by Marc R. Rose
Clouded membranes around the lens capsule may develop during the weeks or months following cataract surgery. Laser surgery can be used to remedy this problem quickly.
Cataract surgery these days involves so little trauma to the eye that you usually can have both eyes repaired at the same time.
Correcting blurred vision due to cataracts is an important preventive measure against falls. Hip fracture is a major risk for older adults with cataracts, who may not see a bump in the pavement or the last step of the staircase. Early-stage cataracts present the greatest risk because a person afflicted with them won’t know to be more cautious because vision loss isn’t very pronounced.
Cataracts cause distorted vision that may become hazy or blurry.
Once you have had surgery, be sure to wear your sunglasses every time you go outdoors. Those who have had lens implants with ultraviolet light filters have more protection. Those who have not had this type of lens implants need to be careful to protect the macula (central retina) from sun exposure. The protection the clouded lens offered is now absent, and the risk of macular degeneration increases dramatically. Needless to say, we strongly recommend you get the lens implants that have ultraviolet light filters.
The bottom line is that you need not live with cataracts or allow them to rob you of your independence. Try the preventive methods outlined in this book for three to six months, and if any of the following symptoms still exist, seek out an experienced eye surgeon:
Vision that is brighter in one eye than in the other (close one eye and check for brightness of view in the other).
Glare in sunlight or dazzling glare from oncoming headlights when driving at night.
Frequent changes in your eyeglass prescription.
A lazy eye that doesn’t seem to move as sharply as the other one.
Inability to read, watch television, or participate in recreational activities.
Diminished color vision (difficulty matching socks and clothing, or others telling you your, hair is overdyed).
Double vision.
Need to avoid dimly lit areas such as dark restaurants or theaters; need for stronger light bulbs or a flashlight to function at home.
Inability to pass driver’s license eye exam.
Nutritional Prescription for Cataracts
Eat a diet rich in soy, spinach, eggs, asparagus, garlic, and onions. Carrots, cantaloupe, yams, corn, and collard and mustard greens are other foods that will help you keep your lenses clear.
Daily Supplements for Cataracts
Vitamin E: as recommended in your multivitamin
Vitamin C: 1,000–2,000 mg
Beta-carotene: 10,000–25,000 IU
Vitamin A: 5,000–10,000 IU
Zinc: 15–30 mg (total for the day)
N-acetyl cysteine (NAC): 500 mg, 2–3 times daily between meals
Rutin (a bioflavonoid): 250 mg
Quercetin (another bioflavonoid): 1,000–3,000 mg (This inhibits aldose reductase, which may be a primary cause of diabetic cataracts.)
Chromium: 200 mcg, to help you control blood sugar
Riboflavin: 50 mg (If you need to add to your multivitamin, do so.)
Coenzyme Q10: 30–90 mg
Curcumin (turmeric): liberally as a spice, or taken as a supplement according to directions on the bottle.
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IN SHORT…
1. Two-thirds of Americans over the age of seventy have cataracts.
2. In cataracts, the flexible, clear lenses become stiff and opaque. It becomes hard to focus, and vision blurs. There is disturbing glare from oncoming headlights at night and from bright sun. Color vision is altered. In the worst cases, difficulty seeing and recognizing faces can be mistaken for senility and can rob older people of their independence.
3. Diabetic cataracts are commonly seen. They result from accumulation of excess sugar in the lenses, causing them to swell and become inflexible.
4. Don’t hesitate to have cataracts removed. It’s a simple procedure that almost always yields good results. As soon as you feel your quality of life is being compromised, talk with your eye doctor about surgery.
5. A summary of the nutritional “RX” for cataracts can be found in Appendix I at the end of this book.
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7
Preventing and Healing Diabetic Eye Disease
Diabetes is much more common than you might think. Eleven million Americans have diabetes, and 40 percent of them show at least mild signs of related eye disease. There are two forms of diabetes: Type I (insulin-dependent), which occurs in children and adolescents; and Type II (non-insulin-dependent), which affects people past middle age.
