To modern medicine, cataracts and glaucoma are to eyes what grey is to hair: an inevitable sign of advancing years. A measure of how closely associated such conditions like cataract are with ageing is the terminology: the most common form of cataract in the West is a version referred to as 'senile cataract', which develops after the age of 50 and is thought to be analogous to losing your marbles in other regards.
That deteriorating eyesight is considered inevitable as we get older has a great deal to do with current statistics: nearly two-thirds of the over-50 develop cataracts, and a whopping 90 per cent develop them over the age of 60. And some 2 per cent of 40- to 50-year-olds and 8 per cent of 70-year-olds develop glaucoma.
Doctors often don't tell the majority of cataract patients that they're developing the disease until it has become full-blown—largely because they've been taught in medical school that, as nothing can be done other than surgery, they may as well allow it to 'ripen' until the patient can no longer see.
But new evidence shows that diseases like cataracts and glaucoma are preventable, because they have a lot to do with diet, nutritional status and the intake of certain environmental toxins.
In fact, explosive new evidence has now linked the development of cataracts to one of the most ubiquitous drugs used by the over-50s: statins.
A team at the University of Columbia in Vancouver, Canada, examined two databases of men aged over 40: the first included more than 162,000 cases of lens opacities, or cataracts, compared with more than 650,000 healthy controls, while the second included around 45,000 cataract patients matched against about 450,000 controls.
The Vancouver team discovered that the risk increased by 27 per cent in patients taking any of the statin drugs for more than a year,1 and the lens damage was enough to require surgery.
This follows the findings of earlier studies comparing the risk of developing cataracts among type 2 diabetes sufferers with that of patients taking statins. While the diabetes patient runs an 82 per cent risk, the statin user's risk is raised by 57 per cent.
In one study,Canadian researchers at the University of Waterloo in Ontario examined 6,397 patients being treated at an eye clinic for cataracts. Of those, 452 had diabetes, and 56 per cent of them were also taking a statin drug.2
The Ontario team believe that, when all other potential factors are adjusted for, the risk of age-related cataract is similar for both types of patients. This places statins squarely in the same category of risk as one of the chief known causes of cataract.
Drugs are also implicated in glaucoma. Evidence based on more than 3,400 women, aged 40 or older who'd taken part in the 2005-2008 US National Health and Nutrition Examination Survey (NHANES), discovered that those taking the contraceptive pill for more than three years were twice as likely to develop glaucoma.3
Yet, perhaps more than any other body part, doctors act as though eyes have a life of their own that's disconnected from the rest of our bodies. The medical profession tends to view eye problems as purely mechanical—a retina that somehow got detached, a globe that somehow got misshapen, or which stubbornly refuses to function correctly or resist going cloudy, a bad toss of the dice that has somehow, without our having anything to do with it, 'just happened'.
Consequently, the prevailing medical approach is to surgically or chemically get those errant lenses or muscles back into line, so correcting vision by attempting to treat the symptoms, but not the underlying cause.
But in most cases, the underlying cause isn't understood and certainly never linked to our diet or any other drugs we may be taking.
However, at least one doctor in the UK took issue with this approach. The late ophthalmologist Stanley Evans went to Africa in 1964 for an extended research programme into the causes and prevention of blindness in Africa.
He planned to stay for five years, but ended up staying for 17 instead on an extended research programme into the causes, prevention, and nutritional correction of blindness and other eye disease. In Africa and at home, Evans also amassed countless anecdotal cases of patients in Africa and the UK (and, indeed, from many other countries too) who were helped or cured simply through diet, supplements and eye exercises.
Evans made the connection between many eye disorders and nutritional deficiencies and, after studying which nutrients were affecting which parts of the eye, he developed a dietary therapy that has helped thousands of patients with a variety of supposedly untreatable illnesses.
When Evans returned to Britain in the early 1980s, he published much of his research in respected ophthalmological journals like The Optician. Even in the 1990s, Evans claimed that the research he had conducted and published for some 44 years was only just being confirmed by other sources.
In fact, he noted, with some amusement, that Roche Pharmaceuticals once organized a conference to study vitamins E, C and A and their role in the prevention of cataracts, accompanied by a great deal of fanfare, when the vitamin division of Roche manufactured the supplement that he had already developed and used on his patients for many years.
Many other orthomolecular physicians, such as Abram Hoffer and Robert G. Smith, and WDDTY's own panel member Dr Damien Downing, have since duplicated Stanley Evans' experience, successfully reversing diseases of the ageing eye simply with a prescription for the right diet and a handful of supplements.
As they have all confirmed in their own work, the chief reason for eye disease as we get older is oxidative stress. This can be caused by environmental toxins like smoking and pesticides, drugs, but chiefly because of a poor diet.
Putting out the fires
The eye's main defence against oxidative stress is antioxidants, particularly vitamin C, vitamin E and glutathione. Vitamin C is a particularly good firefighter because, when it enters a cell, it prevents free radicals from damaging the cell's nuclear DNA as well as the numerous metabolic pathways in the tissues surrounding the cells.
