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Essential Fatty Acids

See Chapter 1 for general information regarding essential fatty acids (EFAs). In general, a very low-fat diet (10 percent of calories from fat) that excludes red meat and dairy products has been shown to reduce the risk of macular degeneration. 9 However, the lack of essential fatty acids, in the form of omega-3 oils, is also a risk factor. When treated with omega-3 fatty acids for four weeks, 85 percent of macular degeneration patients over age 70 experienced improved vision.10

A diet deficient in omega-3 fatty acids is known to cause impaired vision both in animals and in people.11 Low birth weight infants deprived of omega-3 fats because they are not breastfed sometimes experience visual problems. But when EFAs are added to their formula, their visual acuity improves. Animal studies also show that, with age, omega-3 levels in the eye begin to fall. Omega-3 is so essential to the retina that, when this happens, it won't let go; the retina begins to recycle it within the eye.12

Apparently, omega-3 fats are essential for nerve conduction in the retina and to reduce cholesterol, thus helping to maintain retinal nutrition by keeping retinal blood vessels open. But one caution: the more omega-3 fats in the diet, the more antioxidant protection from vitamins C, E and beta-carotene is required.

The best sources of omega-3 EFAs are the flesh of cold water marine fish as well as black currant oil, flaxseed and flaxseed oil and hemp seed. We recommend that you either eat fish rich in omega-3 fats three times per week or take it as a supplement.

Omega-6 EFAs are also important to protect cells from degenerative changes and to reduce inflammation throughout the body. Sources of omega-6 fatty acids are evening primrose oil, borage oil and black currant oil.

Traditional Chinese Medicine

In Traditional Chinese Medicine, macular degeneration is seen primarily as a deficiency in the liver meridian with inefficient blood circulation. Both the kidney and the spleen meridians have also been found to be deficient.

The herbs and acupressure points prescribed for macular degeneration are chosen for their abilities to increase the qi in the liver, kidney and spleen meridi-

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ans. They will harmonize the function of these organs and increase the smooth flow of energy and blood throughout the body, thus bringing increased circulation to the eyes.

Acupressure

See the Macular Degeneration Prevention Program, pages 8687 for the acupressure points for macular degeneration.

Herbal Remedies

A combination of Chinese and Western herbs have been shown to improve the circulation of blood and energy to the eyes. The Chinese formula we use for macular degeneration is Hsiao Yao Wan (Relaxed Wanderer). This is the standard remedy for constrained energy in the liver meridian.

Hsiao Yao Wan helps the liver in its job of spreading qi throughout the body and to the eyes. The most important herb in this formula is bupleurum, whose primary role is to break through obstructions and restore the free flow of energy and blood. The adjunct herbs in the combination peony root, dong quai, poria fungus, atractylodes, ginger, licorice support the liver and digestive system. They help to relieve dampness, promote digestion and move and disperse stuck energy.

In addition to Hsiao Yao Wan, we recommend agrimony, bilberry, ginkgo biloba, ginseng (American and Siberian), milk thistle, dandelion and eyebright.

Agrimony (Agrimonia pilosa) is an astringent herb, meaning it can bind excess fluid, especially blood, so it is particularly good for patients whose macular degeneration involves subretinal bleeding.

Bilberry (Vaccinium myrtillus), the European version of the blueberry, has been called the vision herb for its powerful effect on all types of visual disorders. Research has shown that bilberry can improve night vision, relieve visual fatigue, and protect the eyes from glaucoma, cataracts and macular degeneration. Bil-

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berry improves the delivery of oxygen and blood to the eyes, strengthens the capillaries that feed eye muscles and nerves, and works as an antioxidant to inhibit damage by free radicals.

Researchers believe that the flavonoids in bilberry called anthocyanosides can help prevent or even cure macular degeneration. As an antioxidant, bilberry can scavenge free radicals that can weaken blood vessel walls, causing them to leak. In addition, bilberry strengthens the collagen, which further improves the integrity of the blood vessels, reducing, and in some cases, preventing capillary leakage associated with the more serious wet form. Bilberry also has been shown to improve ocular circulation and oxygenation.

Currently, researchers at the Kellogg Eye Institute at the University of Michigan are conducting a clinical evaluation of bilberry and its effect in deterring and curing macular degeneration.

Ginkgo (Ginkgo biloba) has been shown to increase visual acuity in people with macular degeneration. As we have repeated many times throughout this book, ginkgo increases blood circulation to the head, which includes the brain and the eyes, so it can speed healing of all of the tissues associated with vision.

Ginseng (Panax ginseng) has been used traditionally as a tonic to support the effects of aging. A combination of American and Siberian ginseng help tonify the adrenal glands, a kidney function in Traditional Chinese Medicine. Macular degeneration benefits from strengthened kidneys, so ginseng can be helpful in this way.

Milk thistle (silybum marianum) is an excellent liver tonic. It increases the flow of bile from the liver, helping to detoxify poisons in our bloodstream. It nourishes the liver, reducing stress and increasing energy throughout the body.

Dandelion root (Taraxacum officinalis radix) is another universal liver tonic, aiding in digestion and balancing blood sugar levels, which combine to create good health for the eyes. In addition, dandelion contains antioxidants to help tissues stay healthy.

Eyebright (Euphrasis officinalis) has been known throughout history as an effective herb to help tonify the eyes.

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Macular Degeneration Formula

In addition to the Hsiao Yao Wan formula mix one to two ounces of each of the other herb tinctures together and take one teaspoon twice a day for six to nine months. If the herbs are in capsule form, follow the directions of your health care practitioner. A formula combining most of these recommended herbs is available from Integral Health Apothecary or Starfire International (see Resources).

Homeopathic Remedies

The following remedies have been shown to be helpful for macular degeneration, but should not be taken without being evaluated by a qualified homeopath.

Phosphorus may be used for the ''wet'' type of macular degeneration which includes retinal bleeding.

Sepia is usually used for women who experience black spots in their vision accompanying macular degeneration.

Other Tips

Because ultraviolet rays from sunlight cause so much damage to the eye, always wear protective sunglasses and hats when you are outside.

Macular degeneration patients need reading light to be twice as bright as that found in the average home or office. Magnifiers help too.

Aspirin thins the blood and increases blood flow to the retina; thus, it also can cause retinal hemorrhages. As a result, we do not recommend the use of aspirin for prevention of macular degeneration. However, bromelain, a mild blood thinner, can replace aspirin without its adverse retinal side effects.