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Dr. Mark Roark Answers The Question — Will a Healthy Diet Reduce My Risk of Blindness?

In previous blogs about diet and eye health, we discussed the important connection between nutrition and vision. Specifically, the lack of vitamin A in third world countries is a frequent cause of night blindness and other serious health problems. In industrialized countries, deficient intake of fruits and vegetables that supply the macular carotenoids lutein, zeaxanthin, and meso-zeaxanthin leads to light sensitivity, glare, and suboptimal vision. In this article, we will explore another vital role played by this unique trio of nutrients in reducing the risk of irreversible, central blindness from an eye disease known as Macular Degeneration.

Macular Degeneration is Increasing Worldwide

Why is this topic so important? Age-related Macular Degeneration, or AMD, is the leading cause of vision loss in Americans above the age of 50, including 1 in 3 above age 75. With 14 million Americans affected, AMD is much more common than other eye diseases such as glaucoma and diabetic retinopathy. The number of people affected with AMD worldwide is projected to rise from the current level of 198 million to nearly 300 million by 2040!

What Causes Macular Degeneration?

Though genetics and age play a key role in AMD, there are certain behaviors that affect aging and change the risk of onset or progression of this disease. It is important to identify these “accelerators of aging” which include inflammation, oxidative stress, pollution, toxins, radiation, disruption of body rhythms, accumulation of metabolic waste, and poor nutrition.

In keeping with this concept, research confirms the importance of several modifiable factors in combating AMD. It is highly recommended to avoid smoking, maintain a good level of physical activity and a healthy weight, protect the eyes from sun exposure, and establish a healthy diet that includes omega-3s (ideally from fish), along with generous amounts of colorful fruits and vegetables.

Macular Pigment: Essential for Macular Health

The macula at the center of our retina contains millions of tightly packed photoreceptors —the rods and cones— and uses oxygen more rapidly than any other part of our body, thus creating high amounts of oxidative stress. The very center of this area, containing only cones that enable color vision and the ability to see fine details, must be given special protection throughout our lives to avoid the potential for cumulative damage that can occur without proper nutrition.

The Macular Pigment (MP) (see Figure 1, modified from MacuHealth) is strategically centered in front of the cones and may create a dense, yellow band to effectively filter blue light and protect from additive radiation damage. The three vital pigments that comprise the MP — lutein, zeaxanthin, and meso-zeaxanthin — also provide superb antioxidant protection.

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Figure 1. Macular Pigment may create a protective layer to filter blue light and reduce radiation damage to the macula. Modified from MacuHealth.

What Does Research Show?

Our knowledge has grown immensely due to research completed over the last few decades. Studies such as the Blue Mountains Eye Study have identified a strong association between the intake of macular carotenoids found in foods such as spinach and kale (see Figure 2) and a reduced risk for AMD. Significant macular protective benefits have also been associated with adherence to the Mediterranean diet. For those already diagnosed with a certain stage of AMD, a daily antioxidant supplement that includes macular carotenoids was shown to significantly reduce risk of disease progression.

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Figure 2. Amount of macular carotenoids lutein and zeaxanthin in various foods.

Our Bodies Cannot Make Macular Pigment

It is critical to recognize that without ingesting proper amounts of the right foods or taking select dietary supplements, we may have exceptionally low (or even NO) macular pigment. This lack of MP can allow accelerated aging of the macular to occur (Figure 1) and unnecessarily increase the long-term risk of central blindness.

I encourage better dietary habits and frequently recommend an effective daily triple carotenoid supplement containing 22 mg of macular carotenoids for my patients. Talk to your eye doctor to get a recommendation on the best supplement for your specific needs.

Does My Diet Really Affect My Vision?

Dr. Mark Roark Answers The Question — Does My Diet Really Affect My Vision?

By Mark W. Roark, OD, Fellow of the American Academy of Optometry
Allisonville Eye Care Center, Fishers, Indiana
*Dr. Roark’s Allisonville Eye Care Center is a member of Nanodropper’s partner clinics. Visit our eyecare professionals page to learn how to join Nanodropper’s list of partner clinics.