The juvenile-onset (insulin-dependent) variety is due to destruction of the cells in the pancreas that make insulin. People with this disorder have to monitor their blood sugar levels carefully throughout life and use insulin injections to mimic what their own insulin-producing system would have done: carry sugar molecules into cells to fuel their functions. Without insulin, cells can’t get the energy they need. This type of diabetes makes up only a small percentage of diabetics.
In the more common adult-onset variety of diabetes, the body makes insulin, but the cells have become resistant to it and it doesn’t work properly. Not only is there too much sugar in the blood, but there’s too much insulin. Adult-onset diabetes tends to occur in people who are overweight and in people with all the symptoms that signal heart disease (high “bad” LDL cholesterol, low “good” HDL cholesterol, and high blood pressure).
In diabetic eye disease, retinal blood vessels break down, causing damage to the retina itself.
Diabetes is a disease with far-reaching implications in the body. Diabetics have more heart disease, kidney disease, blood vessel disease in the extremities, and eye disease than the general population.
Both the lens and the retina are affected by the ineffectiveness of insulin and the excess of glucose in the blood that characterizes diabetes, resulting in macular edema (swelling around the macula), new growth of abnormal retinal blood vessels, and retinal hemorrhage into the vitreous gel that fills up the center of the eye.
The first signs of disease we can distinguish in the eyes of a diabetic are small, berry-like bulges in the capillaries. In later stages, we see small white balls known as “cotton-wool spots” and hemorrhage (leakage of fluid and blood components from capillaries) is visible; the cotton-wool spots are an indication that retinal cells are dying. Chances are, we won’t see a patient just for these signs because there’s no loss of vision yet. This is why it’s important for diabetics to have regular eye exams, even if vision seems fine.
If no changes are made in a diabetic’s intake of crucial nutrients, the blood vessels to the macula continue to leak, causing surrounding retinal tissues to swell. There may be fatty deposits on the macula, which we can see as yellowish-white streaks. Some blurring of central vision is likely. At this stage, the diagnosis would be macular edema.
Left untreated, the disease process leads to damage to the capillaries feeding the retina that is so severe that they become useless, and that part of the eye is unable to get nourishment. In response, the body tries to grow new vessels on the surface of the retina. These weakened vessels can break, leading to hemorrhage into the vitreous humor (the fluid in the center of the eye). Blindness is a very real threat at this point.
Because diabetes is a metabolic disorder that affects every process in the body, the recommendations for reversal of diabetic eye disease start with those proven to help control diabetes. Diabetics have been shown in a number of studies to thrive on exercise and a very low-fat, high–complex carbohydrate diet, or on a low-fat, high-protein, low-carbohydrate diet. You’ll have to experiment to find out which one works best for you.
Mainstream Treatments for Diabetic Retinopathy
As soon as you are diagnosed with diabetes, you should have an eye exam. Be sure the ophthalmologist knows you are diabetic. After that point, you should have yearly ey
e exams to detect any traces of retinal disease.
To see leaks in retinal blood vessels that can lead to macular edema and destruction of vision cells, the ophthalmologist injects a harmless dye into a vein in the arm. Special photographs are taken of the eye, and the dye clearly shows any leaks. This test is called a fluorescein angiogram.
Two techniques are available to treat different aspects of the disease.
One is laser treatment (photocoagulation), used to seal off leaky blood vessels and control swelling, or macular edema. New blood vessel growth, called retinal neovascularization, is much more delicate than older vessels, and this raises the risk of leaky blood vessels that allow blood to escape into the eye fluid. If your eye doctor finds this is happening, scatter laser treatment can be used to prevent further damage. Loss of sight isn’t prevented with laser treatment; it’s only delayed for three to four years. Poor dim-light vision and reduced peripheral vision can be side effects of laser surgery. As with any surgical or medical treatment, a careful weighing of risks and benefits is necessary. No mainstream treatment is totally without risk.
