Your patients' natural level of protection against violet-blue light, their macular pigment density, is a product of their genetics and lifestyle.
The key lifestyle improvements that you can help your patients make to improve their eye-health are:
Macular pigments cannot be made in our bodies, they must be obtained through our diet. To get enough macular pigments a person must regularly eat a diet rich in sources of lutein and zeaxanthin such as kale, spinach, and red or orange peppers. To ensure they are well absorbed, foods high in lutein and zeaxanthin should be consumed with healthy oils, because they are fat soluble (see below).
Research has shown, that people with a poor diet are at greater risk of sight loss from age-related macular degeneration, this has been linked to their low macular pigment levels.
Cigarette smoke contains toxins that cause oxidative damage, depleting a person’s macular pigment stores. Smoking is also a strong risk factor for age-related macular degeneration.
Encouraging a smoker to quit, may be one of the best things you can do for their eye health!
Macular pigments are fat soluble, and our bodies have evolved to store them for later use in our adipose tissue when sources of lutein and zeaxanthin are plentiful (e.g. summer). Then when sources of macular pigments are scarce (e.g. winter) our bodies would release them as it uses up our fat stores so that we can have healthy macular pigment protection all year.
But many of us don’t have a winter in our diet anymore and therefore never stop storing macular pigments away in our body fat. As such people with high BMI tend to have lower macular pigment density and therefore less natural protection for the macula. This may partially explain the increased risk of AMD with increased obesity.
Staying active increases metabolism and the body’s ability to adaptively increase antioxidant capacity.
Studies have also shown that regular intense activity enhances the body’s ability to repair DNA damage, which is implicated in AMD.
REDUCE HEV EXPOSURE
Sunglasses and photochromics aren’t just a fashion accessory, they are also an important tool in our arsenal against exposure to harmful radiation, specifically UV and blue light.
Staying out of the sun, hats, blue light filtering lenses and maintaining a high macular pigment density will decrease the accumulation of photochemical damage through life.
High energy visible (violet-blue) light is now known to be a risk factor for advanced ageing of the retina and AMD (see blue light page). Everything we can do to reduce HEV exposure will help maintain healthy vision later in life.