Too often, busy Americans fail to consider how their lifestyle choices — including the foods they eat and the supplements they take — may affect their ability to see. This begs the question: Is vision really affected by what I eat, so that my eyesight suffers if I live mainly on fast food and quick snacks?

It has been known for centuries across several cultures that dietary factors are linked to difficulties with vision, specifically with the ability to see in dim light. For example, Hippocrates, the Father of Medicine who lived from 460 BC to 370 BC, recommended eating raw liver when this malady occurred. His “prescription” was quite effective since Vitamin A Deficiency (VAD) is to blame for this condition, and the liver is the storehouse for vitamin A.

In the 1920s, this fat-soluble substance was finally isolated and given a name. Our bodies cannot manufacture vitamin A, but we can convert it from plant pigments such as beta carotene, found in many colorful fruits and vegetables. This essential nutrient can also be obtained directly from foods such as fish, milk, and eggs; research has confirmed it is vital for proper growth and development, a good immune system, healthy skin and mucus membranes, and normal vision.

Severe VAD leads to persistent dryness of the eye, cloudy vision, eye infections, and eventually, vision loss. Vitamin A is also a vital part of the photopigment found in the rods of our retina, allowing our eyes to adapt to changing levels of light. Without adequate vitamin A intake, “night blind-ness” occurs and is considered an early sign of deficiency.

VAD is rare in the industrialized world. However, it remains a major preventable cause of blindness among children and pregnant women in developing countries, many in Africa and South Asia. It is estimated that more than 250 million children worldwide have VAD with up to a half-million new cases of childhood blindness each year.

When VAD is severe enough to cause major eye complications, the one-year survival rate in this vulnerable population is only 40%, with most survivors having some level of blindness. This is not surprising, since a severely malnourished child is nine times more likely to die of common illnesses than a well-nourished child. When caught in time, however, high doses of vitamin A are effective in preventing this devastating outcome.

Fortunately, global initiatives are in place to assist national governments of poorer countries in ad-dressing this public health concern. This effort is led by the Global Alliance for Vitamin A (GAVA), a partnership among several large organizations. One of these, Nutritional International working with GAVA partners and worldwide vitamin A manufacturers, has provided more than 10 billion vitamin A capsules to children in poor countries at a cost of approximately two cents per capsule. Health care workers give children under age 5 a vitamin A dose of 100,000 to 200,000 international units (or IUs) twice yearly by simply snipping the end from the color-coded capsule and squeezing its con-tents into the child’s mouth. Though more work needs to be done, this has benefited many children and prevented an estimated 1.25 million deaths in 40 countries since 1998.

Few Americans suffer from VAD, yet other dietary deficiencies with long-term health implications do exist. Scientific studies confirm that specific nutrients are necessary for optimal vision and to reduce the risk of sight-threatening eye diseases. The unfortunate fact remains that these nutrients are woefully lacking in the typical Western diet. Our next macular nutrition blog will look at these nutritional deficiencies and provide specific guidelines that promote a lifetime of optimal eye health and excellent visual function.

About Dr. Roark

Dr. Roark graduated from Indiana University with a Doctorate in Optometry and founded Allisonville Eye Care Center in Fishers, Indiana. Dr. Roark specializes in the scientific field of visual performance and ocular nutrition, and has lectured frequently to other Eye Care Professionals, both nationally and internationally. He recently co-authored a peer-reviewed article published in a special edition of the Molecular Nutrition and Food Research journal on “Nutrition for the Eye and Brain.”

3 Reasons Why You Should Kickstart the New Year With Vision Therapy

holidays mug blog imageIt’s that time of year again when we sit down with a pumpkin spice latte in hand and think of a resolution we can take upon ourselves for the new year. Here at , we believe that the best resolutions are the ones that positively impact other areas of our lives and enhance our overall quality of life. Vision therapy offers just that! This therapy is made up of a series of customized visual exercises designed to develop or regain visual processing skills.

