Corn, orange peppers, red grapes, kiwi fruit, orange juice, courgettes and other marrows are also good sources of the antioxidants lutein and zeaxanthin.

People who ate more fibre from breads and cereals had less severe cataracts. She also found that people who took a vitamin supplement had a 40 per cent lower risk of developing cataracts.”

Smoking Increases Your Risk of Eye Disease

Men and women who smoke 20 cigarettes or more a day are two and a half times as likely to suffer from macular degeneration than those who’ve never smoked. Even when people quit smoking, they continue to have a higher risk of developing macular degeneration over the next 10 years than non-smokers. There is also a higher risk among smokers of developing cataracts.

Taking Responsibility for a Healthy Diet

Eat a balanced diet emphasizing a wide variety of whole grains, fruits and vegetables which are naturally low in fat, contain no cholesterol and offer potent disease-fighting properties due to the vitamins, minerals and fibre they provide. Most of our calories should come from whole grains, breads, cereals, fruits and vegetables. Meat, dairy, fats, oils and sweets are shown as smaller parts of the pyramid and should be eaten sparingly. Planning a diet that contains at least five servings of fruits and vegetables each day is also consistent with recommendations from the Cancer Society.

Antioxidants such as beta-carotene, lutein, vitamins C and E, and other nutrients such as selenium, zinc and copper which are found in the macula of the eye. Although no specific dietary recommendations have been formalized, you should consider including foods that contain these nutrients in your diet. Some foods which contain the nutrients found in the macula of the eye are:

• dark leafy green vegetables such as spinach or kale
• oranges or other fruits high in vitamin C
• a wide variety of other fruits and vegetables which are high in nutrients, including (but not limited to) carrots, broccoli and tomatoes
• a variety of whole grains, including (but not limited to) whole wheat and oats
• lentils, soybean products, almonds, sunflower and sesame seeds.

Scientists around the world are now finding compelling consistent evidence that a diet with a high intake of fruits and vegetables offers a protective effect against disease.

Macular degeneration causes significant vision loss in thousands of people each year, and there are few treatment options at this time. Nutrient therapy techniques are currently being studied to see if they can be useful in slowing or improving the condition.

A cataract is an accumulation of dead cells in the inner lens, which makes the lens cloudy and obstructs the passage of light through it, creating blurred vision or glare. Low nutrition levels, a build-up of waste products and ultraviolet light can contribute to the formation of cataracts. Cataracts affect more people than macular degeneration and surgical treatment currently consumes a large part of health care budgets. Clinical experience suggests that cataracts are sometimes reversible and may be improved with a program that includes nutrition therapy and moderate exercise.

A High-fat Diet Can Increase Your Risk of Eye Disease

We’ve all heard about the research showing that a diet high in saturated fat and cholesterol can lead to obesity, atherosclerosis (clogged arteries), high blood pressure, stroke and heart disease. People with atherosclerosis, or damaged arteries resulting from a build-up of fatty deposits along the artery walls, were more likely to have age-related macular degeneration.

An unhealthy high-fat diet was found to increase risk of macular degeneration by 80 per cent.

A higher risk of developing cataracts has also been linked to the consequences of eating a high-fat diet. Being overweight could raise your risk of developing cataracts. The heaviest men were more than twice as likely to develop cataracts as those who weighed the least. women seems to support the same conclusion.

A prescription might be written like this:

OD (right eye) —2.25 —.50 X 175 degrees OS (left eye) —2.00 —.25 X 175 degrees add OU (each eye) +1.50

This prescription is for bifocals. The right eye needs a shortsighted correction of —2.25, and an astigmatism correction of —.50 at 175 degrees. The left lens is slightly weaker, only needing a —2.00 short-sighted correction and a —.25 astigmatism correction. In addition a magnification correction of +1.50 is made on each lens for reading.

Roughly speaking, 20/100 vision needs —1.00 correction, 20/200 a —2.00 correction; however, prescriptions may be stronger to ensure that the patient has perfect vision in the worst possible lighting conditions.

