll put me back on Lucentis to help stabilize
the leaking.”
In the meantime, Arthur
has immersed himself in finding resources to help him live with low vision. He
uses ZoomText, a magnification and reading software program, so that he can work
on his computer. He uses Talking Books to keep up with his reading. He’s a great
believer in Lighthouse for the Blind, a national organization with local ties
that promotes independence, equality and self-reliance of people who are blind
or visually impaired. ”They taught me how to handle simple household chores,
write checks, cook and so on,” says Arthur. Best of all, although he has
difficulties seeing the ball, he still plays golf because “the swing is still
there.”
If you’re of baby-boomer
age, here’s a quick look at three other common eye conditions to be aware
of:
Cataracts: We’re all well aware of the “c” word. Cataracts
occur when the lens of the eye becomes cloudy, and we start to have difficulty
with night driving, reading small print, and problems with light glare. As
Grabow puts it, if we live long enough, most of us are not going to be able to
avoid cataracts in one or both eyes. Indeed, cataracts affect nearly 20.5
million Americans age 40 and older. The good news? The cataract can be removed
and replaced with an artificial lens. This relatively simple procedure usually
corrects nearsightedness, farsightedness, astigmatism and
presbyopia.
Dry eye syndrome: As we get older, our bodies produce less oil, which
affects the tear film in our eyes. The result is dry areas on the cornea,
causing irritation, redness and blurred vision. Other causes are linked to
certain medications, thyroid conditions, autoimmune diseases and menopause.
Grabow says that treatment ranges from using artificial tears to having the tear
duct plugged or permanently closed.
Floaters and flashers: This common condition is also age-related. We’re
born with a clear, gel-like substance called vitreous that fills the space
between the crystalline lens and the retina. With age, the vitreous thins and
can pull free from the retina. When this happens, we’ll experience floaters, or
tiny bits of vitreous gel that cast shadows on the retina. Flashes occur when
the vitreous tugs on the sensitive retina tissue. Although floaters and flashes
are usually innocuous, in some cases they can actually harm the retina. For this
reason, Grabow urges anyone experiencing either to see his or her eye
doctor.
Body
talk
BODY BY WON Tips from a local legend in
fitness.
If you frequent the downtown
YMCA, you’ll see T-shirts proclaiming “Body by Won.” The people wearing them are
all ages and sizes bound by one common connection: Won
Huh.
Who is Won Huh? He’s a
former Mr. Korea with a pumped body that still
looks like it’s made of steel. He’s father of Jason Huh, a young professional
bodybuilder on the national competition scene, and brother to Ki Woon Huh, an
acclaimed master potter. But ask Won and he’ll tell you this: He’s a fitness
instructor with 30 years experience and one simple goal: to help others stay
healthy and fit.
It’s not exaggerating to say
Won is a legend in Sarasota’s fitness circles. People will wait as
long as it takes to sign on with him, and they often work with him for years.
Won says there’s really only
one prerequisite: desire. “Everything
else will follow,” he says.
He recommends working with a
trainer to devise a program that’s followed at least three times weekly. “If
your trainer is good,” says Won, “he or she will constantly re-evaluate it to
reflect your ability level.” He also recommends making an appointment with a
dietitian to plan a custom regime. Won prefers a high-protein, low-carb diet—and
suggests “cutting out fast food.”
The third aspect to a
healthy life: reducing stress. Won does that by finding time to kayak, bike, and
read. Yoga is wonderful, he says, but you can find peace of mind simply by
taking a walk or going into your yard and “touching the dirt. Connecting with
nature brings ease to our souls.”
For an appointment or information, call (941)
724-5192.
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