Vision Therapy is highly effective in treating:

  • Amblyopia, (or “lazy eye”)
  • Strabismus, (or “eye-turn”)
  • Eye movement disorders
  • Focusing disorders
  • Binocular vision problems
  • Vision, balance, and memory problems associated with brain injury

Even those with 20/20 eyesight can benefit from vision therapy because perfect eyesight doesn’t mean perfect vision. Below are the ways in which vision therapy will help you kick-off the new year.

Improve Existing Vision Skills

You’re good at what you do, be it at work, school or sports. But can you do better? By training the eyes and brain to work in unison, you increase your potential for greater performance. Not only will you be more efficient, but performing tasks will become more enjoyable. This especially applies to school-aged children, as their brains are still in rapid development. Vision therapy effectively enables the brain to correctly process information for optimal academic success.

Learn New Skills With Ease

Many people make it their resolution to learn a new skill in the upcoming year but an underlying vision problem can interfere with that. Since learning is 80% visual, vision therapy offers an excellent opportunity to gear up for success! Undiagnosed or untreated vision problems related to convergence and focus can cause memory and reading problems and hinder learning. will use an array of tools, such as prisms, specialized lenses, filters, balance beams, and computerized visual activities to train the eye-brain connection and help you learn more efficiently in almost any area that requires vision.

Gain The Confidence You Crave

Whether you’re a pro-athlete or a 4th grader struggling to read, improved vision skills will boost your confidence. This confidence will surely trickle into other areas of your life leading to increased self-esteem.

Start 2020 by empowering yourself or your child with vision therapy. Call to book your appointment today.

serves patients in Fishers, Carmel, Noblesville, and Indianapolis, and throughout Indiana.

Is My Child Too Young for Vision Therapy?

Preschool Children Vision TherapyThe first years of a child’s life are crucial in ensuring the healthy and normal development of various body parts, especially the visual system. As a child’s body grows, so do the eyes. This can cause changes in vision. Keeping a close eye on, well, your child’s eyes, can help ensure that they are developing in a healthy way.

It’s important for parents and teachers to be on the lookout for problems with visual processing, as they can interfere with a child’s academics, social life, and extracurricular endeavors. This is especially evident during the school years when reading, writing, homework, and after-school activities become a part of their normal daily routine.

Even if a child has no refractive errors (such as nearsightedness or farsightedness) and has 20/20 vision, he or she may still have difficulties with visual processing or focus. These types of visual complications are often more difficult to detect, but may still impact various aspects of a child’s development.

When a child’s visual difficulties hinder their learning or social interactions, it may be time to try vision therapy.

What is Vision Therapy?

Vision therapy is a personalized regimen of exercises that can improve and strengthen visual functions. Each patient has unique needs and different degrees of visual health, which is why and the team at create a customized vision therapy program to get the best results for your child.

Vision therapy is compared to physical therapy, only for the eyes instead of the entire body. The techniques and exercises can teach the eyes to improve specific areas of vision, such as focus, eye teaming, hand-eye coordination, and visual tracking, among other skills. The doctor may include prisms or special eyeglasses to boost the therapy program.

Most children’s vision therapy takes place in our office and usually once a week. You’ll be instructed to continue some of the exercises at home for 15-20 minutes daily, which will support the in-office treatment.

At What Age Can Children Begin Vision Therapy?

Vision therapy is offered to children as young as 6 years of age. Kids can develop problems with visual perception and clarity that aren’t always detected with a standard vision exam or school screening. Of course, every child is different, and the best way to know if they’re ready for vision therapy is to schedule a consultation with .

Does Vision Therapy Really Work?

Vision therapy has been proven to improve visual skills and functions in both children and adults. It is an approved treatment by recognized organizations in the medical community, such as the American Optometric Association and the Canadian Association of Optometrists.

Keep in mind that it can take several months to notice significant improvement. Consistency is key. Young children, especially in the toddler years, need a steady routine to achieve the best possible results.

It’s important to note that vision therapy does not fix your child’s learning abilities or correct any refractive errors. The goal is to improve their visual function so that their skills in reading, writing, schoolwork, and social activities are strengthened for a better quality of life.

Contact and the knowledgeable staff at to schedule a consultation and see whether vision therapy is right for your child.

serves patients in Fishers, Carmel, Noblesville, and Indianapolis, and throughout Indiana.