Eyeglasses do not actually correct the images that your eyes see, they create distortions in proportion. Concave lenses reduce the size of the images you see, and convex lenses magnify the images. Cylinders produce some distortion even though they are aligned to compensate for the irregular shape of the eye.

Health of the eye

Complications affecting the health of the eye are extremely rare, but are possible. During the early healing phase, the eye is susceptible to infection. You will be asked to follow certain instructions, including using antibiotic eyedrops. Carefully following these instructions will decrease the infection rate to far below 1 percent. Even if an infection does occur, use of antibiotic eyedrops should control the infection.

Steroid eyedrops are very important after excimer laser treatment, because they are used to control the healing response. However, if used improperly for too long, these drops can damage the eye by causing cataracts or glaucoma. It is very important to go to all scheduled follow-up appointments, especially if you are still using steroid eyedrops.

Decrease in best Spectacle Corrected Vision

Best spectacle corrected vision is the best vision obtainable when wearing the optimal pair of glasses. It is a measure of the best vision possible with glasses. Of course, you probably will no longer use glasses or contact lenses for distance vision after the surgery, so you may not even be aware if your best possible vision is slightly different.

For the majority of people, a mild decrease in best corrected vision is usually not noticed. A moderate loss of best corrected visual acuity would be noticed by every patient and might make it hard to work in occupations that require fine vision. Severe loss of best corrected visual acuity is exceedingly rare and in fact has not occurred in any of the FDA sponsored tests.

Some professionals, such as commercial airplane pilots, care very much about their best corrected vision. These pilots must have best corrected vision of 20/20 in both eyes to maintain their licenses, so they should carefully consider the small risk of less than 20/20 best corrected vision.

In one large FDA study, 6 percent of PRK patients experienced some decrease in best spectacle corrected vision during the first six months. This decreased to 1 percent by the end of the first year. Importantly, every patient in this study achieved 20/20 best spectacle corrected vision one year after surgery (b).

Either an irregularity or excessive haziness in the corneal surface could cause a decrease in best corrected vision. A common unevenness is known as a “central island,” which is a slightly raised area near the center of the cornea. “Central islands” usually resolve as the healing progresses. Some haziness almost always occurs in PRK as the ‘cornea heals, but it is usually minor and does not affect vision. A small number of people will form excessive haze, which will cause a decrease in the best corrected vision. In one large study, 1 percent of PRK patients had clinically important haze during the first six months after treatment, but only 0.2 percent of patients had clinically important haze two years after treatment (b). Haze is even less of a problem in LASIK patients. When haze does occur, additional steroid drops are given.

In LASIK, unevenness of the flap, or in the tissue beneath the flap, could result in some decrease in best corrected vision. Small irregularities smooth out during the initial three months after the procedure, resulting in a gradual but noticeable improvement in vision. In rare cases, the doctor may choose to lift and reposition the flap, or to apply more laser treatment under the flap.

Patients commonly ask if they can go blind from the excimer procedure. No patient has ever gone blind in any of the extensive FDA studies, but it is remotely possible. A severe infection, severe haze formation that did not respond to treatment, or a severe problem with the flap formation could result in greatly decreased vision, though further excimer laser treatment or other surgery would restore vision in almost every one of these cases.

During the first month of healing, it is common for patients to experience difficulty with vision, including blurred vision, double vision, halos, glare, and light sensitivity. A foreign-body sensation and excess tearing will also occur in many patients during the first month of healing. These symptoms are generally temporary and are a normal part of the healing process.

Some patients will experience difficulties that persist longer than one month. These problems fall into four categories: undercorrection and overcorrection, optical aberrations, health of the eye, and decrease in best- corrected vision.

Undercorrection or Overcorrection

By far the most common complication of excimer laser treatment is undercorrection or overcorrection. These complications occur because the patient experiences an abnormal healing response, or because the laser energy removed slightly too much or too little tissue.

In the case of an undercorrection, the patient will be left nearsighted, though much less nearsighted than before. Further laser treatment, known as an “enhancement” or a “touch-up,” can then be used to improve the vision by decreasing the remaining nearsightedness.

