Macular degeneration is the most common cause of irreversible blindness in people over the age of 65, but there are several hereditary conditions, which can lead to this disorder at a much earlier age. It is a slow progressive disease that affects the center of the vision. This location is called macula and is responsible for central vision and gives us greatest detail in our sight.
The exact cause of macular degeneration and age-related macular degeneration is not known. However the are risk factors such as age, family history, smoking, ethnicity, alcohol, sunlight, obesity, high blood pressure and heart disease increase the risk of developing it.
The earliest changes occur in the choroid, the vascular layer of the eye, underneath the retina and pigmented retinal epithelium. These changes begin as thickening of Bruch’s membrane which is the most inner layer of choroid underneath pigmented retinal epithelium. These thickened areas become raised and have the appearance of warts. These changes produce loss of pigment and cell death of the functioning layers of the retina. It eventually leads to fluid accumulation, hemorrhage and scar tissue. Loss of central vision occurs but this rarely produces total blindness because the peripheral vision is preserved. Patients usually complain of blurred vision and difficulty with close work. They can also develop wavy lines and distortion on the center of the vision and scotomas. There is a higher incidence of macular degeneration with hypertension, arteriosclerotic vascular disease and diabetes.
There are two common types described dry and wet macular deregulation. Approximately 85% – 90% of the cases of macular degeneration are the dry type. In the dry type of macular degeneration, drusen small yellow deposits are accumulated underneath the basement membrane of the retinal pigment epithelium in the macula and are the cause of deterioration of vision. As a result of this accumulation macula thins out and subsequently loses its function. Almost all people over the age of 50 years have at least one small drusen in one or both eyes, however it is only eyes with large drusen that are at risk for late age-related macular degeneration.
In large study called “Age-Related Eye Disease Study 2” (AREDS2) it was found those people may slow their dry macular deregulation by taking these vitamins and minerals daily:
- Vitamin C (500 mg)
- Vitamin E (400 IU)
- Lutein (10 mg)
- Zeaxanthin (2 mg)
- Zinc (80 mg)
- Copper (2 mg)
The AREDS2 data suggested that the beta-carotene in the original AREDS supplements be replaced by lutein and zeaxanthin, which provides a safer drug for those who are smokers or former smokers. Also too even though consuming fish reduced the risk of macular deregulation in the observational studies, the AREDS2 results showed that omega-3 long-chain polyunsaturated fatty acids (docosahexaenoic acid/eicosapentaenoic acid) had no beneficial effect on age related macular degernation!
Approximately 10-15% of the cases of macular degeneration are the wet type. In wet type abnormal blood vessels underneath the retina in the macula area forms. These new blood vessels subsequently bleed and leak fluid, causing the macula to bulge and lift up from its normally flat position. Through this anatomical change patient experience distorting or even destroying of the central vision.
Dry Macular degeneration treatment is generally with nutritional therapy and a diet high in antioxidant and supportive of the macula. Certain vitamins and minerals are prescribed as described above to support the cell structure.
Wet Macular Degeneration Treatments:
Laser Photo-Coagulation and Photodynamic Therapy (PDT), the laser treatment reduces the number of vessels and slows their leakage.
Anti-VEGF (Vascular Endothelial Growth Factor) Therapy work to inhibit blood vessel growth. Anti-VEGF treatment helps reduce the number of abnormal blood vessels in the retina. It also slows any leaking from blood vessels. Anti-VEGF medicine is injected to the eye through a very small needle. Despite the major progress in the discovery of gene variants associated with macular degeneration, the use of genetic testing to predict disease has not been clinically useful.
Role of diet in macular degerantion
There is growing evidence of the importance of nutrition in age-related macular degeneration and there has been a long-standing interest in the role of diet and macular deregulation. This is because macular deregulation is associated with aging.
There is a report on the association between homocysteine, folate (vitamin B-9), and vitamin B-12 and the incidence of macular deregulation over 10 years in people taking part in the “Blue Mountains Eye Study in Australia”. This study found that increased concentrations of serum total homocysteine were associated with about 30% increased development of macular deregulation over 10 years and on the other hand increased concentrations of serum vitamin B-12 were associated with about 30% reduction macular degeneration development and serum folate was associated with 10% reduction in macular degeneration development . Also, high folate intake was associated with a reduced risk of progression to geographic atrophy. Additionally, people with folate or vitamin B-12 deficiency at baseline were approximately twice as likely to get macular deregulation.
In another study “Women’s Antioxidant and Folic Acid Cardiovascular Study”, found that supplementation with vitamins B-6, B-9, and B-12 resulted in a 40% reduction in the risk of developing macular deregulation over an average of 7 years of follow-up.
In another interesting study the consumption of a high-glycemia diet resulted in many macular degeneration features like RPE hypopigmentation and atrophy, lipofuscin accumulation, and photoreceptor degeneration, whereas consumption of the lower-glycemia diet did not. Critically, switching from the high glycemic to the low glycemic diet even late in life arrested or reversed macular deregulation features.
