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What Lifestyle Changes Can I Make?

Treatment of early age-related macular degeneration (AMD), which has no medical treatment, into intermediate and late AMD in some cases, can include making some lifestyle changes might help slow the progression of the disease. While Stargardt disease has no treatment, there are changes you can incorporate into your lifestyle to help slow down the effects of the disease. Lifestyle changes alone aren’t enough to treat macular degeneration, but adopting some of these behaviors into your life can help improve your overall health, as well as your eye health.

Diet high in antioxidants

Antioxidants help protect cells from free radicals, which may contribute to cancer risk and other diseases, and a diet high in antioxidants can promote general health and well-being. It is hypothesized that certain antioxidants, namely carotenoids, in the diet can reduce the effect of free radicals on macular pigment and might affect development or progression of AMD.1

What are carotenoids?

Carotenoids can help build and maintain the thickness of the retinal pigment layer, although it will not reverse or change the damage that has already been done by AMD.1 Carotenoids include beta-carotene, lutein, and zeaxanthin. These can be found in foods like carrots, sweet potatoes, spinach, kale, mangoes, plums, and turnips. For some patients, eating a diet high in antioxidants and carotenoids might help slow the progression of the disease.

What else can I do?

According to the American Optometric Association, taking supplements that contain carotenoids, as well as vitamins C, E, and zinc, might also have positive effects on patients with advanced AMD.1 It should be noted that the AREDS2 formula nutritional supplement that contains lutein, zeaxanthin, vitamin C, vitamin E, and zinc has only been proven to be beneficial in those with intermediate dry AMD in at least one eye. As previously mentioned, however, dietary supplements will not reverse any damage that has already been done by the disease.

Smoking cessation

Smoking cigarettes has been shown to be an important factor in the development and progression of macular degeneration, especially AMD. In fact, it is the largest modifiable risk factor for the disease, with smokers having at least a two-fold higher risk of developing AMD compared to non-smokers.2

How does smoking affect your eyes?

Cigarette smoke contains oxidants, which can cause retinal damage when these chemicals travel through the bloodstream. Cigarette smoke also irritates retinal cells, causing an immune response and inflammation, which can be harmful to the eye.2

How can I start on the path to smoking cessation?

Cigarettes are addictive, and it can be extremely difficult to quit smoking. Talk with your doctor about smoking cessation programs that are available, and look into things like behavior modification programs, acupuncture, or medication. Seek out support groups and let your friends and family know that you want to stop smoking – you don’t have to do it alone.

Weight control

There have been mixed findings about weight and AMD, particularly because increased weight is also tied to other risk factors like high blood pressure and heart disease. While more research needs to be conducted specifically about weight and BMI and their connection to AMD, higher levels of physical activity may have a protective effect against AMD.3

Maintaining a healthy weight

However, it is unclear whether any of these associations can be isolated, since maintaining a healthy weight relies upon so many factors, including, but not limited to, healthy eating, exercise, sleep habits, and even stress levels. Overall, keeping your weight in a healthy range is important for general well-being, so it might be a good idea to talk with your general practitioner about weight management strategies. If it involves an exercise routine, see your general physician to ensure that your exercise routine will be safe and appropriate for you.

Blood pressure

As mentioned previously, high blood pressure, or hypertension, is related to increased weight, lack of physical exercise, and a host of other things, including cigarette smoking. It’s also been associated with decreased choroidal blood flow, which has been associated with the development of AMD.3 The longer one remains hypertensive, the higher the risk of AMD and other retinal diseases such as hypertensive and diabetic retinopathy.3

Ways to maintain blood pressure

There are multiple ways of maintaining your blood pressure at healthy levels, including eating a healthy diet, avoiding cigarette smoking, regular physical exercise, and maintaining a healthy weight. There are also medications that might be appropriate to help you control high blood pressure. If you have hypertension, see your general practitioner to talk about how to manage it. It not only affects your eye health but also your overall health and well-being.

Wearing sunglasses/sun protection

While everyone should take steps to protect themselves and their eyes from ultraviolet (UV) light from the sun, those with AMD and Stargardt disease should be especially careful. UV light can contribute to cataract formation and AMD, and even aggravate existing AMD and Stargardt.4,5 Ways to decrease UV exposure may include wearing dark sunglasses or a wide-brimmed hat when going outside or spending time in the sun. UV rays may penetrate clouds, therefore on overcast days, you should still wear UV protective gear even though it may not seem like you need them.

Low-vision devices

Visual impairment can be devastating, but there are many adaptive devices that can help you maintain your independence and allow you to do many of the things you enjoy. Low vision devices like reading glasses with high-powered lenses, video magnifiers, large-print reading material, talking clocks/watches, and computers with speech-to-text services and large print systems can all help you adapt to your daily activities. Ask your doctor about low-vision devices and aids that might be available to you.

Making changes

Lifestyle changes are just part of the treatment for macular degeneration, especially for AMD. While these things alone aren’t enough and can’t cure the condition, they may help slow down disease progression, allow you to adapt to vision changes, and help you take an active part in your health and well-being. Talk with your eye doctor and general practitioner about ways you can make some lifestyle changes to help manage your macular degeneration.

Jaime R. Herndon | January 2019
  1. American Optometric Association. Nutrition and Age-Related Macular Degeneration. 2018. https://www.aoa.org/patients-and-public/caring-for-your-vision/nutrition/nutrition-and-age-related-macular-degeneration. Accessed October 12, 2018.
  2. Dunaief J. Smoking and Age-Related Macular Degeneration. BrightFocus Foundation website. 2016. https://www.brightfocus.org/macular/article/smoking-and-age-related-macular. Accessed October 12, 2018.
  3. Pennington KL & DeAngelis MM. Epidemiology of age-related macular degeneration (AMD): Associations with cardiovascular disease phenotypes and lipid factors. Eye Vis (Lond). 2016; 3:34. Doi: 10.1186/s40662-016-0063-5. Accessed October 12, 2018.
  4. BrightFocus Foundation. Macular Degeneration – Protect Your Eyes From the Sun. 2015. https://www.brightfocus.org/macular/podcast/macular-protect-your-eyes-sun. Accessed October 12, 2018.
  5. Facts About Stargardt Disease. National Eye Institute. 2015. https://nei.nih.gov/health/stargardt/star_facts. Accessed January 28, 2019.