How to Prevent Macular Degeneration

Remember...peanuts aren't nuts, they're legumes

Remember…peanuts aren’t nuts, they’re legumes

I saw an optometrist recently for a new eyeglass prescription and mentioned that age-related macular degeneration (ARMD or AMD) runs in my family. ARMD is the leading cause of adult blindness in the West. Thank God, I don’t have it….yet.

The optometrist suggested I start taking eye vitamins to help prevent ARMD. Popular eye vitamin preparations around here are Ocuvite and I-Caps. He said a multivitamin like Centrum might be just as effective., a source I trust, says that supplements for prevention probably don’t work and are not recommended. Which means Centrum would be just as effective: i.e., none of them work.

Instead, UpToDate recommends regular exercise, not smoking, and relatively high consumption of leafy green vegetables, fruits, fish and nuts. Although they didn’t mention it by name, the traditional Mediterranean diet provides all of those.

On the other hand, if you already have macular degeneration (wet or dry), UpToDate recommends these supplements (probably based on the AREDS-2 study):

  • vitamin C 500 mg/day
  • vitamin E 400 mg/day
  • lutein 10 mg/day
  • zeaxanthin 1 mg/day
  • zinc 80 mg/day (as zinc oxide)
  • copper 2 mg/day (as cupric oxide)

An reasonable alternative for non-smokers and never-smokers is the standard AREDS formula. It’s the same as above except it substitutes beta carotene for lutein or zeaxanthin. You can buy both formulations over-the-counter in the U.S. pre-mixed so you don’t have to swallow a handful of pills, just one.

I was in a supermarket yesterday checking out eye vitamins and noted that Bausch and Lomb’s AREDS-2 formula costs about $10/month.

I haven’t decided yet whether I’ll take the optometrist’s supplement advice. Probably not. But I’ll go the diet, exercise, and non-smoking route.

Steve Parker, M.D.

4 responses to “How to Prevent Macular Degeneration

  1. Steve, I heard a program on macular degeneration on NPR last week, where the opthamologists who are experts in this field said the same thing about prevention. Supplements have not been shown to help until it develops—but if I had a strong family history, I am quite sure I would take them anyway–they are quite benign, and I won’t be spending money on cigarettes. 😉

    My suspicion is that starting the supplements sooner than they did in the study would show a difference in development rates.

    (Though I agree–the rest of your “lifestyle choices” are far more important than pills, and good food trumps all!)


  2. There are a few epidemiology studies linking omega 6 PUFA and vegetable fats in general positively to AMD, with inverse associations for nuts and fish; saturated animal fats though stiill associated were the safest fats.
    For example –
    there is a series of these studies by Seddon et al.

    • Thanks, George. Sounds like the paleo diet may be even better than the Mediterranean diet for prevention of AMD. Probably be years, if ever, before we see that clinical study done.