An overcorrection will result in the patient being farsighted. If a substantial overcorrection occurs, the patient will need to wear glasses or contact lenses to see well, because the current surgical techniques for the correction of farsightedness are limited. Hopefully, excimer or holmium laser correction of farsightedness will be widely available in the near future.

Undercorrections and overcorrections are the main reason that all patients do not have perfect 20/20 vision after the excimer laser treatment. No patient can be guaranteed perfect vision after excimer laser treatment. If you will be satisfied only with 20/20 vision, then you should not have the procedure, because this result cannot be guaranteed.

Optical Aberrations

Optical aberrations are very common during the first six months of healing. Six months after PRK surgery, 10 percent of patients reported glare, and 10 percent reported halos around lights, though less than 1 percent described these problems as “moderate” or “marked.” By the one-year visit, only 2 percent of patients reported these symptoms, and less than 0.5 percent reported the symptoms as “moderate” or “marked” (a). Ghost images may also occur, particularly during the early healing phases.

Retreatment may resolve problems with halos, glare, or ghost images, although many patients don’t find these optical aberrations unduly annoying. For several weeks after having PRK, Bruce saw starbursts or halos around stoplights when he drove home at night. “It happens less and less,” he said. “When it’s pitch-black and there’s only one light, that’s when I get the star- burst. When there are multiple sources of light, there are no starbursts at all.” The starbursts disappeared a few months after surgery.

Like Bruce, Ethan wasn’t upset by the glare and halos that he occasionally saw around lights after he had PRK. “I had glare and halos even with my contacts,” he explained. “I had it before and after surgery. That’s the way I’ve always seen.”

Irregularity of the treated area, referred to as irregular astigmatism, may cause optical aberrations. As the eye heals, the initial unevenness will significantly smooth out. Optical aberrations may also occur if light is entering from around the edge of the treatment area. In some cases, the treatment area will not be exactly aligned with the pupil. Rare individuals have pupils that dilate significantly more than the treatment area.

to be continued

When one eye is treated at a time, you can resume normal activities within a few days, because you can see well out of the untreated eye while the treated eye is healing.

Ethan had his eyes treated on different days. After the first PRK procedure, his vision was so blurry that he could barely see out of the treated eye. While it was healing, he wore a contact lens in the untreated eye. He could drive, read, and go to work. “I would just concentrate on seeing out of the one eye,” he said. “It’s difficult, but you can do it.”

Nicole, a thirty-seven-year-old actress, also had PRK performed on her eyes on separate occasions. After her first surgery, her eye was tearing and scratchy. “It felt like someone had kicked a whole pile of sand into my eyeball,” she said. She relied on painkillers to dull the discomfort and slept a lot during the next two days.

For the first month or two after the operation, Nicole wore a contact lens in the untreated eye. Her naturally dry eyes, however, caused the eye with the contact lens to become red and gritty. After a few weeks, Nicole decided to leave the lens out. “I just relied on my one good eye until the second eye was treated,” she said. “That was fine.”

Nicole’s second surgery was easy in comparison to the first. She experienced less pain afterward and felt like “more of an old pro,” she explained. “I covered the newly treated eye and read with my one good eye.”

Treating one eye at a time is less convenient for many people, but it is definitely safer. The results from the first eye can be assessed and, if needed, alterations can then be made in the technique planned for the second eye. For example, if an overcorrection occurred in the first eye, less laser energy might be used for the second eye. It takes several months to know with certainty the final outcome from the first procedure. It is very common to have the second eye treated sooner than this, but patients need to know that their first eye is still undergoing some change for several months.

If both eyes are treated on the same day, then the healing for both eyes will occur at the same time. You will not have to go through two separate healing periods or a period of misbalance between the first and second eye treatments. However, your vision will be limited in both eyes at the same time as they simultaneously heal.

After having a long conversation with his doctor, David decided to have PRK on both eyes on the same day. He knew he might feel more pain after the surgery and that it might take longer for him to be able to see clearly, but he couldn’t tolerate contact lenses and didn’t want to have to wear a thick lens on one eye and nothing on the other while recovering from the surgery. “The perceived benefit to me seemed so much greater than the risk,” he said. For two days after his surgery, David had difficulty seeing, but by the third day, he was in good shape. In his mind, the temporary inconvenience was worth the price.