 

8 Tips to Relieve Winter Dry Eyes

Whether you live in a climate with cold winter weather or you are planning a ski trip up north, winter can be a challenge if you suffer from dry eyes. Dry, cool air, cold winds and even drier indoor heating can cause eye irritation, burning, itchiness and redness, and sometimes even excessively watery eyes as more tears are produced to compensate for the dryness. Many people have a chronic feeling that they have something in their eye and some even experience blurred vision. These symptoms can be debilitating!

Dry eyes is one of the most common complaints eye doctors get from patients during the winter season, especially in the cooler climates. That’s why we’d like to share some tips on how to relieve dry eye discomfort, and how to know when your condition is serious enough to come in for an evaluation.

Tips to Relieve Winter Dry Eyes:

  1. Keep eyes moist using artificial tears or eye drops. You can apply these a few times each day when the eyes are feeling dry or irritated. If over-the-counter drops don’t help or if you have chronic dry eyes, speak to your eye doctor about finding the best drops for you. Since not all artificial tears are the same, knowing the cause of your dry eye will help your eye doctor determine which brand is best suited for your eyes.
  2. Use a humidifier to counteract the drying effects of indoor heaters or generally dry air.
  3. Point car vents or indoor heaters away from your face when the heat is on. Try to keep your distance from direct sources of heating, especially if they blow out the heat.
  4. Drink a lot! Hydrating your body will also hydrate your eyes.
  5. Protect your eyes outdoors with sunglasses or goggles – the bigger the better! Larger, even wrap-around glasses as well as a hat with a wide brim will keep the wind and other elements out of your eyes. If you wear goggles for winter sports, make sure they fit well and cover a large surface area.
  6. Soothe dry eyes using a warm compress and never rub them! Rubbing your eyes will increase irritation and may lead to infection if the hands are not clean.
  7. Give your eyes a digital break. People blink less during screen time which is why extensive computer use can lead to dry eyes. Follow the 20/20/20 rule by taking a break every 20 minutes to look 20 feet away for 20 seconds and make sure you blink!
  8. For contact lens wearers: If you wear contact lenses, dry eyes can be particularly debilitating as the contact lenses can cause even further dryness and irritation. Contact lens rewetting drops can help your eyes feel better and may also allow you to see more clearly. Not all eyedrops are appropriate for use with contact lenses, so ask your optometrist which eyedrop is compatible with your contacts and cleaning solution. If rewetting drops don’t help, consider opting for glasses when your dry eyes are bad, and speak to your optometrist about which brands of contact lenses are better for dry eyes. Many people find dry eye improvement when they switch to daily single use contact lenses.

Chronic Dry Eyes or Dry Eye Syndrome

Dry eye syndrome is a chronic condition in which the eyes do not produce enough tear film, or do not produce the quality of tear film needed to properly keep the eyes moist. While winter weather can make this condition worse, it is often present all year round. If you find that the tips above do not alleviate your discomfort or symptoms, it may be time to see a optometrist to see if your condition requires more effective medical treatment.

Diabetes and Your Eyes

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

  • Blurred or fluctuating vision or vision loss
  • Floaters (dark spots or strings that appear to float in your visual field)
  • Blind spots
  • Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.

April is Women's Eye Health and Safety Month

Hey women! Did you know that women are more likely to suffer from vision problems and are at higher risk of permanent vision loss than men? Well 91% of the women surveyed recently didn’t know that, which means that many of them aren’t taking the necessary precautions to prevent eye damage and vision loss.  

According to a recent study, the statistics for many of the major vision problems show that women have a higher percentage of incidence than men. These include:

  • Age-related Macular Degeneration 65%
  • Cataracts 61%
  • Glaucoma 61%
  • Refractive Error 56%
  • Vision Impairment 63%

Women are also more susceptible to develop chronic dry eye, partially because it is often associated with other health issues that are more common in women such as ocular rosacea which is three times more prevalent in women.  Hormonal changes during pregnancy and menopause can also contribute to dry eye.  

