Help With Eye Function

Improve Your Vision

There was a time when meadow, grove, and stream,
The earth, and every common sight
To me did seem
Apparelled in celestial light,
The glory and the freshness of a dream.
It is not now as it has been of yore;
Turn wheresoe'er I may
By night or day
The things which I have seen I now can see no more.
Ode: Intimations of Immortality from Recollections Of Early Childhood
(verse 1 of 11)
William Wordsworth, 1807

nfortunately, as Wordsworth complains in his poem, we lose our ability to "see" as we age. The trap many people fall into - as much today as in the 19th Century - is that aging is "natural." So we're conditioned to believe that we should accept the degeneration of our senses and resign ourselves to the loss of "celestial light," our sight. To the contrary, rather than remain trapped or complain about our losses, it is decidedly better to resolve to do something to solve the problem. By understanding and outsmarting the process of aging - by preserving our mind, our bodies, and our senses as long as we can - we can still be here when the future arrives. Then, with the help of biomedical science, we may yet reclaim our youth.

Nonetheless, if you want to live a long and full life, you need to take care of the biomachinery that provides you with your principal source of knowledge, your eyes. Maintaining good vision is your best defense, and your eyes are your greatest tool for acquiring the knowledge to do just that. Your goal is to be able to say, "The things which I have seen (in my youth) I now can see once more!"

UNBLINDING OURSELVES TO SCIENCE
How are we to best address the health needs of our eyesight . . . what are we to do? Turning to the mainstream of clinical medicine leaves a great deal to be desired. This is what one scientific review has to say:

The leading causes of visual impairment in North Americans are age-related, but appropriate care can preserve useful vision for most older adults. Cataract surgery is highly successful. Early detection and treatment of glaucoma can prevent vision loss. Laser treatment is remarkably effective against diabetic retinopathy. Vision loss due to macular degeneration cannot be delayed in all patients, but low-vision rehabilitation can maximize the usefulness of remaining sight.1

Not exactly cheery. Either surgery or resignation is the prescription. But those of us who swim out of the mainstream know that reviews of this sort are often tainted or skewed towards the old-boy networks. Surgery has a lot more profit in it than prevention through education and nutrient supplements. Paraphrasing British rock 'n roll composer Thomas Dolby, "We must become unblinded by science." The only way to find out what's really out there is to intelligently scrutinize for ourselves what science is telling us.

PRINCIPAL CAUSES OF EYESIGHT PROBLEMS
The four most prevalent age-related ocular diseases are macular degeneration, open-angle glaucoma, cataract, and diabetic retinopathy. Fourteen million Americans currently suffer from age-related macular decline (ARMD), accounting for as much as one-third of the 900,000 new cases of blindness in the United States per year. While the disease remains incurable, it is possible to enhance some of the functions of the eye that deteriorate with age, thus helping to ward off a resignation to helplessness or to expand one's options beyond the growing reliance on the knife to solve our vision problems. A deeper look into the backstream scientific literature, washing rapidly toward the shores of respectability, yields an assortment of hopeful, recent and past studies. These studies show that the consumption of certain dietary supplements can be helpful in maintaining and to some degree restoring proper visual function.

ARMD AND DANGEROUS
The macula is the small spot in the center of the retina on the back interior wall of our eyes, responsible for what we see in the center of our visual field. When operating properly, it provides clarity and sharpness to our vision. This is especially important when reading, driving, recognizing faces, driving a car or anything requiring detailed discrimination. As aging "normally" occurs, ARMD gets worse and our vision blurs and becomes distorted. Lines that would appear straight without ARMD start to become wavy. In time, ARMD may actually block out the center of our sight causing us to become frontally blind.

Fortunately, there is an herbal extract that has been scrutinized for its effect on vision in many European countries, but not here in the U.S. That extract is vinpocetine, which is known to increase cerebral blood flow. Studies have found that in this regard it can improve the dynamics of the eyeground circulation.2 The eyeground is all of the area in the back of the eye which includes the retina and the macula. The macula is the part of the eye concerned with the visualization of fine details. Blood flow circulation is considered to be of great significance for macular health. In fact, one recent study has suggested that ARMD is actually a vascular disorder and that the problem may be a localized case of atherosclerosis.3

In a study of 100 patients, 46 were treated with vinpocetine 10-30 mg/day and 54 were given 30-45 mg/day.4 Significant and relatively quick improvement was obtained for a wide variety of vascular dysfunctions, including those of the eyeground. In another study, in order to increase circulation in the eyeground, vinpocetine was administered to 100 predominantly atherosclerotic patients to increase circulation.5 The ability to distinguish fine details improved in 88 cases, with their visual acuity enhanced 73% on average. In the other twelve subjects there was no positive change, but neither was there any further decline. When the effect of vinpocetine on occlusions and atherosclerotic retinopathies of the central retinal artery was examined, improvement was found to be nearly three times (267%) greater than that of control subjects. This is very significant. At 20 to 30 mg of infused vinpocetine per day, there were few if any side effects, and those disappeared upon dose reduction. Visual improvement occurred as blood pressure normalized causing gentle dilation (relaxation) of the blood vessels in the central retinal arteries.

In another study, three divided daily doses of vinpocetine at 15 mg each were given to 26 ophthalmological patients for periods of from two weeks to three months.6 As long as the course of supplementation lasted, there was significant improvement of visual acuity. Researchers determined that vinpocetine increased blood flow in the retinal precapillary and capillary system, especially to the area previously deprived of oxygen. Sclerosis of the choroid, the vascular layer of the eye between the sclera and the retina, was also found to be relieved due to the effect of the vinpocetine on improved blood flow in the choroid capillaries.

CAROTENOIDS AND AGE-RELATED MACULAR DEGENERATION
Harvard researchers found that individuals who consume the most carotenoids in their diet had a 43 percent lower risk for ARMD than those who ate the least.7 Two carotenoids, in particular, were more strongly associated with a reduced risk for ARMD: lutein and zeaxanthin. This study indicates that higher consumption is good, but can a steady diet of spinach and corn (concentrated sources of lutein and zeaxanthin) increase the macular concentration enough?

The answer is not clear. However, a study was conducted showing that 30 mg of free lutein per day in supplement form could increase concentrations of this carotenoid in the macula by a significant degree.8 The result of this increased concentration of lutein resulted a 30 to 40% reduction in oxidation-promoting blue light reaching the photoreceptors, retinal pigment epithelium, and other vulnerable tissues affected by ARMD.

IMPROVED NIGHT VISION AND EYE BURN RECOVERY
Vincamine is a natural extract of vinca plants, as is vinpocetine. In comparative studies, its benefits have been superseded by vinpocetine and without the side effects associated with vincamine. When vincamine was administered to 18 patients with choriod-retinal circulatory problems and senile macular degeneration diseases, the results were impressive: 71.5% of 14 patients with senile macular degeneration were found to have significant improvement.9 The results were not as good for those with chorioretinitis (inflammation of the choroid and retina) and diabetic retinopathy (retinal pathology). However, overall, improved night vision was noted without side effects.

A double-blind trial of 59 ophthalmological patients also found vinpocetine to be of value for senile retinal macular degeneration.10 The researchers attributed the benefits to improvement of cerebral vascular circulation and the retinal vascular system. Enhanced blood hemodynamics and hemopoietic (blood cell forming) functions improved their visual acuity.

Vinpocetine has been able to help restore normal blood circulation, following vascular damage due to severe burns to the eyes.11 In 136 patients with a variety of different burn severities, vinpocetine helped the restoration of blood filling. It did this rapidly (within only a few months) after the burns occurred by halting inflammation and accelerating the regenerative processes.

VINPOCETINE FOR GLAUCOMA
Glaucoma is a group of eye diseases characterized by an increased pressure within the eye which causes abnormal changes in the optic disc and defects in the field of vision. A variety of hypotensive (blood-pressure lowering) preparations were used to treat 86 patients with open-angle glaucoma.12 The results achieved were positive, especially for one class of hypotensives. Yet, in order to correct any possible vascular disturbances, the blood vessel protector vinpocetine was given over a two year course. Eighty eight percent of the glaucoma cases achieved stabilization.

OTHER NUTRIENTS FOR GLAUCOMA
Forty five patients with early stage open-angle glaucoma were administered either 75 mg (26 subjects) or 150 mg (19 subjects) of alpha lipoic acid.13 There were 31 controls, also with open-angle glaucoma who received only hypotensive therapy. The best results were achieved by those subjects who got the higher levels (150 mg) of alpha lipoic acid. Measurements of vision acuity, visual function, improved sensitivity, and improved tearing was found, especially for those in stage II of open-angle glaucoma. Lipoic acid is thought to improve eye function due to its antioxidant properties and its mitochondrial enhancement influence on ocular tissue metabolism. Helping to explain its role as angioprotector, vinpocetine has been shown to act as a powerful antioxidant.14 It seems to be more potent than vitamin E in that regard.

A variety of vitamins have been found to work synergistically and as cofactors along with alpha lipoic acid in the eye. These include vitamins B1 (thiamine), B2 (riboflavin), B5 (pantothenic acid), B6 (pyridoxine) and C (ascorbate).15 An interesting note: Thiamine levels have been found to be lower in glaucoma patients.16

REDUCING DIABETIC RETINOPATHY
Diabetics are predisposed to retinopathies, meaning they develop abnormal retinal vessels leading to vision impairment. Vinpocetine was given to a combined total of 133 subjects (aged 15 to 55), 87 of whom had chronic liver problems caused by the hepatitis B virus, and two reference groups, 26 patients with uveitis (inflammation of the uvea, one of the coverings of the eye) and 20 normal subjects.17 The researchers found that vinpocetine significantly stabilized functional disorders of the retina, detected in 93.2% of hepatitis B group. Retinal lesions were also reduced in severity by vinpocetine.18

NUTRIENTS THAT CAN HELP CATARACTS
The National Institute for Cancer Research in Genoa, Italy has found in a recent study that the chronic deficiency of various vitamins can influence the occurrence of some chronic degenerative diseases including cataract formation.19 This is no secret for those familiar with the widespread damage that free radicals can do. The vitamins beta-carotene, vitamin E and vitamin C have received the most attention for their ability to arrest oxidative damage from free radicals.

The lens of our eye contains a special pump for the amino acid taurine because taurine is so important to its function. Changes in lens protein structure and lens function due to glycosylation (the generation of carbohydrate radicals) and oxidation are thought to play a significant role in the pathogenesis of cataracts. Taurine is thought to inhibit glycation (the generation of protein radicals) and protect against free radical damage which plays a role in cataract formation.20 Indeed in rabbits, taurine did inhibit the formation of galactose-(sugar) induced cataracts.21 Other antioxidants are also believed to be of value in protecting the lens from damage against opacification (becoming opaque). They are tocopherol (vitamin E), ascorbic acid (vitamin C), alpha lipoic acid, and the amino acid taurine.22 A study examining what happens to astronauts, jet crews, and military radiation-accident personnel subjected to protein leakage and chronic low level radiation verified the protective function of vitamins C and E, alpha lipoic acid, and taurine.

OTHER NUTRIENTS FOR EYE PROBLEMS
There are a wide variety of other nutrients that can be of benefit to the eye.23 Some, rather than participating directly in an ocular function, promote general nutrition on which the eye depends. Both the lens and retina are subjected to oxidative assault and the anti-oxidant vitamins A, C and E can be protective. Zinc plays a role in retinal metabolism and may be beneficial in macular degeneration. Selenium also participates in antioxidant activity and thus is important. Polyphenols, found in green tea and wine, may also be important because of their antioxidant and anti-atherogenic properties.24 The eye contains many fatty acids highly susceptible to free radical damage as well as a complex of fine capillaries that nourish its parts.

SAILING THE SEAS OF VISION
In conclusion, eye health is an important and often overlooked part of most people's nutritional program. Yet it is critical to pursue it avidly, because of the extremely important role that eyesight serves. Without good eyes, we can not even access the information on this page, and our entire health program is like a boat without a rudder or a sail; we simply feel "lost at sea." If we become rudderless, as visual impairment increases with age, other liabilities of aging compile and compound.25 For example, visually impaired elders are likely to have less mobility than those who are non-visually impaired. Difficulty in walking, going outside, or even getting out of bed seems to be associated with visual decline. Specifically, if you're visually impaired and over the age of 65 but not yet 74, your mobility may be decreased by three to four times, unless you do something about it.

Whatever your age, it's not too soon to take preventive action against age-related visual decline. Ultimately, Wordsworth's conclusion in Intimations of Mortality is that the freshness of the way we looked at the world, when we were young, can be refreshed again. Although Wordsworth would not have said so, science too can refresh our vision, literally as well as figuratively.

References

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  2. Kahan A, Szabo M. The effect of ethyl apovincaminate on the circulation of the eyeground. Arzneimittel-Forsch. 1976;26:1965-1969.
  3. Friedman E. A hemodynamic model of the pathogenesis of age-related macular degeneration. Am J Ophthalmol. 1997;124:677-682.
  4. Szobor A, Klein M. Ethyl apovincaminate therapy in neurovascular diseases Arzneimittel-Forsch. 1976;26:1984-1989.
  5. Kahan A, Olah M. Use of ethyl apovincaminate in ophthalmological therapy. Arzneimittelforschung 1976;26:1969-1972.
  6. Brooder G, And L, Doman J. Preliminary report on the use of ethyl apovincaminate in affections of the eyeground. Arzneimittel-Forschung 1976;26:1973-1975.
  7. Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC, Farber MD, Gragoudas ES, Haller J, Miller DT, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA 1994;272:1413-1420.
  8. Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE. A one year study of the macular pigment: the effect of 140 days of a lutein supplement. Exp Eye Res. 1997;65:57-62.
  9. Amorim CA. Clinical study on the action of vincamine on the chorioretinal circulation. Rev Bras Clin Ter. 1973;2:621-626.
  10. Imre G, Nemeth B. The effect of cavinton on cerebrovascular resistance and its use in ophthalmological patients. A double-blind trial. Ther Hung. 1981;29:120-123.
  11. Dmitriev SK; Legeza GV. The characteristics of the engorgement of the eye vessels in the dynamics of the burn process. Oftalmol Zh. 1990;1:21-25.
  12. Pliushko DG; Sobko EG Drug therapy of initial open-angle glaucoma. Oftalmol Zh. 1989;2:72-74.
  13. Filina AA, Davydova NG, Endrikhovskii SN, Shamshinova AM. Lipoic acid as a means of metabolic therapy of open-angle glaucoma. Vestn Oftalmol. 1995;111:6-8.
  14. Olah VA, Balla G, Balla J, Szabolcs A, Karmazsin L. An in vitro study of the hydroxyl scavenger effect of Cavinton. Acta Paediatr Hung. 1990;30:309-316.
  15. Filina AA, Sporova NA. Effect of lipoic acid on tyrosine metabolism in patients with open-angle glaucoma. Vestn Oftalmol. 1991;107:19-21.
  16. Asregadoo ER. Blood levels of thiamine and ascorbic acid in chronic open-angle glaucoma. Ann Ophthalmol. 1979;11:1095-1100.
  17. Slepova OS, Kushnir VN, Zaitseva NS, Titarenko ZD. Dumbrava VA. Clinical and immunological signs of retinal involvement and potentialities off its drug correction in patients with chronic diffuse viral diseases of the liver and in Australian antigen carriers. Vestnik Oftalmologii. 1994;110:27-29.
  18. Olah Z, Potocky M. Treatment of vascular retinal lesions with Cavinton. Cesk Oftalmol. 1981;37:19-23.
  19. Filiberti R, Giacosa A, Brignoli O. High-risk subjects for vitamin deficiency. Eur J Cancer Prev. 1997;6(Suppl 1):S37-S42.
  20. Devamanoharan PS, Ali AH, Varma SD. Prevention of lens protein glycation by taurine. Mol Cell Biochem. 1997;177:245-250.
  21. Malone JI, Benford SA, Malone J Jr. Taurine prevents galactose-induced cataracts. J Diabetes Complications. 1993;7:44-48.
  22. Bantseev V, Bhardwaj R, Rathbun W, Nagasawa H, Trevithick JR. Antioxidants and cataract: (cataract induction in space environment application to terrestrial aging cataract). Biochem Mol Bill Int. 1997;42:1189-1197.
  23. Brown NA, Bron AJ, Harding JJ, Dewar HM. Nutrition supplements and the eye. Eye 1998;12(Pt 1):127-133.
  24. Brouillard R, George F, Fougerousse A. Polyphenols produced during red wine ageing. Biofactors 1997;6:403-410.
  25. Maino JH. Visual deficits and mobility. Evaluation and management. Clin Geriatr Med 1996;12:803-823.

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