Vitamin Supplements for Macular Degeneration

We are commonly asked what vitamin supplements are available for macular degeneration and whether they help.

Over the last 20 years two large studies were conducted to examine the effect of supplements on people with macular degeneration. They were the AREDS (Age Related Eye Disease Study) and then AREDS2.

Unfortunately no vitamin supplement can cure or reverse the damage that macular degeneration causes but in the AREDS and AREDS2 studies a specific combination of antioxidants, vitamins, Zinc and Lutein and Zeaxanthin have been shown to reduce progression of the condition by as much as 25%.  This reduction in progression was only reported in the study for patients that already had at least moderate macular degeneration.  There may be some benefit in early macular degeneration but that was less certain from the study.  The supplements seem to help to reduce the conversion from dry to wet type macular degeneration.

What ingredients were shown to be beneficial in the AREDS2 formulation?

• Vitamin C (Ascorbic Acid) – 500 mg
• Vitamin E (d-alpha-Tocopherol) – 400 IU
• Zinc (Zinc Oxide) – 80 mg and Copper (cupric oxide) – 2 mg
• Lutein – 10mg
• Zeaxanthin – 2mg

You would struggle to achieve these doses in a normal diet.  These amounts are between 5-15x the daily recommended intake.

Is there anything else I can do to reduce my risk of macular degeneration or it progressing further?

• If you are a smoker stop and encourage anyone else in your household to do so also.  Smokers have up to a 4x risk of losing vision from macular degeneration.
• You should wear sunglasses to protect your eyes from UV light.
• A diet rich in green leafy, red and yellow vegetables are a good source of antioxidants.  Nuts and seeds are a good source of Vitamin E.  Fish and Eggs have a high Zinc content.  Lutein and Zeaxanthin are found in eggs.
• Other supplements such as Saffron, Bilberry and Ginkgo biloba do not have strong evidence at this stage.

What supplements should I buy?

We don’t recommend a particular brand of supplement as long as it contains the AREDS2 formulation.  Some examples include:

MDEyes is available at http://www.mdeyes.com.au/ and comes in a once per day gel capsule.

Macutec Essentials (once daily) at https://www.macutec.com.au/view/macutec-once-daily/34

You should check with your General Practitioner (GP) if you intend taking a new supplement.

More reading:

https://nei.nih.gov/amd
https://www.nei.nih.gov/areds2
https://www.nei.nih.gov/areds2/PatientFAQ
https://www.nei.nih.gov/areds2/MediaQandA

Thera Tears Lubricant Eye Drops and Lubricant Eye Gel

Unfortunately there is a worldwide shortage of Theratears until early 2018 but this date could change again.

We recommend Thera Tears lubricant eye drops and gel to many patients because in our opinion and experience they provided the best relief of many dry eye conditions as well as being an excellent fluid for insertion of contact lenses.

• There is no eye drop or gel on the market that is an exact replacement for the Thera Tears products.
• Rather than recommending just one drop to replace it we have had to recommend some options because some patients report that one type is better than another for their particular condition.
• All recommendations are for the single use preservative free containers not the bottles of drops that do contain preservatives.
• If you experience any stinging from the drops you are trialing please stop using them and try one of the other recommended drops or please contact our office.

Replacement for Thera Tears Lubricant Eye Drops

Optive Sensitive – Single use containers – 30 x 0.4ml
Cellufresh – Single use containers – 30 x 0.4ml
Bion Tears – Single use containers – 28 x 0.4ml

Replacement for Thera Tears Lubricant Eye Gel

Celluvisc – Single use containers – 30 x 0.4ml
Polygel – Single use containers – 30 x 0.5g

I keep getting asked what makes our practice different and why people travel so far to see us.

When we fit people with custom contact lenses, we bring together years of experience and the latest technology.

We have invested heavily in the latest technology to measure eyes more thoroughly than anyone else.

Our investment of hundreds of thousands of dollars allows us to obtain a better contact lens fitting and reduce the number of visits required to obtain it.

Because of the large investment we need to charge a fee for our services.  The lenses are not cheap but the price of clear and comfortable vision we think is priceless.

For some people we understand that price is a motivating factor and if so, there are many local chain stores in the shopping centres who can attempt to fit your eyes. That may entail many more visits and the end result may not be as good as what we could provide.  You are choosing to exchange your time for perhaps a lower price for a poorer fit or reduced visual result.

