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Best Way to Age-Proof Your Vision

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Simple lifestyle changes can help you control three common diseases of the older eye: glaucoma, cataracts and age-related macular degeneration. A Johns Hopkins expert shares what the science shows.

What the Experts Do
Nourish Eyes—Inside and Out

When it comes to protecting her eyes, Johns Hopkins ophthalmologist Maria Soledad Romero, M.D., starts with a healthy diet: lots of tofu, salmon and broccoli. She also uses artificial tears in the morning and evening to prevent dry eyes, and always wears sunglasses when she’s out and about.

The effects of aging are hardly limited to wrinkles, creaky knees and gray hair. Just consider the plethora of age-related conditions that can affect your eyes, including cataracts, age-related macular degeneration (ARMD) and glaucoma. What you need to know: Although they are certainly more common in people 50 and older, their appearance is not inevitable.

“It’s very difficult to define what ‘normal’ aging of the eyes is,” says Johns Hopkins ophthalmologist Maria Soledad Romero, M.D. “There are so many variables, such as lifestyle choices, patient history and exposure to certain medications or chemicals.” For instance, African Americans, Latinos and people with a family history of glaucoma are more likely to develop the disease, she says.

That’s why Romero recommends that all adults have a comprehensive eye exam when they turn 40. The results will serve as a benchmark to track any changes in the coming years.

Protecting Your Aging Eyes

Although you can’t control a family history of glaucoma or macular degeneration, there are certain lifestyle changes you can make to reduce your risk of developing eye conditions, says Romero.

Stop smoking.

Current and former smokers have up to four times the risk of developing ARMD—the leading cause of blindness in the U.S.—than those who never smoked. The risk remains high even up to 20 years after quitting. In fact, an Australian study estimated that as many as one in five cases of ARMD-related blindness in that country could be related to smoking. Researchers say there are several reasons for the increased risk in smokers, including cellular changes, oxidative stress and vascular constriction.

Maintain a healthy weight.

Being overweight affects far more than your heart, blood pressure and blood sugar control; it can also affect your vision. Most studies find that overweight and obese people are far more likely to develop cataracts than those who weigh less. Unfortunately, losing the extra weight once you’ve gained doesn’t seem to prevent cataracts.

Studies also suggest that obesity increases the risk of glaucoma, likely by increasing the build up of fluid inside the eye as well as from the effects of high blood pressure, diabetes, high cholesterol and insulin resistance. Obesity also increases the risk of ARMD, possibly by increasing inflammation and oxidative stress in the eyes. Further studies are needed to see if losing weight can improve these conditions.

Slip on the shades.

People with fair skin and blue eyes have a much higher risk of developing cataracts. Indeed, a 1998 Johns Hopkins study was among the first to link sun exposure to an increased risk of cataracts. Exposure to ultraviolet (UV) light also increases the risk of ARMD. The increased UV light is thought to cause changes in the metabolism of the cells in the retina and lens, Romero explains.

Just make sure your sunglasses protect against UV-A and UV-B wavelengths, and that they wrap around your face. A Johns Hopkins study found that up to 20 percent of the sun’s rays can “leak” through the sides of typical glasses.

Enjoy regular activity.

Add this to the list of benefits of exercise: A long-term study of more than 15,000 people found that people who were physically active and drank occasionally experienced less vision loss over 20 years than those who didn’t exercise or drink at all. Remember: Moderate drinking is no more than two drinks a day for men; one for women. And always check with your doctor—who knows your health status best—to make sure alcohol is appropriate for you. 

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