Science & Research

This is an interesting question. The prevalence of age-related macular degeneration (AMD) is lower in populations that do not subsist on a Western diet, and have more dietary fish intake (Japan, for example). However, the current evidence supporting a protective effect of omega-3 fatty acid supplementation on AMD patients is controversial. Some smaller retrospective studies have suggested that omega-3 fatty acids may reduce the risk of progression of early or intermediate AMD to the advanced stage of this disease; however, other studies dispute such an association.

Currently, the large, multicenter National Eye Institute AREDS2 trial is designed to study the effects of omega-3 fatty acid supplementation on patients with AMD. This is a prospective, ongoing study and will evaluate whether omega-3 fatty acid consumption can indeed reduce the risk of AMD progression. Fish oil has been proven to have benefits on cardiovascular health, and with the current evidence, I would not recommend against taking this supplement, as long as you are aware that the evidence for its protective effects on ocular health have not clearly been established yet.

Smoking is a definite risk factor for AMD. The mechanism is thought to be related to nicotine use, as there are nicotine receptors in the retinal pigment epithelium. All AMD patients are advised to stop smoking.

Many AMD patients report decreased contrast sensitivity, which appears to result from the disease process. There are no studies indicating that fluorescent lighting can impact the progression of AMD. In terms of working in your office, you may consider using a different type of indoor lighting that does not aggravate your symptoms. Your retinal physician can also refer you to a low vision specialist who will be able to offer you more suggestions on how to alter your work environment in order to enhance your visual function.

Many sunglasses today offer UV protection. UV rays can still penetrate through clouds, which is why dermatologists still advise wearing sunscreen on cloudy days. Similarly, in order to protect your eyes from UV light, appropriate sunglasses are reasonable to wear, as long as they don't interfere with your vision.

If the "spider webs" or "black dots" move around when you look in different directions, they may actually represent floaters. The only way to determine this is for you to visit an eye doctor for a dilated eye exam. "Spiderwebs" and "black dots" in your vision may be a normal consequence of aging, but may also signify something more serious. These symptoms may precede the onset of a retinal tear or detachment. Please be aware of the following signs and symptoms of retinal detachment that would require you to seek an urgent dilated eye exam:

1. Flashes of light that originate from inside your eye
2. A sudden, significant increase in the number of "spiderwebs" and "black dots" in your vision
3. A "curtain" or cloud coming over part of your visual field

The word edema refers to swelling from excessive accumulation of fluid in a tissue, and was formerly called hydropsy or dropsy. As such, by "macular dropsy,” you are likely referring to what is now commonly called macular edema, which is swelling in the center or the retina (the region known as the macula) caused by fluid leakage. The accumulation of fluid in the macular region can lead to a number of problems including blurred or distorted vision.

You are correct; Stargardt's disease is a rare form of juvenile macular degeneration. And unfortunately, there is no treatment or cure for the disease at present. There is a great deal of research into ways to prevent or treat Stargardt's disease; however, most of the studies conducted to date have centered on the following:

1. Genetic testing to identify the genes likely involved in the development of the disease
2. Development of better imaging strategies to diagnose and track progression of the disease
3. Testing of new treatment and prevention strategies in animal models of the disease

While much information has been gained and the data is promising, much still remains to be learned. There have also been several clinical trials at various levels involving human patients with Stargardt's disease. If you visit "clinicaltrials.gov" you can find up-to-date information regarding government-sponsored clinical trials that are either recently completed or presently underway. Also, if you type the following link into the address bar on your web browser, it will take you directly to a page on that site with links to information related to studies on Stargardt's disease: http://clinicaltrials.gov/ct2/results?term=stargardt

Any sudden decrease in vision in a patient with wet macular degeneration warrants an urgent eye exam. It is possible that your mother has experienced a hemorrhage in her eye from abnormal choroidal vessels. If so, another injection is indicated to hopefully stop the bleeding. Your mother should immediately call her retinal physician if she has any dramatic changes in her vision.