Macular degeneration of the eye is a devastating disease that can steal your eyesight, disrupt your life, and threaten your independence. People with advanced macular degeneration can't drive, read, watch TV, or even see the faces of friends and loved ones.
The problem is that early-stage macular degeneration has no symptoms, so this progressive disorder often goes undetected and untreated until it’s too late. This topic is near and dear to my heart since I’m at risk for macular degeneration.
Over the past 20 years, I’ve helped thousands of patients detect this disease early and use lifestyle interventions to reduce their risk. Since knowledge is power, I want to share what you need to know about preventing macular degeneration and slowing its progression.
What Is Macular Degeneration?
Picture your eye as a camera. The retina is the light-sensing tissue at the back of the eye. It’s responsible for capturing light energy from the front of the eye and transforming that light energy into electrical signals that are then sent to the brain for processing.
The retina is critical for how we see shapes, colors, and motion—and ultimately form images. The macular is a small area in the center of the retina that is responsible for sharp, detailed central vision, or what you see when you look straight ahead.
Your retina and macula are constantly processing light energy. This high metabolic activity generates waste products, called drusen, which look like little yellow or whitish pebbles or stones. (Drusen is the German word for pebbles or small stones.)
Normally, drusen are cleared by a cell layer underneath your retina called the retinal pigment epithelium (RPE). With macular degeneration RPE cells begin to dysfunction and can’t clear drusen as effectively. If this progresses, it can significantly impact your vision, even leading to blindness.
What’s the Difference Between Wet & Dry Macular Degeneration?
Dry (Atrophic) Macular Degeneration: Dry macular degeneration is the most common type of macular degeneration, accounting for 90% of all cases. It’s caused by tiny deposits of drusen that are not cleared.
Early dry macular degeneration causes no symptoms, including no visual changes. The only way to detect dry macular degeneration is with an annual exam where your ophthalmologist dilates your pupils and looks for drusen. So, getting regular eye exams is extremely important.
Left unchecked, drusen continue to accumulate, leading to oxidative stress and inflammation. In its advanced stages, dry macular degeneration can cause significant vision loss, including dark black or grey areas that block areas of your vision.
Although peripheral vision is usually retained, advanced macular degeneration results in loss of central vision and legal blindness. It is the leading cause of irreversible vision loss in people over 60.
Wet (Exudative) Macular Degeneration: This type of macular degeneration occurs when new blood vessels grow in the area behind the retina. Because these abnormal vessels are weak, they leak fluids into the retina and macula, leading to excessive inflammation, tissue damage, the formation of scar tissue, and loss of visual function.
One symptom of wet macular degeneration is metamorphopsia, which is distortion in your vision that causes objects that are straight to look wavy or distorted. Other symptoms can include loss of central vision, where there are areas of dark grey or blackness. Reading, driving, and seeing faces can become extremely difficult.
Age-Related Macular Degeneration Causes & Risk Factors
Some of the risk factors for developing macular degeneration of the eye are beyond your control:
- Age: The older you are, the greater your risk. By age 74, a quarter of Americans will have some degree of macular degeneration.
- Genetics: If you have an immediate family member with the condition, you are more likely to develop it. There are also rare inherited types of macular degeneration that affect young people.
- Sex: More females than males have macular degeneration, primarily because they have a longer life expectancy, and the risk increases with age.
- Ethnicity: White Caucasians have a considerably higher risk of developing macular degeneration than Hispanics/Latinos and African Americans.
- Eye color: Blue, green, and lighter-colored irises contain less protective pigment, which can increase risk.
- Farsightedness: Problems seeing things up close has been linked with a greater likelihood of developing macular degeneration.
The good news is that macular degeneration takes years—and in many cases decades—to develop. So, with regular eye exams and early detection, there is plenty of time to intervene before vision loss becomes an issue.
Preventing Macular Degeneration
- Stop smoking: Smoking is associated with macular degeneration and other eye disorders. In addition to damaging your blood vessels, it depletes levels of lutein, zeaxanthin, and other protective antioxidants. Even secondhand smoke may be harmful. Detoxification and reducing your toxic load beyond smoking are also essential.
