Cataracts

Prevent and Possibly Reverse Lens Opacity

Cataracts are an opacity of the eye lens which gives a visual sensation like trying to look through a cloudy window. In their early stages, cataracts may not be much of a problem. As they progress, however, it can become more difficult, or even impossible, to see clearly. Cataracts are the leading cause of decreased vision in adults over age 65, and cataract surgery is the most common surgical procedure for seniors.

People can get have “age-related” cataracts in their 40s or 50s, though the changes at this stage tend to be small and vision disturbance minimal. By age 55, 15% of people have cataracts. This figure jumps to 50 percent by age 75, and 90 percent by age 85. It’s important to note, however, that cataracts worsen over time … so it’s never too late-or early-to try to prevent them and/or treat them!

Causes of Cataracts

The lens of the eye is made of largely of protein and water. Most of the cells in our body are replaced by new cells over time. However, cells in the lens of the eye have no such “turnover.” The lens that you are born with is the same lens that you will have for the rest of your life.

Light normally passes through the lens of the eye without distortion, as if the lens were made of clear glass. When the lens becomes is injured, proteins within the eye begin to “clump.” This clumping of lens protein results in the characteristic “cloudiness.”

Factors that damage the lens include high exposure to UV-B light, oxidative stress from free radicals, nutrient deficiencies, high blood sugar levels, exposure to radiation, prolonged intake of corticosteroid or other drugs, and cigarette smoking.  Fortunately, these factors are all controllable.

Other less common causes of cataracts include infection and eye injury. There is also a form of congenital cataracts which affects infants and young children.

Cataract Prevention

UV-B radiation from sunlight is thought to be one of the leading causes of cataracts. Wearing UV-B protective sunglasses is a simple way to minimize the damaging effects of UV-B. [Dr. Myatt’s Note: I personally do not believe that sunlight per se is the cause of cataracts. After all, humans have been running around without sunglasses for thousands of years without going blind from cataracts. Could it be that low levels of anti-oxidants, as discussed in the next paragraph, predispose to sunlight damage? Or the decreased protection of the ozone layer that ordinarily filters out UV-B light? Until more is known, I still wear my sunglasses when I’m outdoors for extended periods].

The second known cause of cataract formation is free radical damage to the lens. This free radical damage is associated with a deficiency of anti-oxidant nutrients in the diet. Studies have shown that people with higher intakes of vitamins A,C,E, carotenes (especially lutein and zeanthin) have significantly lower rates of cataracts. In animals, grape seed extract (which is 50 times more potent in antioxidant properties than vitamin C and E) prevented cataracts in rats that had genetic tendencies to develop opacities.

In the large Beaver Dam Eye Study, scientists followed dietary intake of antioxidant nutrients and the incidence of cataract formation in a group of 1,354 adults, aged 43-84, for a period of over seven years. People who ate the most foods high in anti-oxidants had the lowest incidence of cataracts. The researchers concluded that the results “are consistent with a possible protective influence of lutein and vitamins E and C on the development of . . . cataracts.”

In the Nurse’s Health Study, researchers followed 50,828 women, aged 45-67, for eight years. Women who consumed the most vitamin A had a 39% lower risk of developing cataracts than women who consumed the least vitamin A.

Bilberry and vitamin E are have been linked to an improvement in cataracts. In 25 patients with senile cataracts, a combination of bilberry, standardized to contain 25-percent anthocyanosides (180 mg twice per day), and vitamin E (100 mg twice per day) for four months stopped the progression of cataracts in 96 percent of the subjects  compared to 76 percent in the 25 subjects in the control group. In another trial, people who took vitamin E supplements had less than half the risk of developing cataracts, compared with others in the five-year study. A daily dose of  400 IU of vitamin E per day is typically recommended for prevention. Smaller amounts (approximately 50 IU per day) have offered no protection in double-blind studies.

Vitamin C levels in the eye are known to decrease with age. Supplementing with vitamin C can prevent this decrease and has been linked to a lower risk of developing cataracts. People who take multivitamins or other supplements containing vitamins C or E for more than 10 years have been reported to have a 60% lower risk of forming a cataract. In one  study, people taking vitamin C for at least ten years showed a dramatic reduction in cataract risk, but those taking vitamin C for less than ten years showed no evidence of protection.

Diets high in spinach and kale have been reported lower the risk for cataracts. Spinach and kale are high in lutein and zeaxanthin, (carotenoids similar to beta-carotene). Lutein is normally found in the lens of the eye. In another study,  people with the highest intakes of lutein and zeaxanthin were half as likely to develop cataracts as those with the lowest intake.

Can Cataracts be Reversed?

If you are experiencing early vision changes due to cataracts, or have been told during an eye exam that you have “early cataracts,” you already know the conventional medical treatment: “Let them ripen” and we’ll surgically remove them. (“Let them ripen” is doctor-speak for “let them get worse”).

While surgical removal of cataracts can surely be a blessing to people with advanced cataracts, some 20-30% of those who undergo cataract surgery develop a subsequent clouding of the lens capsule, the part of the lens left in the eye to hold the new synthetic lens in place. If the capsule becomes cloudy, additional surgery may be required to restore clear vision. In some cases the surgery can lead to serious complications such as swelling of the eye, infections, and even blindness. Obviously, prevention is easier and safer than surgical “cure.”

Although most of the studies have focused on prevention, several have looked at actually reversing already-existing cataracts.