If you have been through that process and found it to be a false economy and understand you get what you pay for, then we can help. Our practice is growing quickly with word of mouth referrals for exactly this reason.

Are you having problems with your new glasses or contact lenses?

We specialise in second opinions when you aren’t sure if it is your eyes or the glasses/contact lenses that are causing problems.

It can be a very disturbing time when you get your new glasses and things don’t seem right.  Most people when they pickup their spectacles should find them instantly clearly and better than what they have been wearing before.  If you have a large prescription particularly with astigmatism (cylinder) or if there has been a big change in your prescription or the addition of prism to your lenses then they may take at least 10 days to get used to.

We specialise in seeing people who have had eye surgery and sometimes those glasses can be very strong and can take up to 6 weeks to fully settle.

There is no point putting up with glasses that aren’t working well for you.  80% of your world is visual and it is important to see clearly and comfortably.

Don’t waste years of your life putting up with poor vision, make a time to see Andrew or Jean-Pierre for an eye test.

Why can I see a white ring in my hybrid contact lenses

At about the 4-5 month mark of wearing your Synergeyes ultrahealth or duette hybrid contact lenses you may notice a white ring start to form at the junction of the hard central portion of the lens and the soft outer skirt.

This represents a build up of calcium within the lens and is commonly caused by your tear chemistry and use of the hydrogen peroxide based cleaners like AOSEPT.

This represents a cosmetic issue only as it does not affect the vision or comfort of the lens.  The calcium is built up within the material itself so it is not on the surface.

How do I fix this white ring?

Replace the lenses

Synergeyes recommends replacement of the hybrid lenses at the 6 month mark and we are now able to offer a special 2 pack price which represents a 30% discount from the price of buying each pair separately (lenses must be ordered together to obtain the discount but can be supplied after the 1 month follow up visit).

Change your cleaning solution (next time)

If you have noticed this occur it may be best to shift to a non hydrogen peroxide based cleaning solution such as Bausch and Lomb BioTrue.  However this won’t get rid of a white ring already in the lens it may just reduce its occurence next time.

More information?

For more information from the manufacturer please see Synergeyes website

For a lot of people the shift from standing distance glasses to needing something for both distance and reading can be daunting.  You might have heard problems from friends or family that had problems getting used to their multifocal lenses.  It should be understood that the term multifocal lenses and progressive lenses are used interchangeably.  If someone describes a progressive lens it is also a multifocal lens and vice versa.  We use the term multifocal as the lens works for both distance, intermediate (computer) and reading so it has multi-focal lengths.

Common problems with multifocals start with:

Is the prescription correct? 

Who measured your eyes for the prescription was it your optometrist or ophthalmologist?  How old is the prescription?  Is there a chance your eyes have changed from when they were measured?

Are the lenses fitting in the right spot?

A good spectacle prescription is only a part of getting a multifocal lens correct.  If the lens position is even a few millimetres off then you will struggle to adapt to the lens and it won’t work properly.  Sometimes the spectacle frame didn’t fit well before the measurements were taken and after the lens is fitted to you the multifocal lens position is now incorrect.  Unfortunately that means the lens will need to be remade to suit the new frame position.

If we assume the spectacle prescription is correct and the lens position was measured correctly what are some common adaptation symptoms with muiltifocals?

I don’t see as well out to the side of my vision with these multifocals

Yes, the way a multifocal lens is designed leads to some distortion of your side vision.  That means you may have to turn your head more to look behind you particularly when reversing the car.  This is something that you will get used to by moving your head more or adapting how you use your eyes.  You can spend more for better and better multifocal lens technology that minimises that distortion but all multifocal lenses have it.  It is just part of how they work.

I can only see a few words clearly at a time

With a multifocal lens there is a coridoor of clear vision that runs from the top of the lens (distance) through the middle of the lens (intermediate) to the bottom (reading).  This coridoor varies in length and width depending on the design of multifocal lens chosen.  With newer and more advanced multifocal lens designs (more expensive) you will find the width of the clear vision zones to be larger.  Even with the largest reading area and most advanced lenses there is still a limit to how wide your vision is.  Try looking at  one word and without moving your eyes see how far either side of that word is clear with your current reading glasses.  Then try it with your multifocal lens.

