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You have the power today to prevent the three main causes of age-related vision loss

iT'S EASY to fake your age — color your gray, wear trendy clothes — but the minute you reach for your reading glasses, the jig is up. "As you age, the eye lens doesn't flex as easily as it did when you were younger, and it gets difficult to focus on items up close," explains Robert Cykiert, M.D., an ophthalmology professor at the New York University School of Medicine. "It's called presbyopia, and almost everyone is affected by it at some point in their lives."

While there's not much you can do to prevent presbyopia, there is a lot you can do to maintain the overall health of your eyes — and protect against disease-related vision loss, Cykiert says. Although eye diseases tend to strike after age 60, they take decades to develop, so there's ample opportunity to intervene. The three top offenders are cataracts, age-related macular degeneration (AMD), and glaucoma.

Cataracts are the most common, affecting nearly everybody after age 70 but sometimes affecting those as young as 55. It occurs when proteins within the lens deteriorate, affecting the eye's ability to focus light and produce clear, sharp images. The result is a blurring and clouding of vision. AMD involves the abnormal growth of blood vessels in the central part of the retina (macula), which damages the eye's light-sensing cells and causes vision loss in as many as 15 percent of seniors. It's the leading cause of irreversible blindness in Western countries.

Glaucoma affects just 1 percent to 2 percent of seniors. It involves damage to the optic nerve, which transmits images from the eye to the brain, and is accompanied by increased pressure in the eye.

Fortunately, prevention of these diseases isn't that difficult. In fact, caring for your eyes is as easy as caring for your body: Eating right and exercising are half the battle. Set your sights on the following strategies for keeping your eyes in good working order for life.

1. Eat your fruits, veggies — and fish!
Mom was right to push those beta-carotene-rich carrots for eye health, but now you can add kale, spinach, oranges (which are rich in antioxidants), and fish (they're a good source of omega-3 fatty acids) to your disease-fighting arsenal. In a 2005 study of 4,170 people published in the Journal of the American Medical Association, participants who consumed foods containing beta-carotene, antioxidant vitamins C and E, and zinc lowered their risk of developing AMD by 35 percent. These same nutrients may reduce your risk for cataracts, says a 2005 Tufts University study involving more than 4,000 women and published in the American Journal of Epidemiology. In that study, women who ate fish such as salmon or tuna at least once a week lowered their cataracts risk by 15 percent. An Australian study of 2,258 people published in the Archives of Ophthalmology found that eating three or more servings of oily fish per week could reduce the risk of AMD by as much as 70 percent.

Eating right also means avoiding certain foods. New research from Tufts University, published in the American Journal of Clinical Nutrition in June 2006, shows that high-glycemic-index foods such as white bread and table sugar-which the body converts more rapidly to blood sugar than it does low glycemic-index foods such as sweet potatoes and lentils — heighten the risk for AMD. High-glycemic-index foods impair glucose metabolism, which researchers believe may contribute to eye disease.

2. Consider supplements
"Nothing is clearer in the medical literature than the benefit of antioxidants for eye health," says Fred Pescatore, M.D., a family practitioner in New York City who specializes in nutritional medicine. "They literally undo the cellular damage caused by the sun." It works like this: Too much sun exposure raises production of free radicals in the blood-stream, which in turn harms the microscopic blood vessels that serve the eye. "Antioxidants neutralize these free radicals before they can cause too much damage," Pescatore says. Rich sources of antioxidants include blueberries, pomegranates, grapes, oranges, walnuts, sunflower seeds, and green leafy vegetables such as kale and spinach, to name just a few. But if you eat like most Americans, you're not getting nearly enough.

A few small, preliminary studies have shown that some herbs may benefit eye health as well. Ginkgo biloba may help maintain the lining of the blood vessels to keep blood flowing freely to the eyes. Pescatore suggests that seniors take 120 milligrams twice a day. Another promising supplement is bilberry, an herb rich in anthocyanidins, which may help protect eye tissue. Pescatore recommends taking a bilberry supplement that contains other eyeboosting ingredients. His favorite is Eye-Rite, by Carlson Labs, which contains lutein, quercetin, vitamins C and E, and bioflavonoids from cranberries.

If you already have an eye disease, supplements may help slow its progression and preserve your vision. A joint study involving 4,ooo-plus participants conducted by the National Institutes of Health and the National Eye Institute showed that taking 15 milligrams of beta-carotene, 500 mg of vitamin C, 400 mg of vitamin E, 80 mg of zinc oxide, and 2 mg of cupric oxide could lower risk of further macular degeneration by nearly 25 percent. (Always consult an ophthalmologist before choosing a supplement.)

3. Get fit
Exercise and weight control can reduce your risk of developing AMD, according to research by Johanna Seddon, M.D., a surgeon in ophthalmology at the Massachusetts Eye and Ear Infirmary. "And if you're genetically predisposed to AMD — heredity does play a role — exercise can help delay it," she says. Her research, involving 261 people and published in the Archives of Ophthalmology in 2003, showed that patients with a high (above 25) body mass index, or BMI, saw their AMD advance twice as fast as those with a lower BML However, those who got regular exercise — defined as vigorous activity three times a week — slowed disease progression by 25 percent. Exercise, Seddon explains, reduces inflammation; and though the exact mechanism isn't yet clear, there's growing evidence that inflammation is associated with the development of AMD. Several studies, including one published in the journal American Family Physician in 2003, also suggest that regular aerobic exercise can slow the effects of glaucoma by reducing the internal eye pressure that may play a role in damaging the optic nerve.