In one study, supplementation with 15 mg of lutein three times a week for one year significantly improved visual function in a small group of people with age-related cataracts.

Studies conducted in Russia have shown moderate to marked improvement in lens opacity with continued use of eye drops containing N-Acety-l-Carnosine. It took three months of continuous use for measurable improvmenets, and at six months, improvement stabilized. Some of the studies report results as high as 100% of participants experiencing noticeable changes (for the better!) in their vision.

Since N-Acety-l-Carnosine eye drops are not “FDA approved” for use in cataracts, you will see the productslisted as “lubricating eye drops.”

Do they work? I don’t know. But there are enough studies with impressive reports that I would certainly consider using these drops for at least three months if I had any degree of cataracts.

DIET AND LIFESTYLE RECOMMENDATIONS

• Eat a diet high in “Super Foods” and antioxidant nutrients.
• Decrease carbohydrates and simple sugars in the diet. This is especially important for preventing diabetic cataracts. Sugars bind with body proteins to produce AGES (Advanced Glycosylated End-products) that cause irreversible changes in the lens of the eye.
• Drink at least 64 ounces of pure water daily. The vitreous portion of the eye has a high water content.
• Wear high UV protection sunglasses.
• DON’T SMOKE! Smoking greatly accelerates the formation of cataracts.

PRIMARY SUPPORT

• Maxi Multi: 3 caps, 3 times per day with meals. Optimal (not minimal) doses of antioxidants (ACES), carotenes, B complex vitamins, selenium, zinc and bioflavonoids are particularly important for eye health.
• Maxi Greens (Advanced Phytonutrient Formula): 3 caps, 3 times per day with meals. Bilberry, grape seed extract and ginkgo are particularly important, but plant flavonoids in general help protect the eyes.
• Dr. Myatt’s Eye Drops from Hell: rinse eyes 2-4 times per day according to instructions. This formula increases circulation to the eyes and is good for eye health in general.

ADDITIONAL SUPPORT

• Lack of normal stomach acid (low gastric acid) and resultant failure to absorb nutrients from diet and supplementation can contribute to eye disease. I recommend a Gastric Acid Self-Test for anyone concerned about vision and eye health.
• Lutein and Zeaxanthin 15 -20mg, 3 times per week. People with the highest intakes of these two carotenoids had only 1/2 the risk of developing cataracts as the general population. In one study, people who supplemented these carotendoids at the recommended dose has a significant improvement in age-related cataracts.
• Bilberry extract: 1 cap, 2-3 times per day with meals (Target dose range: 120-240mg or more per day).

FOR POSSIBLE CATARACT REVERSAL OR IMPROVEMENT

• Lutein and Zeaxanthin 15 -20mg, 3 times per week. People with the highest intakes of these two carotenoids had only 1/2 the risk of developing cataracts as the general population. In one study, people who supplemented these carotendoids at the recommended dose has a significant improvement in age-related cataracts.
• N-Acety-l-Carnosine eye drops: 1-2 drops per day, 1-2 times daily.

References

1.) Procyanidin-rich extract from grape seeds prevents cataract formation in hereditary cataractous (ICR/f) rats. J Agric Food Chem. 2002 Aug 14;50(17):4983-8.

2.) Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol. 1999 May 1;149(9):801-9.

3.) Nutrient intake and cataract extraction in women: a prospective study. BMJ. 1992 Aug 8;305(6849):335-9.

4.) Preventive medical treatment of senile cataract with vitamin E and anthocyanosides: clinical evaluation. Ann Ottalmol Clin Ocul. 1989;115:109.

5.) Cataract: relationship between nutrition and oxidation. J Am Coll Nutr 1993;12:138–46 [review].

6.) Relationship in humans between ascorbic acid consumption and levels of total and reduced ascorbic acid in lens, aqueous humor, and plasma. Curr Eye Res 1991;10:751–9.

7.) Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 1991;53:352S–5S.

8.) Antioxidant status in persons with and without senile cataract. Arch Ophthalmol 1988;106:337–40.

9.) Vitamin supplement use and incident cataracts in a population-based study. Arch Ophthalmol 2000;118:1556–63.

10.) Antioxidant vitamins and nuclear opacities. The Longitudinal Study of Cataract. Ophthalmology 1998;105:831–6.

11.) Long-term supplementation with alpha-tocopherol and beta-carotene and age-related cataract. Acta Ophthalmol Scand 1997;75:634–40.

12.) Long-term vitamin C supplement use and prevalence of early age-related lens opacities. Am J Clin Nutr 1997;66:911–6.

13.) Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992;305:335–9.

14.) A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. Am J Clin Nutr 1999;70:509–16.

15.) Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition 2003;19:21–4.

16.) Rejuvenation of visual functions in older adult drivers and drivers with cataract during a short-term administration of N-acetylcarnosine lubricant eye drops. Rejuvenation Res. 2004 Fall;7(3):186-98.

17.) Efficacy of N-acetylcarnosine in the treatment of cataracts.Drugs R D. 2002;3(2):87-103.

18.) The effect of a topical antioxidant formulation including N-acetyl carnosine on canine cataract: a preliminary study.Vet Ophthalmol. 2006 Sep-Oct;9(5):311-6

19.) N-Acetylcarnosine, a natural histidine-containing dipeptide, as a potent ophthalmic drug in treatment of human cataracts.  Peptides. 2001 Jun;22(6):979-94