“Other” Eye Conditions Treatments

Who Needs Eye Vitamins | AREDS and AREDS2

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There is only one eye vitamin proven to be effective for any eye disease.  The AREDS 2 formulation for macular degeneration is the only vitamin proven to reduce the chance of severe vision loss in select patients with macular degeneration.


The initial study, funded by the National Eye Institute, was the “Age Related Eye Disease Study” (AREDS) and was to determine the effects of antioxidants and other minerals (principally zinc) on the development and progression of macular degeneration and cataracts.

The initial NIH study found the following:

  • Antioxidants and zinc had no effect on the development or progression of cataracts.
  • Antioxidants and zinc reduced the chance of vision loss in a select group of patients with macular degeneration.
  • Beta-carotene (an antioxidant) increased the chance of lung cancer in smokers.


A second study, Age Related Eye Disease Study 2, also conducted by the National Eye Institute (NEI), was designed to determine:

  1. if beta-carotene could be replaced with the antioxidants lutein (anti-oxidant) and zeaxanthin (carotenoid)
  2. if the addition of omega-3 fatty acids affected the development and progression of macular degeneration
  3. the value of zinc in the development and progression of macular degeneration.

AREDS 2 Conclusions

Essentially, the AREDS 2 study confirmed the positive conclusions of the first study, and that:

  • Omega-3 fatty acids had no effect on the development or progression of macular degeneration.
  • Removal of beta-carotene did not negatively affect the progression of macular degeneration.
  • Lutein and zeaxanthin may serve as an adequate substitute for beta-carotene and did not show evidence of promoting lung cancer in smokers.

Do You Need Any Vitamins?

It should be stressed that most patients do NOT need to be taking vitamins.

Only patients who have been diagnosed with macular degeneration AND who also have select risk factors should be advised to take the AREDS 2 formulation.  Specifically, if your doctor determines that you have intermediate or advanced risk factors based upon a dilated eye examination, then you may consider taking the AREDS 2 formulation for macular degeneration.

Risk factors determining the severity of the disease include

What Can You Expect?

The AREDS 2 are NOT going to improve your vision.  The AREDS 2 will decrease the chance of severe vision loss by about 25% given the fact the you have higher than normal risk factors for the progression of the disease.


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Macular Degeneration

Signs and Symptoms of Macular Degeneration

is the deterioration of the central portion of the retinathe macula, which is the area of the retina that controls visual acuity and color perception. Macular degeneration usually occurs in people over the age of 55 and is more common in people of northern European ancestry.

Symptoms of Macular Degeneration

The most common symptoms of macular degeneration are blurry vision, blind spots, and distortion.  

New distortion should always be examined and can be monitored at home with the use of the Amsler grid.

Blurriness, blind spots, and distortions are also common symptoms in the following eye diseases:

  • macular edema (swelling) from many causes
  • epiretinal membrane
  • macular hole
  • diabetic retinopathy

Distortion is a common symptom of a disease of the macula and is does not signify a particular disease (i.e. get examined).

The Macula

The macula provides our central “20/20” vision.  As you are reading this article, your eyes are moving to keep the text focused on your macula.  When you are staring at an object, you are focusing the object on your macula.

Macular degeneration can be wet or dry and both types progressively affect the central vision causing blurriness, blind spots, and distortions. However, the wet form causes more serious vision loss.

Retinal Degeneration

For reasons yet to be discovered, the macula degenerates with age.  There are probably environmental risk factors, such as smoking, which increases the chances of developing macular degeneration.

The vast majority, 90% of cases, are the dry variety, which causes very slow, yet progressive blurry vision.  Wet ARMD causes the development of abnormal blood vessels within the layers of the macula.  These blood vessels cause destruction of the normal retinal tissue and can leak fluid and bleed.

Regardless of the type of macular degeneration, the initial symptoms are the sameblurriness, blind spots, and distortion.  However, wet macular degeneration can destroy vision rapidlyin days or weeks.  

What Can You Do?

If you have symptoms such as persistent blurry vision, blind spots, and/or distortion, make sure you get a complete dilated eye examination. 

While there are many causes of blurry and distorted vision other than macular degeneration, you want to make sure that you get an early diagnosis so whatever eye condition is causing your visual symptoms, the proper treatment can be initiated early in the process.  

Early diagnosis and treatment of eye diseases may prevent or limit permanent vision loss.


Macular Degeneration

Do Drusen Diagonse Macular Degeneration?

The simply answer is, no, not all patients with drusen have macular degeneration. Drusen can be associated with macular degeneration, but are not diagnostic of the disease.

In other words, a person can have drusen AND macular degeneration which means that the two conditions are associated because they can occur together, but the presence of drusen by themselves without other signs or symptoms does not mean macular degeneration is going to occur or is in the process of occurring.

What are Drusen?

Drusen are spots (lesions) that form in the layers of the retina. There are two types and can be “hard” or “soft.” based upon appearance.   The presence of a few small drusen is normal with advancing age.

Drusen can be found anywhere in the retina.  When they are located outside the macula, they are usually of no consequence and are not related to any disease, especially macular degeneration.  I am only concerned when they are located within the macula.

Unfortunately, most non-retina doctors do not mention that drusen away from the macula are of little consequence and can simply be a family trait.

When Should Macular Degeneration be Diagnosed?

Let’s take the scenario of a patient having only hard drusen and no other signs of macular degeneration such as pigment changes, fluid, or blood.

Is there vision loss?  If there is vision loss, the next thing I do is determine if there are reasons for it other than macular degeneration, such as cataracts.

When a patient has no vision loss or a loss of vision that is explained by something such as cataracts, I do not necessarily diagnose macular degeneration.

I know that many doctors DO diagnose macular degeneration every time they see drusen, and in my opinion, this is not correct or fair. Unnecessarily pronouncing this diagnosis to patients causes many people worry, anguish, and stress as they wait to go blind from a disease they do not have.

Best Test for Macular Degeneration Diagnosis

If there is any question about the diagnosis of macular degeneration, have your doctor order a fluorescein angiogram.

A fluorescein angiogram (FA) is the best test for a definitive diagnosis of  macular degeneration (ARMD).  The test is performed by a retinal specialist and each eye is injected with a dye (not iodine based) called fluorescein.  As the fluorescein dye travels through the retinas, pictures are taken which help the retinal specialist diagnose or rule out macular degeneration.

In cases of a positive diagnosis for macular degeneration, a fluorescein angiogram will also distinguish between wet ARMD and dry ARMD, so that the proper treatments can be undertaken as soon as possible.

All the best,

Randall Wong, M.D.
Retina Specialist
Fairfax, Virginia 22030

Macular Degeneration Video

What is Macular Degeneration

Macular degeneration is a common retinal disease which may lead to legal blindness.  More specifically, it affects the macula, the portion of the retina which provides central reading vision.

Thus, macular degeneration only affects central vision.

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