When using a multifocal lens it is best to point your nose at what you want to look at.  If you are finding that the reading or computer zone is too small it may be that you need special reading or computer glasses where the entire lens is focussed for the screen or up close.  That means you would need a separate pair of glasses for this but they would be customised exactly for what you want.

The ground seems to be in a different place or I feel taller than before

Because the bottom of the multifocal lens is stronger for reading that magnifies the bottom area of your vision causing some people to feel like the ground has shifted or they have grown longer legs.  For most people this will pass within a few days of getting their multifocals.  Rarely some people never get used to it and need to stay with separate distance and reading glasses.  This is more common if you suffer from migraines, car sickness or light sensitivity.

I feel like I have to tilt my head backwards to see clearly in the distance

This may be because the lens centres have been set too low or the prescription is not strong enough in the distance.  I would make a time to discuss this with your optometrist.

I have to tilt my head in towards my chest to see clearly in the distance

This happens if the lens centre is too high meaning that in the normal head position you are looking through the intermediate (computer) or reading section of the lens.  Sometimes the frame can be adjusted to lower the lenses and improve the vision considerably.  Other times the lens needs to be remade to be placed in the correct position.

I find the reading area very small

Sometimes the frame curvature on your face is too flat meaning that both eyes are not looking perpendicular to the lenses.  That means that we need to curve the frame on your face (dihedral angle/wrap angle) to improve your binocular vision and improve the apparent width of the reading zone.

I am having lots of problems with my multifocals they just aren’t working

If you have been successfully wearing multifocals before then it is likely there is something wrong with either the fitting or prescription of the lens.  If you haven’t worn multifocal lenses before it may be an adaptation issue but it is worth discussing with your optometrist.

The Katt or ICD scleral contact lens has been designed to vault over the entire cornea and rest on the white of your eye.  What that means is the lens does not impact on the cornea which is the most sensitive part of the eye and instead rests out on the white of your eye.  We aim to have at least 300 microns of distance which is filled in by tears or moisturising drops between the contact lens and your cornea.

Because there is this distance between the back surface of the lens and your eye the lens is more adaptable if the shape of your cornea changes during the day or over time.  In fact if you take care of the lenses well and your eyes don’t change too significantly the lens can last for 2 years or more.

Whilst the upfront cost of the lens is higher than a small diameter RGP (hard) lens or even a hybrid contact lens because of the way it is fitted it can last much longer meaning the cost is almost equivalent over time.  The ability of the lens to rest gently on your eye and reduce some of the problems associated with contact lens wear mean it is an even better option.

For more information about the ICD lens design see ICD lens website.

You have two eyes and they need to last you for life.  We made a decision to invest in the latest technology to examine your eyes.  That technology is very expensive but we know it allows us to help more people.

There is a gap for your eye examination and we will discuss the specific costs with you when you book the appointment.  Some people require more time than others and more testing.

Medicare only covers the cost of a standard eye examination every 2 years.  In certain cases if you have a progressive visual disorder, new signs or symptoms or a significant change of vision it may also cover a comprehensive examination before that time.  Unfortunately Medicare will not cover the cost of more advanced eye examinations and diagnostic technology.

Don’t spend thousands on an overseas diving trip if you won’t be able to see the reef clearly when you are there.

The team at Eye5 can help give you the clearest and most comfortable vision in a prescription diving mask.

Because the lens in the mask tends to sit slightly further away from your eye we need to calculate the exact lens power required to correct your vision.  You might have tried lenses before that were close enough off the shelf but to see the smallest detail clearly you need the fine tuning that we can provide.

We expect that your lenses will slowly improve in comfort and vision (stability and clarity) over the first 4-6 weeks of wearing them.

We normally want to see you again a month after you first get your lenses to measure and see if there needs to be any small modifications.

Don’t worry if your vision is changing slightly right up until 4 weeks as that is normal.  For some people it is not until the 4th week when their vision starts to become clearer and their lenses more comfortable.

Everyone is different and these are a completely custom fitted lens to your eyes.  Whilst general advice is helpful remember it is general and may not apply to your exact situation.

If you have any questions don’t hestitate to get in touch with our optometrists.