As we age, maintaining our vision becomes a higher priority. Age-related macular degeneration, or AMD is the leading cause of vision loss among seniors. While there’s no cure for the disease, there are simple things you can do to help prevent or slow the progression of the disease.

Step 1: Stop smoking

Probably the number one way to prevent AMD is to stop smoking or not smoke in the first place. Consider findings from these studies. If you are a smoker, stop now. Smoking is a major risk factor for developing macular degeneration.

• Smokers are up to four times more likely than non-smokers to have macular degeneration, public health experts at the University of Manchester said in a British Medical Journal report. In Great Britain, an estimated 53,900 people older than 69 have AMD attributed to smoking. Of that number, 17,900 are legally blind.
• Another study from the Massachusetts Eye and Ear Infirmary showed that current and past smokers had a 1.9- and 1.7-fold greater risk, respectively, of AMD compared with non-smokers.

Step 2: Eat plenty of greens

Eating plenty of dark, leafy greens may help with macular degeneration prevention. A study published by researchers at the Massachusetts Eye and Ear Infirmary reported that people who consumed the most vegetables rich in carotenoids (lutein and zeaxanthin) had a 43 percent lower risk of AMD than those who ate these foods the least. Carotenoid-rich vegetables include dark, leafy greens, especially raw spinach, kale and collard greens.

“In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD,” the researchers said.

The authors concluded that “consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative (‘wet’) AMD, the most visually disabling form of macular degeneration among older people.”

Step 3: Take a daily multivitamin supplement

Taking vitamins and minerals from a trusted source may be a good idea for many reasons, including general eye health. Particularly for an older person, it may be difficult to obtain all the nutrients you need from diet alone. Ask your doctor for advice about which supplements might work best for you based on your specific health needs.

Step 4: Consider an AREDS nutritional supplement

Two large clinical trials sponsored by the National Eye Institute (NEI) have suggested certain nutritional supplements can slow the progression of AMD among people with early and intermediate stages of macular degeneration.

AREDS1. The antioxidant vitamin formula used in the first AREDS study contained the following ingredients:

• vitamin C – 500 mg
• vitamin E – 400 IU
• beta-carotene – 15 mg
• zinc – 80 mg (as zinc oxide)
• copper – 2 mg (as cupric oxide)

The results of AREDS1, published in 2001, revealed patients at high risk of progressive AMD who took the daily antioxidant and zinc supplement had up to a 25 percent reduced risk of their macular degeneration progressing to an advanced stage (depending on the degree of AMD present at the start of the trial), compared to matched participants who took a daily placebo pill.

Popular AREDS-formula eye vitamins include I-Caps (Alcon), Ocuvite PreserVision (Bausch + Lomb) and MacularProtect Complete (ScienceBased Health). Variations of these products and eye vitamins from other manufacturers also may contain lutein and zeaxanthin and/or omega-3 fatty acids.

Step 5: Eat more fish

Research also has shown the benefits of eating fish for macular degeneration prevention: Some studies show that eating fish regularly can help prevent macular degeneration.

• A study at the Massachusetts Eye and Ear Infirmary showed that senior men with the highest levels of fish consumption (more than two servings weekly) were 45 percent less likely to have AMD than those who ate the least amount of fish (less than one serving per week).
• Brian Chua and researchers at the University of Sydney demonstrated similar findings. They evaluated 2,900 people aged 49 or older. Participants who ate fish at least once a week were 40 percent less likely to have beginning-stage AMD develop than those who reported eating fish less than once a month or not at all. Those who ate fish at least three times weekly were less likely to have late-stage AMD.

Step 6: Exercise regularly and maintain a healthy weight

Regular exercise reduces macular degeneration risk, according to a study in the British Journal of Ophthalmology. In this study, 4,000 people ages 43 to 86 were monitored for 15 years. After considering other risk factors such as weight, cholesterol levels and age, researchers found that people who led an active lifestyle were 70 percent less likely to have AMD develop during the follow-up period. To be included in the active group, participants must have walked at least two miles a day, three times weekly, or the equivalent.

Step 7: Eat fruits and nuts daily

Eating fruits and nuts can help reduce your risk of macular degeneration:

• A 2004 study at Harvard Medical School showed that participants who ate three or more servings of fruit daily had a substantially lower risk of “wet” or advanced AMD.
• Another study from the Massachusetts Eye and Ear Infirmary demonstrated that eating nuts helped deter progression of early or intermediate AMD to more advanced stages.

Step 8: Reduce refined carbs in your diet

Diets high in refined carbohydrates increase the risk of AMD, which was confirmed in a study published in the American Journal of Clinical Nutrition. Highly refined foods have a high glycemic index, causing a rapid increase in blood sugar and insulin release. Examples of refined carbohydrates include white bread, white rolls, baked white potatoes, donuts and pretzels. Low glycemic index foods include most fruits, brown rice, multi-grain and whole grain breads, apple juice and carrot juice.

Be careful, though, when considering the glycemic index of foods. The glycemic index (GI) was developed in 1981 by researchers at the University of Toronto. It is a value from 1 to 100 that indicates a food’s effect on a person’s blood sugar level, with a value of 100 being equivalent to the change caused by the same amount of pure glucose. A food with a high glycemic index increased blood sugar level more severely than foods with lower GI values.

Step 9: Control your blood pressure and cholesterol

Some evidence indicates that controlling cholesterol can protect you from macular degeneration. Cholesterol is a fatty substance that can build up in blood vessels, inhibiting blood flow necessary for maintaining health of eye tissue.

Also, blood pressure control may be important for macular degeneration prevention. Major investigations including the Framingham Heart and Eye Studies and Beaver Dam Eye Study indicate a significant link between high blood pressure and development of advanced, potentially blinding forms of macular degeneration.

Step 10: Wear sunglasses with UV and blue light protection

Major studies show no conclusive evidence that overexposure to the sun directly causes macular degeneration. But some findings suggest at least an association between AMD and cumulative eye damage from overexposure to both UV and high energy visible (HEV) or “blue” light.

As an example, a recent major study found that people who consumed too few antioxidants, in combination with overexposure to blue light, were four times more likely to develop advanced or “wet” AMD. For this reason, it is a good idea to wear sunglasses that protect against both UV and HEV light outdoors.

Step 11: Have regular eye exams

Last but not least, have regular eye exams. The American Academy of Ophthalmology recommends a dilated eye exam at least every two to three years if you’re between 45 and 60 and every year after the age of 60. By following these steps, you’ll know you’ve done everything you can to prevent AMD. But if you’re strongly genetically predisposed to develop macular degeneration, it still may develop and worsen.

Regular eye exams can help your eye doctor detect AMD and monitor it so that you can receive proper AMD treatment, if appropriate, beyond these preventive measures.