When a cell has adequate vitamin E, the cell membrane can act as a sentinel, preventing oxidation and reducing damage,4 even halting any damage to photoreceptors.
In fact, just having vitamin E sitting in the fatty layer of the cell membrane can prevent oxidation of its fatty acids and proteins,5 and may even lower pressure in the eye, the cause of glaucoma.
These powerhouse vitamins can also help to quench fires in the macula, the central part of the retina known to degenerate as we age, and appear to work in synergy.6
But oxidative damage from light consumes vast quantities of these antioxidants; in fact, the concentration of vitamin C in the eye is 20 times higher than its concentration in the blood.7 This means we need to take loads of it and the other antioxidants to achieve any true benefit, particularly if we're already showing signs of developing eye disease.
However, so powerful are these vitamins, says orthomolecular expert Robert G. Smith, that ageing eyes show improvement in such areas as the retina, optic nerve and blood vessels feeding the eyes after just two weeks of taking 600 mg of vitamin C, even in those who don't have a deficiency of the vitamin.8
Here are the main diseases of the ageing eye, and the nutritional ways to combat them with diet.
What is it? One of the leading causes of blindness in the UK, glaucoma happens when eye pressure, due to an obstruction in the outflow of the aqueous humour (the fluid between the lens and cornea), is increased and eventually damages the optic nerve. The orthodox methods of treating glaucoma are usually surgery or a variety of drugs that aim to constrict the pupil of the eye, inhibit secretion of aqueous humour, aid aqueous outflow and/or even lower hypertension in the eye—with varying levels of success. Surgery is thought to be necessary if the pressure in the eye is very high and drugs have failed to lower it.
What causes it? In Evans' experience, many cases of glaucoma are the result of nutritional deficiency. Vitamin A deficiency, in particular, causes the cornea to soften and its texture to change from a glassy pearl-like appearance to a dull matte surface; it can even cause the cornea to collapse completely.
Aside from not getting enough carotenoids in your diet, too much alcohol destroys vitamin A and may be responsible for changing the permeability of the connective tissues during the early corneal changes caused by vitamin A deficiency. The other main culprits are drugs and a high-sugar diet full of processed foods.
What is it? After excessive oxidative damage, cloudiness develops in the crystalline lens of the eye or lens capsule, absorbing water and swelling. Varying in degree from slight to complete opacity that blocks the passage of light, cataracts are the leading cause of blindness in the underdeveloped countries. But some 11 million Americans also have cataracts, as do one in three Brits.
During most of our life, lens tissue can actively repair itself to keep lens proteins intact, but with old age and damage due to oxidation from absorbing UV rays and ionizing radiation (the kind that has traditionally been considered the most worrisome), the lens tissue can't maintain itself in good condition;9 its crystalline protein becomes cloudy and the absorbed water causes it to swell.
What causes it? Aside from diabetes and drugs like statins, other environmental insults include toxins, trauma, radiation, prescribed and non-prescribed drugs, alcohol and tobacco use.
Although age can be a factor in its onset, it is definitely not the root cause. As Evans often pointed out, many people at age 90 are free of cataracts, and his work in Africa convinced him that it's basically a nutritional disorder. Indeed, he and other doctors have had ample experience demonstrating that, when a person follows a good diet, cataract isn't likely to develop.
When cataract starts, the protein cells of the lens gradually begin to change. When lens protein completes this transformation, it's irreversible, but if you improve your diet and supplement programme before that, cells that are still in the process of changing can be reversed and transparency restored.
"Even when it has begun," noted Evans, "if these measures are taken, its development can in many cases be arrested."
So even if a cataract has been developing for years before you initiate your nutritional therapy, you can improve your visual acuity just by keeping up a good diet. The cataract won't develop further and you can avoid or at least delay surgery for years.
This is always preferable to surgery because, once the crystalline lens is removed, you'll need an artificial lens in the form of thick glasses, contact lenses or an implant—none of which comes without drawbacks or risks. Thick lenses severely curtail sight, whereas contact lenses can cause corneal ulceration and glaucoma as well as other sight-threatening complications.
Even when cataract surgery is successful, there are inherent risks with the use of implants, including glaucoma, intraocular inflammation and damage to the vitreous during surgery, possibly causing retinal detachment.
A bitter pill
The latest evidence shows that patients taking statin drugs have an increased risk of cataracts—just like patients with type 2 diabetes. In one study, type 2 diabetes sufferers had an 82 per cent increased risk, while statin-takers had a 57 per cent increased risk.
Burning out the eye
Robert G. Smith, author of The Vitamin Cure for Eye Disease (Basic Health Publications, 2012), maintains that another main culprit of the eye's oxidative stress is excessive light, which generates free radicals—that is, molecules with an unbound electron—which are extremely reactive and can damage the biochemistry within a cell. And eyes are particularly susceptible because they sit right at the surface of the body.