The role of the doctor cannot be overemphasized. Some clinics would like you to think that the laser does all the work and that the surgeon is not very important. Remember—the laser is just a tool the surgeon uses to correct your vision and, like other tools, the way it is used makes all the difference. Also, the laser will not be monitoring your progress or initiating adjustments after the procedure—the doctor will.

Be wary of clinics that de-emphasize the surgeon, and make sure that you know your surgeon and feel comfortable with his or her manner, education, and experience.

Be wary also of slick advertisements. A good advertisement means nothing more than the clinic has a good advertising agency. It does not mean that the doctor is right for you.

Carefully check the credentials of the doctor. See if the doctor is board certified and make sure that you respect the doctor’s education, training, and experience. Has the doctor just started performing surgery to treat nearsightedness and astigmatism, or has the doctor been doing so for many years? As a consumer, you need to be aware that there are several ways of correcting nearsightedness and astigmatism. Does the doctor perform both major types of excimer laser surgery—PRK and LASIK—or does the doctor prefer one type? Does the doctor also perform radial keratotomy, astigmatic keratotomy, or other procedures to correct nearsightedness and astigmatism? In some cases, these other procedures may be more appropriate for you.

Does the doctor listen to you, and does the doctor clearly answer all your questions? Does the doctor seem to care about you and your individual needs?

But the question arises, how much should we be using tinted lenses? The research can be confusing. There have been a lot of warnings recently in the media on the growing dangers of ultraviolet light, and UV light has actually been shown to be a risk factor for cataracts along with poor diet, diabetes, use of steroids, and smoking. Studies show that blue-eyed people who do not wear sunglasses in tropical climates have a higher incidence of cataracts than brown-eyed people who wear sunglasses. Still, some authorities maintain that it isn’t clear from the research that protecting one’s eyes from sunlight will actually reduce the risk of developing cataracts. Clearly we need to continue to study these factors, but we also need to be aware that research shows that some exposure to full-spectrum natural light, which includes ultraviolet light, is necessary for good general health and also for healthy eyes.

Advertisers and marketers have made tinted contacts and tinted glasses (sunglasses) popular fashion items. I see people using coloured lenses for standard-prescription use indoors and out, day and night. Perhaps the product appeals to our desire to spend leisure time in the sun while we actually find ourselves working more at occupations that require us to put in long days indoors. The reality is that many people wear tinted lenses more while reading the newspapers and magazines, and shopping in the malls where tinted lenses (sunglasses) are marketed, than they actually wear them at the beach.

At one time I wore sunglasses a lot, even though I lived in Seattle where people are always complaining about the grey, rainy days. I feel that the combination of wearing contacts, working constantly indoors under fluorescent lights, and wearing sunglasses often, even on cloudy days, had made me very sensitive to bright light. Moderately bright days and even the lights at live theatre performances would cause me to squint and make my eyes water so that I had a hard time keeping my eyes open. When I began to correct my vision, I realized that people with good eyesight were able to adjust to normal sunlight without squinting. The iris is designed to contract to block out bright light, and the brow ridge is designed as a natural shade for our eyes. I found that weaning myself away from the over-use of sunglasses not only solved the problem of light sensitivity, but also improved my distance sight. This was probably because a smaller pupil size focuses light at a finer point, making the image clearer.

My home has two rooms which receive a lot of natural light during the day, and two rooms which receive little natural light. My eye chart is in a low-lit hallway. After I have been reading or working on the computer, I sometimes find that the letters on the chart are blurry. I’ve noticed that going over to the window and looking out for a few seconds relaxes my eyes so that even after I return to the darker hallway I can see the chart more clearly. Now I try to do as much work in the naturally lit rooms as I can. When I do find myself reading in a dimly lit room, I feel my eye muscles working harder to adjust.

Sometimes fluorescent lights also bother my eyes now that I have improved my short-sightedness. Even though I can still see the smallest line on the reading chart easily, I recognize that using good light while reading helps my eyes relax. I have purchased full-spectrum lamps for the rooms I spend a lot of time in because they give brighter, better colour-balanced light. My plants also seem to like them better!