- Maintain your ideal weight: Many studies have shown that people who are obese or have an increased waist-to-hip ratio (abdominal obesity) are at higher risk of macular degeneration. This is critically important. Choose foods that are not only healthy but also anti-inflammatory.
- Exercise regularly: Physical activity benefits all aspects of your health, including your eyes. A recent meta-analysis found high levels of physical activity to be protective against early macular degeneration. You want to add movement to your daily life and engage in vigorous activity at least 2 to 3 days a week.
- Eat a healthy diet: Research reveals that healthy diets such as the Mediterranean diet, rich in omega-3s, olive oil, and vegetables, help to stave off macular degeneration. Ensure you eat plenty of kale, collards, mustard greens, Swiss chard, spinach, and other foods with proven eye benefits. These dark leafy greens are nature’s richest source of lutein, zeaxanthin, and meso-zeaxanthin—the carotenoids that make up the protective macular pigment that filters out blue light and counters free radical damage.
- Take supportive supplements: The landmark Age-Related Eye Disease Study 2 (AREDS 2), sponsored by the National Eye Institute, found that supplements containing lutein and zeaxanthin plus vitamin C, vitamin E, zinc, and copper slowed progression of macular degeneration of the eye by about 25% in individuals at highest risk.
- Control your blood pressure: High blood pressure damages blood vessels in the eyes, restricting blood flow and the delivery of oxygen and nutrients to the retina and macula.
- Be aware of blue light exposure: Blue light is a high-energy wavelength of light in sunlight and LEDs, which backlight smartphones, tablets, computers, and other digital devices. Prolonged exposure to blue light from these devices is linked with eye strain, dry eyes, sleep problems, and increased risk of macular degeneration. Try to limit your screen time, especially in the evenings. Plus, the macular pigments, lutein, zeaxanthin, and meso-zeaxanthin act as our eyes’ internal blue light blockers.
How Much Lutein & Zeaxanthin for Macular Degeneration Prevention?
Most Americans get just 1–2 mg of lutein, zeaxanthin, and meso-zeaxanthin in their daily diet. That’s why I believe supplementation with these and other proven nutrients is essential.
If you are concerned about macular degeneration—as all adults should be—I recommend the following daily doses of lutein and zeaxanthin for preventing macular degeneration:
- Lutein 6-20 mg
- Zeaxanthin 2-4 mg
- Meso-zeaxanthin 2 mg
The extract I usually recommend is Lutemax 2020, which contains the same ratio of these carotenoids found in the dark leafy greens known for their vision benefits.
Lutemax 2020 is highly bioavailable, meaning it reliably raises blood levels of lutein, zeaxanthin, and meso-zeaxanthin.
Most importantly, it has been proven to increase macular pigment optical density (MPOD)—the concentration of carotenoids in the macular- one of the best indicators of macular health. This means greater protection against harmful blue light, more robust antioxidant protection, and reduced risk of damage.
Other Protective Nutrients for the Eyes
Other nutrients with proven benefits for the eyes include:
- Vitamins C and E, zinc, and copper: These vitamins and minerals, along with lutein and zeaxanthin, are part of the supplement shown in the AREDS 2 clinical trial to curb the progression of age-related macular degeneration.
- Bilberry: This tried-and-true botanical is a concentrated source of anthocyanins, potent antioxidants that help to reduce eye fatigue, dryness, itching, and redness. Bilberry
may also improve visual accommodation or the ability to switch focus from near to far objects.
- Saffron: A relatively new ingredient for eye health, saffron extract enhances retinal health and helps to improve visual acuity and night vision. It also has positive effects on mood and brain health.
The Bottom Line
A steep rise in macular degeneration is predicted in the next few decades as our population ages—all the more reason to be proactive about your eye health.
There are few age-related macular degeneration symptoms early on, so ensure periodic checkups with your eye doctor, especially after age 50, when your risk increases significantly.
Most importantly, practice prevention. You may not be able to control all risk factors. Still, by making healthy lifestyle choices, boosting levels of protective nutrients, and addressing other conditions linked with macular degeneration, you can dramatically increase the odds of preserving your vision throughout your life.