The second technique that your eye doctor may use if he or she finds that you have had a hemorrhage into the vitreous humor that fills the middle of the eyeballs is called a vitrectomy. Precision instruments are used to remove the blood from the vitreous jelly.
Aspirin may be recommended to increase retinal blood flow, but we recommend you avoid it. A large-scale study of 3,711 diabetics showed no advantage for those who used aspirin over those who didn’t. As we mentioned previously, aspirin can aggravate existing eye problems by causing leaky blood vessels, and it can be very harmful to the stomach.
Nutritional Prescription for Diabetic Eye Disease
Treatment for any complication of diabetes begins with good control of blood sugar levels through diet, supplements, stress management, and exercise. The Ten Steps to Restoring Vision and Vitality outlined in the first chapter are your foundation for controlling diabetes. The majority of adults with Type II diabetes can stay off insulin and diabetes drugs if they’re willing to change their lifestyle.
This means regular exercise (at least thirty minutes five times a week and preferably more) and a willingness to virtually eliminate sugar and refined grains from the diet. Refined grains include white and whole-wheat bread (look for whole-grain bread), cakes, cookies, chips, pasta, and white rice aspartame (NutraSweet) for sugar. It’s a known eye toxin, and dangerous chemical with too many side effects for anyone struggling to stay healthy and save vision. If you have a craving for sweets, try some fresh fruit.
The mainstay of a healthy diet for stable blood sugar is vegetables, with protein (eggs, meat, fish fowl, tofu) and complex carbohydrates (brown rice, whole grains) as an accompaniment.
In view of the side effects of diabetes drug treatments, insulin problems, and poorly controlled blood sugar—including heart disease, kindly disease, and vision loss—it seems well worth it to make sacrifices to maintain good health.
Until new lifestyle habits are established and you’re in a routine, blood sugar should be monitored at least four times a day. It’s important to notice what raises or lowers your blood sugar and to keep track of these factors. High blood pressure also should be monitored and well cont4rolled to keep blood vessels healthy. Nearly all high blood pressure can be low management. Everything we recommended above blood pressure as a beneficial side effect.
We ask our diabetic patients to keep a detailed daily journal for at least three months, recording their blood sugar, blood pressure, everything they’ve had to eat or drink, amount of exercise, as well as what has happened during the day. This is powerful and illuminating exercise in self-awareness on every level, and we highly recommend it for anyone with chronic health or emotional problems.
Eat plenty of bioflavonoid-rich foods, like blueberries, cherries, raspberries, and red onions.
Daily Supplements for Diabetic Eye Disease
Some of the supplements listed here, as well as the recommended dietary guidelines above, will improve insulin sensitivity and lower blood sugar levels, so it’s very important to monitor blood sugar when you start this supplement program and make the necessary adjustments.
Vitamin C:2,000 mg (This may alter the color of urine strips; work with a health care professional if you are diabetic and think you need more than 2,000 mg of vitamin C daily).
B vitamins: as recommended in your multivitamin
Vitamin E: as recommended in your multivitamin
Beta-carotene: as recommended in your multivitamin
Quercetin: 500–1,000 mg
Chromium: 100–200 mcg, to help balance blood sugar
Vanadyl sulfate: 10–20 mg, to help stabilize blood sugar
Magnesium: 400 mg, at bedtime, to help control blood pressure
N-acetyl cysteine: 500 mg, 2–3 times between meals
Omega-3 oils from cold-water fish twice a week
Garlic: 1 raw clove, with food, or 1,000 mg of the odorless capsules
Zinc: as recommended in your multivitamin
Carnitine: 500 mg
Alpha lipoic acid: 500 mg in divided doses (Studies are confirming that this powerful antioxidant reduces diabetic symptoms such as nerve damage and dangerously high blood sugar due to insulin resistance. It also protects the lenses from formation of diabetic cataracts. Remember to monitor your blood sugar closely because it can cause a significant drop in blood sugar.)
