The Eye Practice

Cataracts are quite common but...

Did you know that at least 50 million people around the world lose vision as a result of cataracts, annually?

If cataracts are detected early they can be treated and vision restored. Left undetected, would mean permanent vision loss.

So, what are cataracts? Basically, when a cataract develops, there is a loss of transparency on the lens of the eye. It is like a clouding effect on the lens of the eye. This limits the amount of light that can pass through the lens to the retina. Over time, as cataracts progress, less light can pass through the lens and you slowly yet painlessly lose vision. This can often occur as a natural result of aging, but all too often it is found in younger people.

Why?

One risk factor is smoking! Compared to non smokers, smokers of 20 cigarettes or more per day are twice as likely to develop cataracts. The more cigarettes smoked per day, the higher the risk.

Studies show that cigarettes contribute to the formation of cataracts in two ways.

1. Free radicals found in tobacco smoke attack the eye directly, potentially damaging lens proteins and the fiber cell membrane in the lens.*

2. Smoking reduces the body's level of antioxidants and certain enzymes which may help remove damaging protein from the lens.**

Smoking has been associated with a myriad of negative ocular health effects including Age Related Macular Degeneration and Dry Eyes.

As eye care professionals we strongly recommend that smokers seek help to stop smoking. Health campaigns have certainly improved public awareness on the connection between tobacco and visual impairment, so if you are a smoker and  concerned about your ocular health, come in and see one of our highly trained optometrists for a comprehensive eye health evaluation.

*McCarty CA, Nanjan MB, Taylor HR. Attributable risk estimates for cataract to prioritize medical and public health action. Invest Ophthalmol Vis Sci 2000;41:3720–25.

**Shalini VK, Luthra M, Srinivas L et al. Oxidative damage to the eye lens caused by cigarette smoke and fuel smoke condensates. Indian J Biochem Biophys 1994;31:261–66.

Macular Degeneration we now know is the most common cause of legal blindness in an age group greater than 50.  With life expectancy increasing, we will have a potential tsunami of new cases of macular degeneration.  This will create a huge burden on the individual, on their families and on society in general if we do not take a stance against this debilitating condition from now!

To take an effective stance we need to know what risk factors can be modified and what cannot be modified. 

So what are the risks factors for Macular Degeneration

• Age - the older we get the more likely we are to develop MD.
• Female
• Caucasian - especially with light coloured eyes.
• Long Sighted (Hyperopia)
• Family History
• Smoking
• High Blood Pressure
• Overweight
• Lack of Exercise
• Poor Diet
• Ultraviolet exposure

It is not difficult to work out from the risk factors above what you can influence and what you cannot.  What you can influence for macular degeneration or for any other chronic disease are called modifiable risk factors.

What is interesting is that by improving your exercise level and your diet, not only will you reduce your chance of developing macular degeneration, but also reduce your risk of heart disease, strokes and Alzheimers.   Smoking of course is a given, and wearing sunglasses outdoors is easy.

As an aside macular degeneration seems to be linked with lack of Vitamin D, which we create by ultraviolet exposure.

Reducing your weight seems to be a function of controlling portions, increasing protein intake and reducing carbohydrate and saturated fats.  If you can then add at least 4 brisk exercise sessions per week you are done.

Appropriate nutrition is also important so the following should be added to your diet:

• Green Leafed vegetables
• Fish Oil or Flaxseed Oil (Omega 3)
• Take a Lutein supplement

What defines brisk exercise?

This is most important as whoever designed human bodies designed them to move.  Resistance training as well as cardiovascular training are just as important as each other in obtaining weight loss and general fitness and well-being.

Getting your diet right and getting an appropriate level of exercise is harder than it sounds.  It is not surprising that there is such a massive industry around weight loss - the problem is most people try and ultimately fail.  Why?

There are many reasons but the main one is that one needs to make a life time commitment to eating differently and exercise.  Dr Jim Kokkinakis this year joined the Exercise Franchise called Vision Personal Training in Kogarah.  For an investment of $50 per week (yes this might not be cheap enough for everyone) you can use the gymnasium and the fitness classes they run as much as you like, whilst having a one-on-one personal training session per week.  The key to this is that they monitor and advise about your diet, while inspiring you to great fitness. You are accountable to someone and every week you have an appointment that you will keep.

Within 4 months Dr Kokkinakis lost 20 kilos and now fits in to his wedding pants from 25 years ago!

Changing the way you eat and exercise is achievable - it requires an honest commitment.  It certainly can be done by yourself, but being accountable to someone else really helps.

Macular Degeneration potentially could be a huge, huge issue if we do not pounce on it now.  By modifying our lifestyle it is possible to reduce the enormous burden of this disease significantly.

It is safe to say that most people in the world today are aware of the harmful effects of smoking. Everyone should also be aware of the connection between smoking, heart disease and lung cancer.

Yet it amazes me to see how many people still smoke and worse still how many people are taking this habit up knowing the dangers and risks! That said, smoking has decreased significantly over the past 20 years however seems to have plateaued over the past 5 years. 

As I mentioned earlier most people know the connection between smoking and heart and lung disease but how many know that smoking and eye disease are also linked?

On average, people who smoke about 1 packet per day have more than  2.5 times the risk of macular degeneration. They are also at higher risk of getting cataracts and diabetic eye disease.

And if all this isn't reason enough to stop smoking, breaking the habit is even more important if you have diabetes or want to avoid it!

If you smoke and think you are otherwise in great shape, think again. Smoking between 16 and 25 cigarettes per day increase your risk of Type 2 diabetes by 3 times that of a non-smoker.

Quitting this habit is not easy, but the benefits are huge. It is difficult to see the damage that smoking causes to the lungs when you visit your GP, damages to the eyes however are quite clear.

When having an eye exam, your optometrist is in a position to take digital retinal images which can show you the damage that has been caused to your macula.

At The Eye Practice we are able to not only take digital retinal images, we are also able to take OCT images that show damage on an even more microscopic level. The sooner you stop smoking, the sooner the body can start repairing itself.

In future posts we will discuss Smoking and Eye Disease in more detail.