Monthly Archives: September 2016

Dietary dilemmas

After a member of the Retinal Detachment support group on Facebook gave us all the heads up that the question of whether certain foods or nutritional supplements could improve eyesight was going to be explored on the BBC2 programme ‘Trust me, I’m a Doctor’, I decided I’d better dust off the TV and  tune in.  As the haunted fish tank is something which no longer features in my life, I completely forgot.  But – hurrah for iPlayer – I managed to catch up with it a couple of weeks later.

The programme mentioned the three carotenoids which are important for eye health: lutein, zeaxanthin, and meso-zeaxanthin.  These are pigments found in plants, which protect our eyes from damaging blue or UV light.  Lutein and zeaxanthin are found in green leafy vegetables such as kale and spinach, brightly coloured peppers, sweetcorn, broccoli, and a number of other fruits and vegetables (check out ‘Good Eye Food’ for a more complete list).  Meso-zeaxanthin can’t be found in plants but it’s believed that it’s made in our bodies from lutein.

The programme went on to refer to recent research undertaken by Professor John Nolan at the Waterford Institute of Technology in Ireland, which suggests that increasing the levels of these three carotenoids in our diets can improve our eyesight.  The programme makers put this to the test by conducting an experiment in which ten volunteers drank a green smoothie every day for five weeks.  The recipe had been designed so that it contained high levels of lutein and zeaxanthin, in order to find out whether it was possible to improve the eyesight of the volunteers through diet.  The presenter, Michael Moseley (by the way, he really *did* qualify as a doctor… I checked), also took part in the experiment, but he took supplements containing lutein, zeaxanthin, and meso-zeaxanthin every day for twelve weeks.  Now, I’m not even going to start discussing the results because these experiments are clearly flawed.  The sample size of ten volunteers for an experiment such as this is miniscule.  Not only that, but the viewer was given no information about the other variables or whether they had even been considered.  For example: were the volunteers all of the same age; did they have any medical conditions; what was their eyesight like to start with; what was the rest of their diet like… etc.  The timespan of five weeks also seems extremely short.  Not only that, but the programme didn’t compare like for like.  Results of ten volunteers over five weeks were directly compared to results of one (!) volunteer over twelve weeks.  Making the claim, “Research suggests that it’s cheaper and more effective to take supplements” based on these experiments is dodgy to say the least.

Upon reading a couple of articles associated with the programme, I discovered that the Waterford Institute of Technology had carried out a year-long study of approximately 100 volunteers who all took the same supplements.  “I don’t get it!”, I complained to my sister, in annoyance.  “Why have they done this pseudo-scientific experiment when an actual proper researcher has carried out the work to obtain far more convincing data?  Why didn’t they just discuss the real research?”  “It’s telly, isn’t it?”, observed my sister with the wisdom of one who’s watched a fair amount of trash over the years.  “They’ve just dumbed it all down to reach a wider audience.”

As I was a little frustrated by all this TV malarkey, I went off to look up some information about the research undertaken by the Waterford Institute of Technology.  I learned that Professor Nolan is Principal Investigator of the Macular Pigment Research Group, the mission of which is to “study the role of nutrition for optimising visual function and prevention of blindness, cognitive function and prevention of Alzheimer’s disease”.  In conducting trials for their research, they recruited volunteers with normal eyesight and volunteers who had been diagnosed with early-stage age-related macular degeneration (AMD) in one eye.  Their website specifically states that people with diabetes or who have had laser eye surgery were not suitable.

