Last month a story came out of England about a teenager who went blind from eating only junk food. I found this very interesting and bookmarked the article so I could blog about it when I had the time. Well oopsie, September passed by in a blur and the email I had saved with the link to the article got buried in my inbox until yesterday when in a frantic attempt to organize my life by starting with my work emails I encountered the article I had saved. After doing a little research on the story I was glad I waited to share the information because the initial story that most of the media outlets shared left out certain details that misrepresented the real lesson to be learned from this young man’s tragic vision loss.
The basic story is that a teenager in the UK whose diet consisted of Pringles, white bread, french fries and occasionally some ham lost his eyesight to a condition called nutritional optic neuropathy which like it sounds, develops due to the lack of the proper nutrients that the eyes need in order to function. Many of the articles used this story as a cautionary tale, admonishing junk food eaters and parents of picky eaters that this is what could happen if you don’t eat a healthy diet. Turns out the young man who went blind was not a “picky eater” but rather , he had an eating disorder called ARFID (Avoidant Restrictive Food Intake Disorder) which led to various nutritional illnesses. The media however jumped on the bandwagon of the evils of junk food and fad diets instead of using the story as an opportunity to bring awareness to the importance of detecting mental health disorders in children and teenagers. Does poor nutrition due to a diet limited to french fries lead to blindness? Absolutely that can happen, but this story was way more complex than simply blaming Pringles and fries.
Contrary to popular belief, a cataract is not an eye disease, rather it is a natural age related change to the lens of the eye which causes it to become opaque and difficult to see through. Generally cataracts are very slow growing and most commonly develop in people over the age of 55. Signs and symptoms can be subtle at first, ranging from blurry vision, glare from headlights, difficulty driving at night and frequent eyeglass prescription changes. Most people come into the office complaining that their glasses are not working when in reality they are experiencing blurred vision from cataracts. 
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Age Related Macular Degeneration (AMD) is one of the leading causes of vision loss in patients over the age of 60 in the United States. Since February is AMD awareness month let’s talk a little about the detection, diagnosis, and treatment of this potentially visually devastating condition. The macula is the central part of the retina and if it is damaged central vision becomes impaired. There are two types of AMD, one is “dry” and one is “wet”. Dry AMD comprises roughly 90% of AMD patients and is characterized by thinning of the central retina and deposition of yellow spots (called drusen) in the macula. Although dry AMD is slow to progress and vision loss may be minimal, it can progress to a more intermediate or advanced form of dry AMD which can then progress to wet AMD. Wet AMD happens when abnormal and fragile blood vessels grow underneath the retina and then bleed (this is why it is called ‘wet’) causing destruction of the central vision. Dry AMD has no treatment per se, however there are lifestyle changes that can be taken in order to deter the progression from dry to wet. These lifestyle changes include smoking cessation, UV protection such as sunglasses, and ingestion of nutrients such as lutein and zeaxanthin in foods such as spinach or kale or in a vitamin supplement. Wet AMD is treated with drugs that are delivered into the vitreous (inner jelly like portion of eye) and go under the the broad umbrella term of “anti-VEGF” agents. Laser treatments and PDT (photodynamic therapy) are other treatments utilized in wet AMD.
Symptoms of macular degeneration include blurry vision, darkening of vision, loss of color vision and visual distortion. Once the central vision is lost, there is no way to restore it and low vision devices such as telescopes and magnifiers can be helpful to maximize the remaining vision. Early detection of AMD is crucial in order to preserve central functional vision which is why yearly eye exams are so important.
The other day the cutest little girl came in for her first eye exam. She was starting third grade and was an excellent student reading above grade level. Her parents were sure she didn’t need glasses but thought it was time for her to start having routine eye exams. She was articulate and outspoken and wanted to be done with her visit so she could get on with her day. She read the eye chart in her right eye all the way down to the tiniest letter and was eager to do the same on the left eye. To everyone’s surprise she struggled, barely getting down to the second to last line, guessing and growing frustrated as she realized something wasn’t right. She also had some trouble seeing in 3D which indicated that her two eyes were not working together. At the end of the exam I told her parents that although her right eye was perfect she was hyperopic, or farsighted in her left eye and the large discrepancy between the two eyes had created amblyopia (lazy eye) in that left eye. She left with a new pair of glasses and a follow-up appointment in three months. 
This little girl and her family were lucky that she was doing so well in school despite her amblyopia and suboptimal visual system. Don’t wait until your child complains or you get a note sent home from the school nurse or your child’s teacher – book your childs yearly exam now before the school year gets underway. 
Park Eye Center 