As Smith wrote: "Believe it or not, whenever we go out into sunlight, virtually all the pigment in our rod photoreceptors is bleached in a few seconds and must be regenerated before we can see again in the dark.
"This pigment is regenerated by vitamin A (retinyl or carotene), which we must obtain from food. After many decades spent outside in bright sunlight (and with inadequate nutrition), the oxidative damage can build up and cause the cells to be dysfunctional or die."
As the years go on, oxidative stress can overwhelm the eye's antioxidant defenses, and become a major factor in age-related eye diseases.1 On the other hand, says Smith, certain foods are constant firefighters and, when consumed regularly, will put out these oxidative fires and keep your eyesight well into old age.
Other potential causes of cataract
•Pilocarpine drops, used for glaucoma
•Non-steroidal anti-inflammatory drugs (NSAIDs), which can increase cataract risk by 40 per cent1
•Excessive sunbathing (if nutritional status is poor)
•Laser surgery to correct myopia
•Cortisone and other steroids
•Heavy metals; if you smoke, the cadmium goes straight to the lens,2 and lead exposure has also been linked to cataracts.3
Diet to prevent eye diseases of old age
The following diet and supplement plan has been shown to slow or prevent the formation of cataracts and glaucoma. In fact, says Smith, the entire carotenoid family is amazing eye food, but lutein and zeaxanthin, both found in green leafy vegetables, make up the main constituents of the filter in the macula that removes blue light from crossing into the retina.
Eat a high-protein diet. One of the chief reasons that Africans developed cataracts and other eye diseases, Evans discovered, was a major deficiency of protein. Aim for 70-80 g/day and include lots of fish.
Red-coloured seafoods like crab, lobster, shrimp and salmon are rich in astaxanthin, an antioxidant known to improve visual acuity after consuming modest amounts. Just 6 mg/day can improve visual acuity.10
Eat your greens and blues. All carotenoid antioxidants are good for your eyes, but spinach, kale and cabbage, in particular, are rich in lutein, the king of the carotenoid family in terms of eye health.11
Ignore the orthodox anti-egg low-cholesterol advice. Egg yolks are rich in lutein, as are kiwis, grapes and corn. Anthocyanins, found in blue and purple fruit like blueberries, red and purple grapes, and blackberries, can help night vision.12
Go Mediterranean. Cook fresh from scratch and include lots of fresh, organic fruits and vegetables, olive oil, legumes and good-quality protein.
Drink in strict moderation. One to two drinks a day can halve your risk of developing cataracts compared with teetotallers or those drinking any more than that.13
Stop smoking. It's not great for your lungs, but it's almost as bad for your eyes.11
Get off the drugs. Besides statins, steroids and NSAIDs like aspirin, antidepressants, anticoagulants, antacids, antibiotics, certain antipsychotics and even antihistamines have been linked to eye disorders.
Move it. Exercise has been shown to help with eye pressure, cataracts and even short-sightedness. Just 25 minutes of walking every day can make a difference.
Wear shades when the sun shines. Continuously exposing your eyes to intense sunlight is linked to a high incidence of cataracts (see box, page 33).14
Take breaks from your computer. Let's face it: the blue light emitted from computers, tablets and smart phones definitely isn't great for your eyes.
Eye healthy supplements
Antioxidants have been shown to have synergistic effects in repairing or preventing oxidative damage. And besides the beneficial effects of vitamins A and C, vitamin E has been shown to lower pressure within the eye and to protect photoreceptors from oxidative damage.
Vitamin A (as beta-carotene)
Suggested daily dosage: 5000-25,000 IU (but with supervision)
Vitamin C, shown to lower eye pressure at high doses
Suggested daily dosage: 1-10 g
Suggested daily dosage: 400-500 IU
Fish oils (omega-3)
Suggested daily dosage: at least 1,400 mg EPA and 1,000 mg DHA
B-complex vitamins (B1, B2, B6, B12) at high doses, but often lower in patients with glaucoma
Suggested daily dosage: B-100 complex capsules
Folate (l-methylfolate, not folic acid)
Suggested daily dosage: 1,000 mcg
Suggested daily dosage: 150 mg
Chromium, as patients with glaucoma are often low in this and other minerals
Suggested daily dosage: 200 mg
Suggested daily dosage: 50 mg
Suggested daily dosage: 400 mg
Vaccinium myrtillus (bilberry or European blueberry) herbal extract (VME), shown to improve glaucoma
Suggested daily dosage: 200 mg
Ginkgo biloba herbal tincture, which can improve blood flow to the eyes in glaucoma patients15
Suggested daily dosage: 40 mg three times a day
Eye drops containing N-acetylcarnosine (NAC), an antioxidant shown to improve eyesight in most people with cataracts;16 Can-C Eye Drops (available on the internet) have been found to help 90 per cent of patients see better.