After further reading around the subject, I was still no closer to an answer as to whether or not supplements containing lutein, zeaxanthin, and meso-zeaxanthin would help me, as an RD patient.  So, I turned to my eye buddies, posting a question on the RD support group site asking whether anyone had specifically been recommended to take nutritional supplements by their ophthalmologist.  Unusually, there was a fairly resounding silence.  Only one person said that she had been recommended a supplement containing lutein by an ophthalmologist.  Someone else said that her retinal surgeon had told her that lutein may be helpful but that it couldn’t be known for certain.  Another person made the sensible comment that even supplements can be harmful so it’s best to seek medical advice to ensure the benefits outweigh the risks.  So I guess that’s one more question for the ophthalmologist at my next appointment…

Looking to the future

On Friday evening, when I spotted the headline, ‘Robot operates inside eye in world first’, I was obviously intrigued and so naturally clicked on the link to have a read.  I was immediately engrossed.  The article reported that a team, led by Professor Robert MacLaren at John Radcliffe Hospital in Oxford, had used a robot in performing surgery to remove a membrane from the eye of a 70-year-old man.  The membrane had grown at the back of his eye, causing a hole in his retina and thereby destroying his central vision in that eye.  As I well know, this type of surgery would normally involve instruments being inserted into the eye and operated by hand.  Apparently, use of the robot involved the surgeon using a joystick and touch-screen to guide a thin needle into the eye, using a microscope to monitor its progress.  The tiny movements required for the intricate surgery at the back of the eye were achieved by the surgeon making large movements with the joystick.

I was very excited to read Professor MacLaren’s explanation: “Normally when we do this operation by hand we touch the retina and there is some haemorrhage but when we used the robot the membrane was lifted cleanly away.”  My excitement grew, as I read his comment, “We can certainly improve on current operations, but I hope the robot will allow us to do more complex and delicate operations that are impossible with the human hand.”  This made me think that perhaps, as using the robot is more accurate, surgery performed in this way could potentially result in less inflammation, thereby reducing the likelihood of development of PVR.  Since I’ve read that PVR is the main cause of failure of retinal reattachment surgery (and it’s certainly the case for me, unfortunately), this would be an impressive breakthrough!  Of course, I have no idea whether this would actually be the case, but it seems logical.

My excitement rapidly transformed into a slight feeling of queasiness, as I went on to read that the robot is also ‘able to filter out hand tremors from the surgeon.’  HAND TREMORS FROM THE SURGEON?!  I’ve had three vitrectomies under general anaesthetic and two under local.  For the latter, I was most concerned about keeping my head still.  I never even considered the possibility of worrying about potential HAND TREMORS FROM THE SURGEON!  [Shudders]  Great.  So now that’s just one more teeny little thing to worry about when the dreaded occasion of surgery number six comes along.  [groaning internally]  Still – maybe they’ll have perfected the robot by that time.  I can but hope.

I digress, but nevertheless appear to have meandered back to the main point, which is… hope.  From what I’ve read in the past couple of years, my main hope for the future of RD treatment has been in potential advancements in stem cell therapy.  I know that Professor MacLaren is also involved in research into gene therapy, as well as work on the so-called ‘bionic eye’, or retinal implant, which made the news earlier this year.  I was somewhat less excited about the retinal implant upon realising that it relies on an attached retina and a fully functioning optic nerve.  However, it was still fascinating to read about it.  I also found it incredibly moving to watch film footage of the lady with Retinitis Pigmentosa who had been fitted with the implant managing to read the time on a clock face after almost six years of blindness.

Another subject of research I’ve read about with interest has been the discovery in the US that a certain chemical could be used in eye drops to ‘dissolve’ cataracts.  As cataract surgery is commonplace and highly successful these days, this might not seem like such a big deal.  But it still requires a surgeon and an incision, and so there’s a subsequent risk of infection as well as a risk – albeit a small one – of retinal detachment following cataract surgery.  It would surely make everything so much easier if the cataracts could simply be ‘dissolved’ using eye drops.

One of the most difficult aspects of dealing with a serious eye condition which can lead to sight loss is the accompanying and relentless sense of fear.  Fear of what the future may hold; fear of losing independence; fear of blindness.  Reading about such fantastic advances in research and potential treatments of the future is hugely encouraging and helps to counteract a little bit of that terrible fear.  I really hope that such research will continue to progress well and that one day blindness might even become a thing of the past.

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