Since our eyes evolved in an atmosphere of full-spectrum light, we have adapted to it and still require it for optimal health. All lenses, both tinted and plain, block some rays from natural light. Each colour blocks certain light frequencies and reduces the total amount of light that reaches the eye. For most of the year we get up before dawn, work indoors most of the day, and end our workday around sunset. We may even work out in an indoor gym and rely on artificial lights to simulate sun exposure if we experience seasonal affective disorder. Before using tinted lenses as standard daily wear, we may want to think about how much full-spectrum light exposure we are actually getting.

But even though I enjoy computers, I still seem to notice some niggling little resistance to increasing the time I have to spend on them. Although it makes a lot of sense to convert more and more printed material into computer files, I would hate to give up reading a printed copy of the morning newspaper. I also would have a hard time giving up the pleasurable experience of snuggling up on the sofa with a good book or magazine. Sometimes I wonder if this is just my own knee-jerk reaction to moving into the high-tech age, but I think that the truth is that it is just not as relaxing working on the computer as it is reading a printed page. This is especially apparent when I am ready to do a final read-through on the computer — I give up and print out a copy which I can read in a more comfortable and leisurely setting.

Generally speaking, optometrists have reported that workers who use video display units (VDUs) have more visual focusing complaints than those viewing printed material, and the complaints increase as the workers spend more hours at the computer. What are the most common problems that people complain about?

• blurred vision
• colour perception changes
• discomfort with prescription glasses
• double vision
• eye focusing problems
• eyestrain
• headaches
• irritated eyes
• short-sightedness.

The indirect symptoms include:

• back, neck, shoulder or arm pain
• irritability
• increased nervousness
• lowered visual efficiency.

Do any of these problems reflect your own experiences? I’ve definitely noticed some of these symptoms in myself.

Computer use is very demanding on our visual abilities.The eye could not focus on the video terminal with the same accuracy as the printed page. Over a period of hours the computer user’s focus point relaxed and extended beyond the screen, causing the screen to appear less clear and harder to read. Optometrists have found that a few computer users overfocus, which means they are focusing at a point in front of the screen so the image they see is not clear. Other computer users experience a breakdown of eye coordination skills which causes them to see double images after working on the computer for long periods of time. If an individual lacks the visual skill to see the image easily on a computer screen, he may begin to tense his body and move his head in an attempt to focus better. This may lead to posture- related pains in the neck, shoulders or back. Because workers are not aware of ways to reduce computer-induced visual stress, they may make begin to experience job burnout, high absenteeism or visual problems such as short-sightedness or eyestrain.

In the average case which develops in late life, the natural therapist is concerned with the biochemistry. Why has the lens become opaque and what natural therapies can reverse the biochemical changes? The balance of calcium and silica is critical from the natural therapist’s point of view. It is very easy for this balance to become disturbed because of Western dietary patterns.

Nellie, aged sixty-six, is a good case to explain the treatment. Her case is typical of many observed during fifteen years in practice. She did not come originally for cataracts, although these must have been developing already. Her problems included a very sore tongue, exhaustion, sluggish bowels, haemorrhoids, sinusitis and vertigo. These conditions were all successfully resolved and she returned intermittently for further maintenance treatment over a period of several years. Natural therapies were also used to restore health after surgery to her thyroid gland.

Treatment for the cataracts was started in 1985. The chief ingredients to dissolve the opacity of the lens in most people are homoeopathic silica and calcium fluoride, both in the 30th potency. In some cases this must be continued over several years. Nellie was pronounced free of her cataracts by the specialist about eighteen months after treatment commenced.

The basic naturopathic treatment which she had taken over a period of years would have accelerated the treatment of the cataracts. Supplements during this time included liver herbs, magnesium and potassium phosphate, vitamin C and vitamin B- complex. Magnesium, vitamin B2, and vitamin C, have all been shown to influence the health of the crystalline lens of the eye.’ Without these supplements, the homoeopathic remedies would probably not be very effective. The synergistic activity of natural therapies is again obvious.