Macular Degeneration: Do supplements help?

richard leung_kings college hospitalAs the open enrollment period for Medicare advantage plans just came to a close, I have seen a big group of seniors start to take advantage of their new vision insurance. With the uptick in senior patients also came a sizable group of patients with Age-Related Macular Degeneration (ARMD), the leading cause of vision loss in persons older than 65 years old. ARMD is a debilitating disease which is divided into two subtypes, wet (10% of patients) and dry (90% of patients). Macular degeneration robs the patient of their central vision. Although wet macular degeneration is often more devastating, treatments have been developed to combat the primary cause – and statistically speaking, more patients will suffer from the dry variety.

Until 2001 there was no scientifically proven method to slow the progression of the dry ARMD. A study called AREDs proved that a specific vitamin formula could reduce a patient’s risk of conversion from moderate to severe dry macular degeneration by 25% over 5 years. With this study and its recently completed follow up study, AREDS 2, pharmaceutical companies began pouring money into the development of products that followed the scientifically proven formula and other products that claimed to “support eye health” but have not been proven in bias-free studies. As usual, if there is money to be made, someone will fill the void.

Many of my patients both with and without macular degeneration ask me if they should take a vitamin for their eyes. While I cannot say that vitamins will not be beneficial to a person’s vision, I do worry that my patients are spending their hard earned money on vitamins that are unproven in their ocular benefit. In fact, a recent study discovered that only 4 out of 11 top products contained the exact formulation recommended in the AREDs studies.

So what is a patient to do? First, if you have macular degeneration make sure you see your optometrist at their recommended intervals and get involved in your treatment by making sure you know the stage of your condition and the type of macular degeneration you have. If you have moderate degeneration or worse, your doctor should provide you with a specific recommendation for an AREDs or AREDs 2 formula supplement. If you do not have macular degeneration or have very mild degenerative changes you may not need vitamin supplements so long as you have a very good diet, exercise regularly, protect your eyes from ultraviolet light and refrain from smoking. I will say that patients who admit to poor diet or have a family member with macular degeneration may be at greater risk and should ask their optometrist about a multivitamin supplement. Additionally, smokers should really try quitting, as smokers have at least a 4x greater risk of macular degeneration. Smokers should also realize that some supplements have vitamin A which can be carcinogenic for them so they should be especially careful about which supplement they take. At the end of the day, being knowledgeable about your condition and seeking a doctor who is proactive will go a long way to keeping your sight.

In this holiday season I wish you all good health and a happy and peaceful 2015.

~ David C. Ardaya, O.D.
California Optometric Association
http://www.coavision.org
http://www.eyehelp.org

Health care reform & vision coverage for your children

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Children’s vision now covered by most plans
If your child is covered by an individual or group health insurance plan in California, their annual eye exam and eye glasses are covered with no out-of-pocket cost until the child reaches age 19. This is required for health plans purchased through or outside Covered California.

Legal residents of California will be able to get health coverage through a new marketplace established by Covered California. Starting in 2014, there will be several new and expanded government programs, including Medi-Cal, that offer financial assistance to reduce the cost of health insurance.

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  1. Premium assistance — Federal help will be available to reduce the cost of an individual’s or family’s monthly health insurance payments.
  2. Cost-sharing assistance — Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay at the time of medical care.
  3. Medi-Cal assistance — Starting in 2014, Medi-Cal will cover more people under age 65, including people with disabilities and those with incomes $15,856 or less a year for a single individual and $32,499 or less for a family of four. Medi-Cal is free for those who meet the requirements and is part of the changes included in the Patient Protection and Affordable Care Act (Affordable Care Act).

An online calculator at the Covered California website helps estimate how much it will cost to purchase health insurance in 2014 and the amount of financial assistance available to qualified individuals. In addition, by completing a Covered California application, an individual will learn whether he or she qualifies for financial assistance.

~Kristine Shultz, Government and External Affairs Director
California Optometric Association