Dr. Grossman’s Blog

Almost 4% of men in the United States develop dry eye disease (DED) after age 50, while almost 7.7% of men over 80 develop the disease, making it one of the most common eye conditions in the country.  By the year 2030, DED is expected to affect more than 2.79 million US men.

Typical symptoms of dry eye include dryness, grittiness, irritation, difficulty reading for long periods of time, burning and even the seeming contradiction of excessive tearing or watering.

In the study, published in June issue of Archives of Ophthalmology, researchers analyzed data on 25,444 men over the age of 50 who participated in the Physicians’ Health Study I and II.  DED was defined as the presence of clinically diagnosed dry eye or severe symptoms (both dryness and constant or frequent irritation).   About 3% reported a previous diagnosis of dry eye, while 6.8% said they had constantly or frequently experienced at least one symptom such as dryness or irritation. Roughly 2.2% reported both symptoms constantly or frequently.

Although research has shown DED is more common among women, about 1.68 million men over age 50 in the United States now have the disease.

Researchers also noted that DED risk increases with age, hypertension, benign prostatic hyperplasia (a noncancerous enlargement of the prostate), and antidepressant use.

Learn about vitamins and other nutritional products recommended for dry eye, and review a list of drugs that can cause dry eye symptoms at the Natural Eye Care website

SOURCE:  “Prevalence of Dry Eye Disease Among US Men,” Schaumberg, et al, Arch Ophthalmol. 2009;127(6):763-768.

Researchers studied food and vitamin/mineral supplement consumption of adults in the United States in an effort to measure whether older adults were consuming enough nutrients.

In this study, 4,384 adults aged 51 years and older were evaluated.  1,777 reported taking supplements daily, 428 took them infrequently, and 2179 did not take daily supplements.  Nutrient intake distributions were estimated using the Iowa State University Method.

The results? 

Overall, less than 50% of adults evaluated met the Estimated Average Requirement (EAR) for folate, vitamin E, and magnesium from food sources alone.

Of those who were taking supplements, 80% or more met the EAR for vitamins A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium.  However, it was noted that some supplement users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin A.

The researchers concluded that a large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements can help compensate for this deficiency, but only an estimated half of this population uses them daily.

Learn tips for taking vitamins and maintaining good digestion

Read about good food sources for nutrients

SOURCE: “Older adults who use vitamin/mineral supplements differ from nonuser in nutrient intake adequacy and dietary attitudes”, Sebastian, et al, Journal of the American Dietetic Assoc 107(8):1322-32, 2007.

Antioxidants not only help prevent some eye diseases, they may also help limit progression of the diseases

It’s known that taking antioxidants helps delay the onset of some eye diseases associated with aging, such as cataract. Now researchers believe that antioxidants can be effective if damage to retinal tissue has already set in.

Researchers at the University of Maryland School of Medicine studied the effects of reactive oxygen species (ROS)-induced damage to retinal tissue. An increase in ROS levels can result in significant damage to cell structures — a situation known as oxidative stress. Oxidative stress is a significant risk factor in the development of many eye diseases associated with aging.

Since the formation of cataract is a well-defined progressive disease, believed to be related to a continued generation of ROS in the aqueous humor, the researchers hypothesized that even a late start with an appropriate antioxidant could halt the process and delay cataract development and vision impairment.

The results? Adding pyruvate – known to be an effective ROS scavenger — to lens cultures after lenses had sustained 50% damage was significantly effective in preventing progress.

Pyruvate can be found in foods such as red apples, and to a lesser extent, in dark beer and some cheeses.

Learn more about antioxidants

Read more about antioxidants and their importance in maintaining healthy vision

SOURCE:  “Oxidative damage to lens in culture: reversibility by pyruvate and ethyl pyruvate”, Varma, et al, Ophthalmologica, 2008; 222 (3):194-198.

Researchers at the University of Pennsylvania School of Medicine have created the first animal model of age-related macular degeneration (AMD) caused by a mutation known to produce disease in people.

AMD is the most common cause of vision loss in elderly people, affecting more than 10 million people in the U.S. and about 50 million world-wide. Because AMD develops late in life (patients typically show symptoms of AMD after age 60), it is a difficult condition to investigate.

Although some forms of AMD are inherited, one type is thought to be caused by a mutation in the Efemp1 gene. Researchers introduced the disease-causing mutation into the Efemp1 gene of mice. These Efemp1-mutant mice develop the same basal deposits as people with AMD.

It is believed that these mice will provide a means to study how basal deposits form and what they are made of. The mice can also be used to test potential treatments to prevent basal deposit formation.

“To better develop treatments for preventing the progression of AMD, we need to understand the real biochemical details of how AMD occurs,” says lead author Eric A. Pierce, MD, PhD, Associate Professor of Ophthalmology at Penn’s K.M Kirby Center for Molecular Ophthalmology. “To do that, we need a model, and now we have one.”

Learn more about age-related macular degeneration (AMD)

Read other studies about macular degeneration

SOURCE: Model To Study Age-related Macular Degeneration Could Pave Way For Better Treatment, Pierce et al, University of Pennsylvania School of Medicine (2007, October 10).

It’s no surprise that failing eyesight leads to more accidents, but a new study shows early intervention to correct even minor visual impairment may prevent injury.

Decreased vision in older people is commonly related to an increased risk of falling, and a new study has scientifically evaluated this link. The goal of the study was to determine whether visual loss was associated with a higher incidence of injurious accidents and whether walking speed or physical activity influenced this association.

416 people aged 75 to 80 years were tested for visual acuity. Those testing at less than 20/60 in the better eye (with spectacle correction when necessary) were defined as visually impaired. Those tested with visual acuity between 20/60 and 20/40 were defined as having lowered vision. Those testing at greater than 20/40 were defined as having normal visual acuity.

Hospital records of accidents with injuries were monitored for ten years, during which 239 participants (58%) suffered at least one injurious accident. Even considering other factors (age, gender, eye-related diseases, diabetes and cardiovascular diseases), the risk of injurious accidents for participants with lowered vision was 1.45 compared with those with normal visual acuity.

Interestingly, participants with visual impairment did not have an increased risk for accidents over those with lowered vision, and neither walking speed nor physical activity had a mediating effect on the relationship between visual loss and accidents.

Researchers have therefore concluded that lowered vision is a risk factor for accidents in older people independent of mobility and physical activity.

In light of this research, early intervention strategies such as proper correction of vision or cataract extraction are truly important in preventing accidents in the elderly.

Read more about vision loss prevention

SOURCE: Kulmala J, Era P, Parssinen O, et al. Lowered vision as a risk factor for injurious accidents in older people. Aging Clin Exp Res 2008;20(1):25-30.