It’s important for women to know the risks for eye-related diseases and vision impairment and the steps they can take to prevent eventual vision loss.  Here are some ways that you can help to protect your eyes and save your eyesight:

  • Find out about family history of eye diseases and conditions.
  • Protect your eyes from the sun by wearing 100% UV blocking sunglasses when outdoors.
  • Don’t smoke.
  • Consume a healthy diet with proper nutrition and special eye health supplements as prescribed by an eye doctor.
  • Adhere to contact lens hygiene and safety.  
  • Adhere to cosmetic hygiene and safety precautions. 
  • Protect your eyes against extended exposure to blue light from computers, smartphones and LED lamps. 
  • If you are pregnant or planning to become pregnant and have diabetes, see an eye doctor for a comprehensive eye exam. In women who have diabetes, diabetic retinopathy can accelerate quickly during pregnancy and can present a risk for the baby as well. 

Mothers are often charged with caring for the eye health of the entire family, but too often their own eye health needs fall to the wayside. It is critical that mothers take care of their eyes and overall health so that they can be in the best condition to care for their families. 

Speak to your eye care professional about your personal eye health and vision risks and the precautions and measures you should take to protect your eyes.  Encourage the other women in your life to do so as well.  Once vision is lost, it often can’t be regained and there are many steps you can take to prevent it with proper knowledge and awareness.  

The most important way to prevent vision loss is to ensure you schedule regular eye exams. Don’t wait for symptoms to appear as many eye issues are painless and symptomless, and sometimes by the time you notice symptoms, vision loss is untreatable. 

Understanding Eye Color

eyes green close up woman

Eye color is a hereditary trait that depends on the genes of both parents, as well as a little bit of mystery. The color of the eye is based on the pigments in the iris, which is a colored ring of muscle located at the center of the eye (around the pupil) that helps to control the amount of light that comes into your eye. Eye color falls on a spectrum of color that can range from dark brown, to gray, to green, to blue, with a whole lot of variation in between. 

Genetics

The genetics of eye color are anything but straightforward. In fact children are often born with a different eye color than either of their parents. For some time the belief was that two blue-eyed parents could not have a brown-eyed child, however, while it’s not common, this combination can and does occur. Genetic research in regards to eye color is an ongoing pursuit and while they have identified certain genes that play a role, researchers still do not know exactly how many genes are involved and to what extent each gene affects the final eye color.

The Iris

Looking at it simply, the color of the eye is based on the amount of the pigment melanin located in the iris. Large amounts of melanin result in brown eyes, while blue eyes result from smaller amounts of the pigment. This is why babies that are born with blue eyes (who often have smaller amounts of melanin until they are about a year old) often experience a darkening of their eye color as they grow and develop more melanin in the iris. In adults across the globe, the most common eye color worldwide is brown, while lighter colors such as blue, green and hazel are found predominantly in the Caucasian population. 

Abnormal Eye Color

Sometimes the color of a person’s eyes are not normal. Here are some interesting causes of this phenomenon.

Heterochromia, for example, is a condition in which the two eyes are different colors, or part of one eye is a different color. This can be caused by genetic inconsistencies, issues that occur during the development of the eye, or acquired later in life due to an injury or disease. 

Ocular albinism is a condition in which the eye is a very light color due to low levels of pigmentation in the iris, which is the result of a genetic mutation. It is usually accompanied by serious vision problems. Oculocutaneous albinism is a similar mutation in the body’s ability to produce and store melanin that affects skin and hair color in addition to the eyes.

Eye color can also be affected by certain medications. For example, a certain glaucoma eye drop is known to darken light irises to brown, as well as lengthen and darken eyelashes.

Eye Color – It’s More Than Meets the Eye

It is known that light eyes are more sensitive to light, which is why it might be hard for someone with blue or green eyes to go out into the sun without sunglasses. Light eyes have also shown to be a risk factor for certain conditions including age-related macular degeneration (AMD).  

Color Contact Lenses

While we can’t pick our eye color, we can always play around with different looks using colored contact lenses. Just be sure that you get a proper prescription for any contact lenses, including cosmetic colored lenses, from an eye doctor! Wearing contact lenses that were obtained without a prescription could be dangerous to your eyes and your vision.  

 

 

 

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