Get Well Wednesdays: The Eyes Have It

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Dr. Neal Adams is the former Chief of the Division of Visual Physiology at the Wilmer Eye Institute of the Johns Hopkins Hospital, Johns Hopkins University School of Medicine and the former Chairman of the Department of Ophthalmology at the Paul L. Foster School of Medicine at the Texas Tech University Health Sciences Center.

His private practice, DC Retina, focuses on providing patients with surgical and nutrition-based care.

Dr. Adams earned his Bachelors in Chemistry from Yale University and his M.D. from Johns Hopkins University. He is a graduate of the Wilmer Eye Institute Residency Program. Following completion of a Retina Fellowship at Wilmer, he was selected to join the Faculty at Johns Hopkins and honored with Johns Hopkins Wilmer Eye Institute’s highest award to a junior faculty member – the Maumenee Scholar. He was then selected to lead the Division of Visual Physiology. Dr. Adams is Board-Certified in ophthalmology.

Dr. Adams has received many honors as a highly skilled surgeon, clinician, academician, and researcher. He also devotes time to research endeavors focused on retinal disorders. Dr. Adams has coined a new category of retinal degenerations, called the “retinal ciliopathies.”

Adams is the author of Healthy Vision, which aims to raise awareness about eye health.

Why and when did you decide that you needed to be active in educating people about the link between nutrition and eye health?

When I started my career on the faculty at Johns Hopkins, many times my patients would ask me, ‘What can I eat to help protect my eyes? Carrots? Broccoli?’ I soon realized there was a real need for good information. And the answer goes way beyond carrots. So, I spent about 8 years reviewing the medical literature and the science on nutrition for the eye. The proven links between nutrition and eye health went beyond what I had ever imagined.

What is the most surprising thing you found in your research into nutrition and the eye?

In our bodies, the level of nutrients is higher in the eye than anywhere else. For example, the level of vitamin C in our bodies is highest in the back of the eye, about 100 times higher than in our blood stream. We often talk about vitamin C and the common cold, but there is little scientific evidence that vitamin C helps protect against the common cold. However, there is a tremendous amount of scientific evidence that vitamin C protects against cataract formation; study after study shows vitamin C decreases the risk of cataract by 50%, 60%, 85% (depending on the study). But if you take vitamin C pills by themselves, you’ll increase the risk of cataracts, because without the appropriate balance of antioxidants, vitamin C becomes a toxic chemical dehydroascorbate that damages the eye. The book teaches the reader these important lessons.

What illnesses are possible to detect by just looking at someone’s eyes without equipment?

Without specialized equipment to look inside the eye, we can focus on the eyelids and front of the eye, and detect a wide-range of illnesses that affect other parts of the body-conditions ranging from neurologic disorders such as myasthenia gravis, to hormone and endocrine disorders such thyroid disease, to inflammatory and vascular disorders such as sarcoid or rheumatoid arthritis.

For example, we can look at the white of the eye and we can see red spots or patches on the white of the eye. These can be signs of high blood pressure (most commonly) or of excessive heavy exercise, blood-thinning medications (such as aspirin or ibuprofen), smoking, diabetes, bleeding disorders, viral infections (such as influenza or the “flu”), vitamin C deficiency in infants, and inflammatory disorders such as lupus. With equipment to look inside the eye, we can see over a hundred common conditions and dozens more uncommon ones.

What is the most common eye illness that can be reversed with good nutrition?

Diabetes is the leading cause of blindness in the U.S. Diabetes affects some 30 million Americans. When we think of reversing a common eye illness, diabetes is the first thing to come to mind. However, more common than diabetes is dry eye, which affects 1 out 6 people, and can be reversed with some simple good nutrition. Beyond that, macular degeneration, which affects over 1/3 of people over the age of 75 and affects nearly 1 out of 10 people in their 40’s and 50’s, certainly benefits from a dose of healthy nutrition.

Do we know everything there is to know about the eye? Are there any mysteries that we’re trying to solve?

The most fascinating mystery is how to turn on cells to regenerate our retinas when they degenerate. There are certain fish and amphibians that constantly regrow their retinas, just like a lizard may regrow its tail when it gets cut off. Well, guess what? In our eyes, we have those same cells that regrow in fish and amphibians. These are a type of adult stem cell that we all have in our own eyes, and if we could figure out how to jump-start them, then we could use our own stem cells to maintain the health of our retinas.

Do you recommend eye vitamins?

Patients often ask me about taking eye vitamins. Nutrition for the eye can be a complex solution and you need to balance your nutrients-not too much and not too little-but make sure that you get enough of the ones you need. Unlike pills, whole foods often naturally have a broad complex spectrum of vitamins and nutrients that work in tandem and we don’t know enough about all those interactions to mimic them in pills. And there’s no one-size-fits-all solution when it comes to pills.

What about the role of exercise in eye health? What exercises can you do that help your eyes?

There are many health benefits of exercise. Increasing your blood flow is one of the top health benefits and a research study that came out this year showed that being physically active over a 20-year period decreases your risk of having poor vision by a whopping 60%! Exercise is really about keeping your health in tip-top shape. Combined with nutrition, it is a simple and powerful tool to healthy vision.

Who should wear sunglasses and why?

The surface of the eye contains powerful ultraviolet blocking capability, so not much ultraviolet light really gets into the eye. However, the heat energy from light gets into the eye, and the heat energy from the sun burns. You may recall as a kid holding a magnifying glass up to the sun and burning a hole in a leaf. Well, the eye acts just like that magnifying glass. It makes sense to limit sun exposure and limit the heat energy from the sun with sunglasses.

Dr. Neal Adams’ Eye Healthy Dinner Menu:

Below is a dinner menu Dr. Adams created that would provide the maximum nutrition for healthy eyes.

APPETIZER: A delicious kale salad filled with red, yellow, and green peppers and a light dressing of olive oil and balsamic vinegar.

Kale is full of lutein and zeaxanthin, loaded with bioflavonoids and a super serving of vitamin A. It also has a very powerful anti-inflammatory agent call diindolylmethane (DIM for short). The peppers give you a variety of powerful antioxidants: glutathione, troxerutin, and quercetin as well as being loaded with vitamin C. Peppers have more vitamin C than any other common fruit or veggie — 3 times more than oranges and twice the amount as kiwis!

ENTRÉE: Garlic-ginger marinade grilled wild-caught salmon with a side of cinnamon-crusted sweet potato.

Salmon is the all-star of fish with 1,600 mg of DHA per serving, benefiting many eye conditions, ranging from dry eye to retinitis pigmentosa to macular degeneration. Ginger contains bioactive compounds called gingerols that are quite beneficially potent! Garlic contains bioflavonoids and a compound called allicin which promotes good health. Cinnamon is packed with bioflavonoids and sweet potatoes are loaded with vitamin A and the antioxidant coenzyme Q10 that helps produce energy and digest debris.

DESSERT (can’t forget desert): A little bit of lightly-honey-sweetened frozen yogurt flavored with natural dark chocolate, topped with a fresh fruit compote and fresh mint.

Chocolate packs in a ton of antioxidant bioflavonoids….in fact the top two sources of bioflavonoids by far are cocoa beans and unsweetened dark chocolate! The honey also has bioflavonoids, yogurt has vitamin B2, and mint promotes the survival of neural cells. Fruits are super-antioxidants.

TEA: Whether herbal, green, white, or black, tea is packed with a varied range of different bioflavonoids. So be sure to include tea in your diet!

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