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IN SHORT…
1. Type II (adult-onset) diabetes is a very common disease in aging Americans and usually strikes those who are overweight and have high blood pressure, high “bad” LDL, and low “good” HDL cholesterol levels. The body still makes some insulin, but it doesn’t do its job of carrying glucose into cells for energy. Levels of insulin and blood sugar can be dangerously high.
2. Type I diabetes involves destruction of the cells of the pancreas that make insulin. Injections of insulin need to be timed appropriately throughout the day so that glucose can enter the cells and fuel their function.
3. Diabetics are more prone to cataracts and blindness due to new blood vessel growth or hemorrhage over the retina than the general population. It’s crucial that you see your eye doctor as soon as you are diagnosed as diabetic and to go for thorough checkups every year.
4. Eating a low-fat, high-fiber diet, avoiding sugar and refined carbohydrates, losing excess pounds, exercising, and learning to cope with stress can keep diabetes under control without drugs.
5. It helps to keep a journal of what you’re eating, how you feel, and blood sugar levels for the first few months after you’re diagnosed. Frequent monitoring and close control of blood sugar can help to stave off eye problems.
6. Laser treatments can preserve sight in those with leaky eye vessels. Vitrectomy is used to “clean up” hemorrhages into the vitreous humor that fills the eyeball. Aspirin may do more harm than good for those with diabetic eye disease. Your best bet, as always, is to use diet, exercise, and supplements to control your diabetes.
7. A summary of the nutritional “RX” for diabetic eye disease can be found in Appendix I at the end of this book.
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8
Preventing and Healing Retinitis Pigmentosa
Retinitis pigmentosa (RP) includes fourteen types of disorders involving the pigmented cells of the retinal surface (epithelium). These visual pigments are part of the cells of the retina and are responsible for the eye’s sensitivity to light. They are shed and replaced by new pigment cells. People with retinitis pigmentosa have abnormal pigment cells that clump together on the retina and can’t be flushed out of the eye. Only a fraction of people with eye diseases suffer from RP, and the fact that it is so rare has impeded the progress of working towards a cure.
Symptoms begin with night blindness, often starting in childhood. A progressive loss of side vision occurs in the person’s third decade of life. Tunnel vision (by the age of forty or fifty) and eventual
total blindness are the end result of retinitis pigmentosa. It’s a difficult disease to have because there is no known mainstream medical treatment. The work being done on retinal cell transplantation is promising, but we still don’t know whether it will provide us with a cure for RP. Up to half of RP cases are genetically linked.
Retinitis pigmentosa is a rare eye disease that affects the pigmented cells in the retina of the eye.
Half of those with RP will develop cataracts, and most have problems focusing, reading, and adjusting to bright light. Headaches are also common, as are the anxiety, anger, and depression that result from the knowledge that vision will fade and eventually disappear.
If you have been diagnosed with RP, you should know that you are not helpless. You can slow the progress of the disease substantially by using the advice in this book. Researchers are looking into theories that an inflammatory process that affects many systems of the body is what causes the damage done by RP. It may be an autoimmune disease like arthritis, where the body develops antibodies (its natural disease-fighting agents) against its own tissues, doing them harm as it would a dangerous bacterial or viral invader.
The most important thing RP patients can do while we seek causes and cures is to give the eye all the tools it needs for maximum antioxidant protection. Look at Chapter 3 for advice on how to boost glutathione levels. You also should carefully read and follow our guidelines in Chapter 9 on digestive tract problems. Supplementation of digestive enzymes (bromelain is particularly gentle and effective) as well as Lactobacillus acidophilus and Lactobacillus bifidus bacteria can make a big difference for those who suffer from gas, bloating, or other symptoms of irritable bowel (diarrhea, constipation, intestinal cramping). Those symptoms mean you aren’t efficiently absorbing the nutrients from the food you eat.
One-third to one-half of those with RP have a family history of the disease. Here are some of the predisposing factors for retinitis pigmentosa in those without a genetic history: