Loss of Visual Acuity and Environmental Toxins

by Dr. Susan Tanner, MD

In environmental medicine, one of the key things to remember is that any organ system can be targeted and impacted when the body’s threshold of tolerance has been exceeded. Exposures to toxins including environmental contaminants (mold, mycotoxins, chemicals), illnesses such as viruses and other infections, and heavy metals including lead, mercury, cadmium all add to the body’s toxic load over time. The eyes and visual acuity are not spared from the risks of these toxic exposures. Most apparent, as far as vision is concerned, is the issue of macular degeneration, the leading cause of age-related vision loss. Thus, understanding signs and symptoms of macular degeneration as well as taking preventative measures to avoid or mitigate toxic exposure may be a window of opportunity to lessen or reverse vision loss, because once it has progressed, there is no going back to correct damage.

What is Macular Degeneration?

A brief explanation of eye anatomy and how the eyes work may help to begin understanding this disorder. The retina is a layer of nerve cells in the back of the eyeball which detects light waves and then sends signals to the brain to enable vision. The macula is the part of the retina responsible for straight-ahead vision. When the cells of the macula are damaged, through oxidative stress, possibly from a person’s exposure to some of the toxins mentioned above, then visual sharpness or acuity is affected. Driving and reading may become more and more difficult, progressing to the point that they are impossible, and blindness can eventually result.

There also seems to be a genetic predisposition to macular degeneration, but that does not mean that just because your parent(s) may have had it, you, too, will suffer. If you take active steps to protect your vision and to prevent things known to cause macular degeneration early on, you can definitely have a good outcome.

Dry and Wet Macular Degeneration

Part of prevention is understanding the two types of the condition.

1. Dry macular degeneration – Also called atrophic macular degeneration (AMD), dry macular degeneration occurs when the cells of the macula become fragile and break down. The macula gets thinner with age, and usually progresses slowly over several years through the stages of early, intermediate, and late. There are no medical interventions for late, dry macular degeneration.

2. Wet macular degeneration – This condition occurs when blood vessels beneath the retina grow and leak, which then damages the macula. It is the less common type of macular degeneration and is the more severe and progressive form and is the one that more commonly leads to blindness. Any stage of dry macular degeneration can turn into wet, but it wet macular degeneration is always late stage.

Interventions and Treatment Options

There are some medical treatment options for wet macular degeneration to stave off blindness which may help to various degrees in some people. I think the first step in prevention of macular degeneration is the awareness that this can happen when the body has undergone significant or cumulative events which would accelerate oxidative stress. Of course, this brings us back around, again, to the triad of needs for optimal health: clean air, clean food, clean water. While certainly there are additive things to do to reduce the risk, having the “cleans” in place goes farther than any other interventions in reducing the influx of potentially damaging substances. In other words, avoiding the main exposure risks in your air, water, and food, creates the greatest path to preserving eye health.

For supplemental interventions, two large meta-analyses of human studies found that a higher intake of omega-3 fatty acids, especially from fish oil, is associated with a reduced risk of the development and progression of macular degeneration. One of the studies showed that patients with the highest intake of Omega-3 had a 49% reduction in risk of developing age-related macular degeneration! These studies involved hundreds of thousands of subjects. In general, it was found that for each additional 1,000 mg of omega-3 per day, the risk for early macular degeneration was lowered by 6%, and the risk for late macular degeneration was reduced by 22%. (1)

The way that omega 3 fatty acids may work are several different ways:

1. They are structural components of the cell membrane of the maculae. They have anti-inflammatory, neuroprotective and other effects that decrease the processes that lead to macular degeneration. (2)

2. The retina of the eye is an extension of the optic nerve, which extends directly from the brain. Omega-3 fatty acids help to shield the retina from degenerative changes that damage these cells. (3)

In addition to Omega 3 fatty acids, there are other nutrients that have shown very promising protection against eye disease. These fall mainly in the family of the carotenoids. Carotenoids are pigments found in plants, such as lutein, zeaxanthin, and meso-zeaxanthin, which concentrate in the outer membrane of the retina, where they provide structural support to the maculae and protect the cells from harmful wavelengths of light that can damage the eye. One study showed subjects with the highest intake of lutein and zeaxanthin and a 41% lower risk of developing advanced macular degeneration. (4)

Based on this information and these studies, to protect your eyes, I suggest doing the following things–it will not only help with prevention of age-related vision loss but will have beneficial impacts on your body as a whole!

1. Avoid known toxins. Toxins include high levels of mold in your indoor or built environment, chemicals, municipally treated water, and unhealthy foods- anything that accelerates oxidative stress on your body! Do what you can to test and treat your home safely for mold.

2. Consume the full rainbow in your diet. Your diet should include plenty of those antioxidant-rich high lutein/carotenoid substances, such as carrots, leafy greens, blueberries, pomegranate, turmeric.

3. Get plenty of Omega-3 fatty acids. Eat cold water fish from northern seas, such as wild-caught salmon, cod, sardines, and halibut at least once or twice weekly.

4. Consider supplementing with eye micronutrients.  I like polyphenols from berries that contain flavonoids, anthocyanins, proanthocyanins, procyanidins, and resveratrol, Omega 3 fish oils from reputable sources, Vitamin C, and a complete multivitamin with sufficient amounts of copper, zinc, and vitamin E. Lutein supplementation has also been shown to be helpful.

5. Don’t leave out treating your nasal passages! The nose is the superhighway to the brain and the rest of the body for inhaled toxins. Make sure you are consistently addressing your nasal passages by irrigating them with simple saline and an antifungal/antimicrobial additive, and by using a safe, daily-use nasal spray, like CitriDrops Nasal Spray that treats fungus and inflammatory allergens.

(Note: Access to many professional-grade supplements that are not directly linked in this article may here.)

  1. Jiang, Hong, et al. “Dietary Omega-3 Polyunsaturated Fatty Acids and Fish Intake and Risk of Age-Related Macular Degeneration.” Clinical Nutrition, Oct. 2021, https://doi.org/10.1016/j.clnu.2021.10.005.
  2. Harvard School of Public Health. “Fats and Cholesterol.” The Nutrition Source, 24 July 2018, www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/.
  3. Rezende, Flavio A., et al. “Omega-3 Supplementation Combined with Anti–Vascular Endothelial Growth Factor Lowers Vitreal Levels of Vascular Endothelial Growth Factor in Wet Age-Related Macular Degeneration.” American Journal of Ophthalmology, vol. 158, no. 5, Nov. 2014, pp. 1071-1078.e1, https://doi.org/10.1016/j.ajo.2014.07.036. Accessed 26 June 2022.
  4. Wu, Juan, et al. “Intakes of Lutein, Zeaxanthin, and Other Carotenoids and Age-Related Macular Degeneration during 2 Decades of Prospective Follow-Up.” JAMA Ophthalmology, vol. 133, no. 12, 1 Dec. 2015, p. 1415, jamanetwork.com/journals/jamaophthalmology/fullarticle/2448581, https://doi.org/10.1001/jamaophthalmol.2015.3590.
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