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Vitamins and AMD


Smoking Linked to Macular Degeneration


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AREDS2 Nutritional Study for AMD








Q.     How can I be tested for floaters?

Floaters are most easily seen when looking at a homogeneous field such the open blue sky without the presence of clouds (away from the sun!).  A large white wall, well illuminated, without anything on it will also work.  You can test both eyes open then with individual eyes.  Because floaters come and go, you must realize that you may not see any floaters at one time and be able to see floaters at another time.  If you see a "floater" all the time in the same location that is bigger than a dot or piece of hair, it may not be a floater, but rather, it could be a sign of a retinal/vitreous hemmhorage (if so see an eye doctor ASAP to be on the safe side).

To test yourself for floaters, look up at the sky (or wall) and slowly move your eyes all the way to the left and then all the way to the right, back-and-forth, repeatedly, for about 15 seconds.  If you have floaters, as you move your eyes back-and-forth you'll see something that moves with your eyes as the eyes move.  If you think that you see a floater then try to look directly at it.  What should happen is that as you try to look directly at it the floater will appear to move in the same direction as your eyes and you'll never really be able to look at the floater "dead-on".  This is because the floater is inside the eye and, as a consequence, as you move your eyes the floater will also move at the same speed and in the same direction as the eye movements.  If you look real closely, you may notice that when you stop moving your eyes the floater(s) actually continues to move, for a little while, in the same direction as the original eye movement.

What do you look for and what do floaters look like?  Floaters can take-on a number of appearances.  If the cells that compose the floater are in focus, then the floater will appear as a well defined single circle or small ring or group of circles stuck together.  If the cells that make-up the floater are out-of-focus, the floater may look like a shadow of a small object, a blob, a dull or dark string, or even look like a bug with one or two arms.

It is common for people to see floaters particularly older people, over the age of 30 or so.  People that have a high refractive error (need thick glasses) are also more prone to floaters earlier in life.  In general, floaters come and go and nothing can be done about them - just learn to live with them.  However, if all of a sudden you see a lot of floaters or/and have a large dark "shadow" in part of your visual field, you should consult with your eye doctor.


Q.    What causes black floating spots in my vision?

Floaters are condensations of cells in the gel part of the eye, known as the vitreous.  Floaters appear as dark spots, as web-like objects, as a dot with arms, or strings.  Floaters are often associated with high myopia (very nearsightedness) and with aging.  A lot of floaters my be a sign of serious eye disease such as a retinal break, tear, or retinal detachment.  If you see a lot of floaters, suddenly, or see bright dots or flashing lights, you need to see an Ophthalmologist immediately.  There is no treatment available for typical, nonpathologic, floaters.  Also see Vitamin A and Floaters in this section.


Q.    I've been wanting to tell someone about my experience with floaters in my eyes.  I was taking vitamins and eating a healthy diet, dried fruit and vegetables and fruit juices.  The skin on my feet started to crack, my skin became dry and I developed floaters in both eyes so bad that the nurse sent me to a specialist....I was consuming three to four times the recommended vitamin A.  I stopped taking vitamins.  It's taken two years and the floaters are gone.  I seriously believe the vitamin A was to blame.   I would like to see a study done on this, since so many drinks are adding vitamin A to fruit drinks our children are consuming.

Vitamin A is the active principle in carotene which has three types; alpha, beta and gamma.  Beta carotene is about twice as strong as alpha and gamma.   Vitamin A is essential in retinal function since the rod photoreceptors are made-up of vitamin A (retinene, retinal) and a protein substance called opsin.  A vitamin A deficiency can cause nightblindness and xerophthalmia (drying of the conjunctiva and cornea).  Deficiencies of vitamin A are rare, and usually occur as a result of malabsorption (due to intestinal surgery for Chrone's disease or Cystic fibrosis), liver disease (alcohol cirrhosis) or excessive intake of vitamins C or E.  Too much vitamin A, called hypervitaminosis A, causes symptoms similar to a brain tumor including increased intracranial pressure, blurred vision and swelling of the optic nerve (papilladema), headaches, dizziness, vomiting, diarrhea and a protruding of the front of the head.  Hypervitaminosis A occurs when daily intake exceeds about 50,000 IUs/day.    However, the dosage that causes hypervitaminosis A depends on body weight and may be substantially less if you're a female, child or are of small stature. 

