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Macular Degeneration - Healthy Vision Checklist

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Dr. Diane Bovenkamp

Maintain healthy vision throughout your life by following the tips and suggestions from our "Healthy Vision Checklist."

  • Sarah DiSandro:  Hi, I’m Sarah DiSandro and I am with the BrightFocus Foundation, a nonprofit organization leading the fight to save sight and mind. First, I’d like to caution that the information we are providing today is a public service of the BrightFocus Foundation, and is not intended to be medical advice. So please consult your physician. All medications and supplements should only be taken under medical supervision. And the BrightFocus Foundation does not endorse any medical product or therapy.

    Today, Dr. Diane Bovenkamp, Science Communications Specialist, will be sharing a list of healthy vision tips developed by the BrightFocus Foundation. Hello Diane.

    Dr. Diane Bovenkamp: Hello Sarah. First of all, it’s very important to have a comprehensive dilated eye exam every year. It may help you see better and could identify common eye diseases that have no warning signs.

    Sarah DiSandro: What tests are included with a comprehensive dilated eye exam? 

    Dr. Diane Bovenkamp: There are different tests that will detect age related macular degeneration or glaucoma.

    Your doctor will choose which test to use in your examination.

    To detect macular degeneration, your comprehensive eye exam should include a number of tests, including eye dilation, fundoscopy or ophthalmoscopy, a visual acuity test or eye chart test, and fundus photography.

    For eye or pupil dilation, the doctor dilates your pupils with eye drops to view the back of your eye. Dilation allows the doctor to see your retina more easily to determine optic nerve damage.

    For fundoscopy or ophthalmoscopy, the doctor aims a bright beam of light into your dilated eye to view the retina, choroid, blood vessels, and optic disk.

    The visual acuity test or eye chart test measures your sight from various distances. While seated 20 feet from an eye chart, you are asked to read standardized visual charts with each eye, with and without corrective glasses.

    Fundus photography is done after dilating your pupils. The doctor focuses light through the cornea, pupil, and lens, and uses a customized camera to photograph the back of your eye, including the retina, macula, and optic nerve, to look for signs of disease.

    Sarah DiSandro: Are these the same tests that are used to detect glaucoma?

    Dr. Diane Bovenkamp:Eye doctors use several tests to detect glaucoma. Some of these tests are the same as for macular degeneration, including: eye dilation, ophthalmoscopy, and the visual acuity test. There are additional tests for glaucoma, including tonometry, visual field testing, pachymetry, gonioscopy, and optic nerve imaging. That’s a long list, but you may encounter one or more of these tests in your doctor’s office. So, I want to explain what’s done for each one.

    Tonometry measures the pressure inside the eye. There are many different machines, called tonometers, that differ by the way they measure this pressure, including ones that use up puff of air or physically touches the numb di with a digital pen or other type of instrument.

    Visual field testing measures the entire area seen by the forward-looking eye to document straight-ahead and side vision. It measures the dimmest light seen at each spot tested. Each time a flash of light is perceived, you respond by pressing a button.

    Pachymetry uses an ultrasonic wave instrument to help determine the thickness of the cornea and better evaluate eye pressure.

    Gonioscopy allows the doctor to view the front part of the eye (called the anterior chamber) to determine if the iris is closer than normal, to the back of the cornea. This test can help diagnose closed-angle glaucoma.

    Last, but not least, optic nerve imaging uses one of a number scanning techniques helps document optic nerve changes over time.

    Sarah DiSandro: Are any of these tests painful?

    Dr. Diane Bovenkamp: No. All of these techniques are painless and non-invasive. A doctor will determine which methods to use during your examination.

    Sarah DiSandro: Are there any other ways that you can take charge and keep your vision as healthy as it can be?

    Dr. Diane Bovenkamp: Yes. It’s helpful to know your family’s eye health history. Many eye diseases are hereditary so you may be at a higher-than-average risk of being affected.

    Another important activity is to eat right to protect your sight. Eat a diet rich in fruit and vegetables, particularly dark leafy greens such as spinach, kale, or collard greens, and fish high in omega-3 fatty acids such as salmon, tuna, and halibut. A healthy diet can lower the risk of getting some eye diseases, like age-related macular degeneration.

    In addition,maintaining a healthy weight can help to keep your eyes healthy.Being overweight can increase inflammation in your body and increase your risk of developing other diseases.

    This can be achieved by not only eating right, but also by exercising daily or as often as you can, especially aerobic exercises, to improve your immune system and blood pressure, and your eye and brain health.

    Having cardiovascular disease has been linked to an increased risk for macular degeneration. Therefore, it is suggested that you try to maintain a normal blood pressure of 120/80.

    Also, try to limit caffeine intake. Some reports indicate it may have a small effect on blood pressure.

    Sarah DiSandro: Diane, are there any non-diet or exercise activities or habits we can do to keep our eyes healthy?

    Dr. Diane Bovenkamp: Yes, there are a number of things we can do.

    Something that most of us don’t think about is that it’s extremely important to wear protective eyewear when you’re participating in sports or finishing tasks at home or at work. Eye trauma may lead to damage and make you susceptible to some eye diseases, including angle-closure glaucoma.
    You may have heard this from your family doctor, but it’s best to quit smoking or never start. Toxins found in cigarette smoke have been linked to an increased risk for developing a number of diseases, including macular degeneration.

    Wear high-quality sunglasses that have “99 to 100 percent UVA and UVB protection” and a wide-brimmed hat as often as possible when you are outdoors, to lower your risk for cancer, macular degeneration, and other eye diseases. If you aren’t sure about your shades, ask your optometrist or optician to check their protection level.

    Here’s something that you can do that isn’t strenuous or involve buying anything:give your eyes a rest.Reduce eyestrain by looking away from your monitor or other near work every 20 minutes, to a distance of 20 feet in front of you, for 20 seconds.

    If you do have a family history or have been diagnosed with macular degeneration, perform Amsler grid tests at home.

    Sarah DiSandro: Could you explain what an Amsler grid is, and how to test with it?

    Dr. Diane Bovenkamp:  Certainly, you cover one eye and focus your other eye on a grid composed of black, straight lines running horizontally and vertically, with a black dot in the center. If any of the lines on the grid appear wavy, missing or distorted, it may be an indication of macular degeneration. You should set up an eye exam right away.  You can find a free, PDF version of an Amsler Grid at: That’s A-M-S-L-E-R. 

    Sarah DiSandro: Ok, thanks. Are there any other tips from BrightFocus’ Healthy Vision Checklist that you would like to share with us today?

    Dr. Diane Bovenkamp: Yes. Please make sure that you take all medications, as prescribed. Have one pharmacy or doctor confirm that the drugs have no risks for interactions or interference from non-prescription drugs or herbal supplements. This is important for not only protecting the health of your eyes, but to prevent accidental health issues or permanent damage to the rest of your body.

    Lastly, it would be wise to stay informed about recent advances in research on preventive activities and treatments for macular degeneration and glaucoma, like the services and news alerts provided to you by the BrightFocus Foundation. The results from new scientific studies and clinical trials are being published all the time and could give you and your doctor useful information to decide what is the best way to preserve your personal health and vision.

    Sarah DiSandro: Thanks everyone for listening. Stay tuned for future podcasts on vision. For more information about Glaucoma and Macular Degeneration or to get involved in advancing research to end these degenerative eye diseases, visit, or call 1-855-345-6NGR. That’s 1-855-345-6647.

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