4. Quit smoking
According to the Mayo Clinic, cigarette smoking is the "single most preventable cause of macular degeneration." A recent study published in the Archives of Opthalmology found that smokers have nearly double the risk of AMD nonsmokers have. Researchers believe toxins associated with smoking may decrease blood flow or cause dots to develop within eye capillaries. It may also increase free radical production. "There are dozens of toxic chemicals in cigarette smoke that can damage blood vessels in the retina, contribute to AMD, and cause cataracts to progress," explains Cykiert.

5. Go under cover
"Wearing sunglasses — even when it's cloudy — is absolutely the best thing you can do to protect your eyes, starting from as early an age as possible," says Pescatore, noting that the damage is cumulative. In a 1988 study published in the New England Journal of Medicine, researchers from Johns Hopkins Hospital found that of 838 men working on Maryland's Chesapeake Bay, those with the most sun exposure had three times the risk of developing cataracts as those with the least exposure. Ultraviolet light (specifically UVB, the potent, short-wave rays considered to be the main cause of melanoma and other skin carcinomas) oxidizes proteins in the eye's lens, altering them in such a way that they stick together, occluding the lens. Invest in a pair that protects against both UVB and UVA, the long-wave rays that cause wrinkling and other signs of photoaging. (For a range of styles at every budget, see "Smart Shades," page 60.)

6. Take care of contacts
Sloppy contact lens care invites the spread of bacterial infection into the delicate structures of your eye, potentially causing severe corneal damage and possible loss of vision. Early this year, a huge jump in the number of fungal keratitis infections among the country's 38 million contact lens wearers made this abundantly clear. Fungal keratitis is a severe infection of the cornea that kills tissue and causes inflammation that's hard to control, leading to vision loss if not caught in time. "In previous years, there were maybe a dozen cases annually, but there have been 130 confirmed cases just in the last six months — even showing up in places as far away as Hong Kong," says Cykiert The vast majority of patients who developed the infection were using a specific cleaning solution, which has since been recalled.

To protect your eyes, always wash your hands before handling contact lenses; discard used solution; and thoroughly clean lens cases with soap and hot water. If you use disposable contact lenses, don't try to extend the expiration date. Toss them according to the manufacturer's recommendations.

7. See your doctor
One of the best things you can do to protect your vision is to have a thorough eye exam by an ophthalmologist every two to four years, starting at age 40 (after age 65, you should increase your visits to once every one to two years). Your doctor should check your eyesight, inspect your glasses if you wear them, test your eye muscles, and take an eye pressure reading. Alert your doctor to a family history of age-related eye disease or diabetes so you can be followed very carefully for early warning signs.

8. Swap the drops
If your doctor prescribes eye drops as a treatment for allergies or a diagnosed eye infection, absolutely use them. But if you're just lubricating dry eyes or trying to erase evidence of last night's revelry, use natural tear-replacement drops (such as Murine Tears Lubricant Eye Drops, Opti-Free Replenish Rewetting Drops, or TheraTears Lubricant Eye Drops) instead of remedies that purport to whiten red eyes. These products often contain tetrahydrozoline hydrochloride, which relieves redness by shrinking blood vessels temporarily. After their effect wears off, blood vessels dilate, causing rebound redness.

SMART SHADES
Over time, exposure to ultraviolet light can cause long-term damage to your eyes. To protect them, ask your optometrist for a UV coating on your prescription glasses. And wear sunglasses that offer protection from UVA and UVB rays. To be sure, check labels or look for the seal from the American Optometric Association (aoa.org). Choose frames that fully cover the eye area with lenses that aren't too dark: Dark lenses can cause your pupils to dilate and let in more light. If your eyes are light-colored, you may need extra protection; try wraparound shades with side coverage. We've picked five frames that do the job and look good as well.

Fashion-forward Donna Kara n has jumped on the aviators bandwagon with this super cool pair, updated in ultrahip bronze. (Donna Karan bronze aviators, #DK2509, $199)
If you constantly lose sunglasses, this pair from Isaac Mizrahi for Target is perfect for you. It offers maximum UV protection for just $20. Get yourself a spare pair! (Isaac Mizrahi for Target Shield in green-brown/ brown, $20)
Handcrafted Smith shades block UVA,UVB, and even cancer-causing UVC rays. With their distinct pearlized finish, they help safeguard your eyes in sporty style. (Smith Charm in pearl/ brown gradient, $99)
Don't let the ultrafashionable animal print fool youthese High Definition Optics lenses from Oakley are some of the most technologically advanced in the industry, providing 100 percent UV filtering and maximum clarity. (Oakley Script in green tortoise/dark bronze, $140)
Carved from naturally sustainable zebrawood, these large square frames from iWood Eco Design (iwoodecodesign.com) offer a unique, customizable look. Choose from a variety of woods, lens colors, and frames. (iWood Ecodesign #304 in zebrawood, $350)
PHOTO (COLOR): EYES ON THE PRIZE: Smart diet and lifestyle choices offer protection.

PHOTO (COLOR): HERBAL HELP: Ginkgo biloba

PHOTO (COLOR)

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By Aviva Patz

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