Can hypervitaminosis A cause floaters?  We were unable to uncover any scientific evidence about such a link.  However, since hypervitaminosis A can cause papilledema it is possible that it could also cause excessive floaters.  Also, it is interesting that it took almost two years for the floaters to disappear.  Since vitamin A is stored in the liver in relatively large amounts, it can take years for excessive amounts of vitamin A to leave the body or, conversely, for a vitamin A deficiency to develop after absorption is reduced.  For example, in Crohn's disease large amounts of the intestines are removed and about 7 - 9 years later patients sometimes develop nightblindness due to vitamin A deficiency.  So the time frame of a few years for the elimination of excessive amounts of vitamin A to leave the body and for the floaters to disappear is the ball park.

Can hypervitaminosis A cause cracked feet?  The scientific literature is also moot on this point.  Vitamin A is essential for epithelial (skin) function so we would not eliminate the possibility that excessive amounts of vitamin A could cause epithelial dysfunction - including cracking feet and dry skin.  We do agree that more research is needed in the adverse consequences of excessive vitamin intake, particularly since Americans consume large amounts of vitamins.

Web site visitors, if you have any personal experiences with problems associated with supplemental vitamins please send us your comments and we'll tabulate the comments in a future Featured Article on the subject of supplemental vitamins and your vision.


Q.    [Why do I have] floaters in eye that make cataract operation almost worthless?

If you have had a cataract operation recently and have floaters so bad that it seems that the cataract operation was worthless, you need to see your ophthalmologist ASAP.  Although some floaters are common in the elderly and in people with high refractive errors, sometimes a lot of floaters is a sign of a serious eye problem.   Cataract surgery can result in retinal tears and retinal detachments and one sign of these conditions is a lot of floaters.  If you have a retinal tear or retinal detachment you may need eye surgery to prevent the condition from getting worse and causing a permanent loss of vision.  Cataract surgery is very traumatic for the eye and sometimes the surgery will generate quite a bit of floaters, but these should clear-up after a while.

Q.    About a year ago I was diagnosed with high blood pressure.  At the time I also experienced flashing lights when in the dark and bright dots and flashes.  I also developed floaters in both eyes.  My doctor thought that I may have a small hemorrhage from the retina...Could the flashing lights be the result of high blood pressure or is a detached retina a possibility?

A retinal hemorrhage can cause the flashing lights and floaters that you are experiencing.  High blood pressure can also lead to a retinal hemorrhage, although you should also be checked for diabetes.  A retinal hemorrhage can also lead to a retinal detachment so all of your conditions warrant close medical supervision.

Q.   I am a 17 year old male, and I am having trouble with my vision. I see floaters all the time, I see halos around all lights at night time, and during broad daylight I see dark flashes all the time. It is really disturbing and scary. Can you tell me what is wrong?

You need to see an eye doctor ASAP.  Unless you are real nearsighted (myopic) you should not be seeing floaters.  Lots of floaters may be a sign of a retinal tear, detachment or/and bleeding in the eye.  Are you diabetic?  Sometimes a retinal hemorrhage as a result of diabetes will cause some of your symptoms.  You may have a serious eye problem and need to see an eye doctor NOW.

Q.    Vitamin A and Isotretinoin and floaters?  I took isotretinoin (13 cis-retinoic acid) for acne and it gave me floaters...

Isotretinoin, commonly called Accutane can cause a number of vision problems including poor vision at night, corneal opacities and "visual disturbances", possibly including floaters.  Women who are pregnant or who may become pregnant SHOULD NEVER use Accutane because it can cause birth defects.  Accutane can also cause a condition called pseudotumor cerebri - the symptoms include headache, nausea, vomiting and visual disturbances.  If you have these symptoms and are taking Accutane, you should call your doctor immediately about stopping the drug and see an ophthalmologist. 



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