Gut microbiota are responsive to diet, and the study showed in addition to high glycemic diet, microbiota in the Clostridiales order was associated with macular degeneration feature. Particularly Serotonin and Bacteroidales order in addition to low glycemic index diet were protective against macular degenration feature.
The gut-retina axis is a true fascination as modification in the intestinal microbiome can be protective of this sight threatening disease.
At Sand Institute we follow Dr. Kondrot’s three day program protocol as alternative eye care improvement of the vision. This is a comprehensive 3 day program and one year of follow up care.
The summary of the 3 day program is as follows and what is includes in the 3 day program:
Day 1: Evaluation
A in depth eye history: This is required to explore and understand the underlying cause of the disease, which has contributed to the eye problem and use this information to develop a treatment plan to regain vision.
Past medical history: This is very important, as it will show the connection between physical problems and those contributing to your eye disease
Medications: every medicine can have a toxic effects on the eye condition of you eye
Dietary history: food is your best medicine
Evaluation of stressors in your life: We help you to establish a program to reduce them
Investigation of heavy metal exposure: Diagnostic testing– Important to find out where you are with your vision, what needs to be done and then we repeat these tests at the end of the 3 days to measure your improvement your improvement.
ETDRS assessment of vision acuity: Much different than the standard snellen or big “E” eye chart.
Light house contrast sensitivity. The test measures your ability to see letters of lighter and lighter contrast. This is related to toxicity and heavy metal poisoning.
Color Campimetry Testing: We do visual fields using movement with 4 separate colors – red, green, blue and white.
Zinc Taste Test: A simple 2 minute test that measures the intracellular levels of zinc. Zinc is a key nutrient not only for the eye but also every enzymatic function in the body. A deficiency of zinc is a red flag that there is probably nutritional deficiencies in other vitamin and minerals.
6 hour urine for heavy metal toxicity: This test is the gold standard to determine the levels of toxic minerals in your body. Several capsules of a chelating agent are taken which cause a release of heavy metals that are locked in your neurological tissue, fat and eyes. Urine is collected for 6 hours and then sent to a specialized laboratory for analysis.
Day 2: Treatment
Microcurrent Therapy: Microcurrent is a well established therapy that improves blood flow, stimulates cellular activity, reduces scar tissue and inflammation, and helps to balance the autonomic nervous system. Your 3 day program will begin with treatments that balance your autonomic nervous system, balances neuroendocrine functions and treatments to reduce stress. We will program a detoxification program to help to reduce toxins in your body which are contributing to your disease. Emphasis will be placed on developing and fine tuning a customized program for your eye problem. This program will be fine tuned over the 3 days. Each day you will have 2 eye programs, a stress reduction program and a detoxification program.
Syntonic Light therapy: Syntonics or optometric phototherapy, is the branch of ocular science dealing with the application of selected light frequencies through the eyes. It has been used clinically for over 70 years in the field of optometry with continued success in the treatment of visual dysfunctions, including strabismus (eye turns), amblyopia (lazy eye), focusing and convergence problems, learning disorders, and the aftereffects of stress and trauma. In recent years, Syntonics has been shown to be effective in the treatment of brain injuries and emotional disorders. A specific wavelength of light will be selected to help detoxify your eye, stimulate retinal function and balance the autonomic nervous system. Each day you will receive 2 light therapy treatments.
Myers Cocktail: This is a specialized intravenous vitamin mixture designed to give you the key vitamins and minerals to support the eye and visual function. It is highly suggested that all patients receive this mixture especially if you were measured deficient in zinc. It is also suggested that all patients in the program receive a Myers cocktail once a month until nutritional levels are at an optimum level.
Ozone oxidative therapy: This uses highly reactive oxygen gas which has an amazing ability to stimulate regeneration and healing. Ozone Therapy is a breakthrough treatment that is able to detoxify as it heals. It is used to treat a wide range of chronic conditions, including Macular Degeneration. We are also using ozone eye drops to help stimulate the healing of the eye.
Day 3: final evaluation
ETDRS assessment of vision acuity, Light house contrast sensitivity and Color Campimetry Testing are repeated the results are compared to the pretreatment measurements.
Each patient will then have a private consultation with Dr. Sand to review the results and outline their treatment program to continue improving their vision
Cost for the Kondrot Program which includes all of the following:
- 3 days of evaluation and treatment
- Personalized microcurrent machine with up to 10 programs
- Light therapy equipment
- One month and 3 month telephone follow ups.
- 6 month return visit to the center.
- One year of reprogramming of microcurrent machine.
- Instructional material including and telephone support.
- The cost includes all of ancillary treatments such as, Myers cocktail, ozone
therapy and additional testing that might be needed.
Please call office for the cost of the program.