Glaucoma is a disease that can affect people of all ages, but one that seniors are at a particularly higher risk for. It is considered the most preventable cause of vision loss, but if left untreated, can cause damage to the eye’s optic nerve and result in irreversible vision loss, and even total blindness. The disease tends to run in families and most often occurs in people over the age of 60.
January is Glaucoma Awareness Month, and to help spread the word, we had the wonderful opportunity to sit down with Dr. Stuart P. Richer, OD, PhD, Director, Ocular Preventive Medicine, at Captain James A Lovell Federal Health Care Facility. Dr. Richer has shared his expertise in Ocular Preventive Medicine, along with his advice and best practices for adults to maintain healthy vision into their senior years.
Interview with Dr. Stuart P. Richer OD, PhD, Director, Ocular Preventive Medicine, Captain James A Lovell Federal Health Care Facility
What are some common challenges that you see seniors facing with their vision, and how does your practice help resolve those challenges?
Age Related Macula Degeneration (AMD) is the leading cause of loss of visual independence in the United States, effecting “cultural vision” – the ability to read standard newspaper size print and/ or drive a car. This degenerative disease ultimately results in a loss of independence for seniors, especially if both eyes become involved, which is typically the case. 50 % of patients who populate our country’s low vision and Blind Rehabilitation Clinics have suffered from AMD. This disease is in part a disease of ageing, with a strong genetic component that rises exponentially in the 8th and 9th decade of life. That is, there are some 10x as many seniors with AMD between the age of 85 and 95 than between the ages of 75 and 85. It is far more prevalent than a simple doubling of cases every decade, and the 85 to 95 age group is the fastest growing US demographic. We need to redouble our efforts to promote preventive eye care while patients are younger. Our medical center has been a national leader in this effort.
Maintaining independence for seniors is a central part of Freedom Home Care’s mission. In your opinion, what sets them apart from other in-home care-giving services?
I would say that Sharon Burack (President/CEO) sets the organization apart, because she is not only a clinically trained therapist with decades of clinical experience. She also contributes a commanding understanding of the challenges faced by older Americans, both physically and financially. This is gleaned from her years of professional experience dealing em pathetically with the elderly, as well as members of her own immediate family.
Can you share the best practices for adults to maintain healthy vision into their senior years?
1) Eat plenty of antioxidant, mineral and nutrient rich fresh vegetables and fruit. Keep your diet as colorful as possible, and free of processing whenever feasible. Lutein-containing spinach and kale and zeaxanthin-containing yellow peppers are particularly good at building protective and vision-enhancing retinal macula pigment.
2) Limit intake of corn, vegetable oils and trans fat from processed and fast food restaurants, while increasing consumption of quality oils containing omega III fats. The latter would include the oils from fish and nuts. After 50 years of age, limit meat consumption that contains an absorbable form of iron called “heme iron”. This type of iron is linked to degeneration of the eyes and brain as well as other organs. Be careful with long-term iron supplementation, and if you must take iron, do so only under direction and guidance of your physician.
3) Limit simple carbohydrates, such as white breads, white potatoes, white rice and pasta, and bypass regular and diet soft drinks, in favor of water and teas.
4) In-take high quality protein, such as grass fed, organic eggs containing both omega III fats and lutein. The lutein in egg yolk that provides the egg with its yellow color is 4 times more bioavailable when eaten with the fat from the egg. The highest quality egg costs as little as 25 cents.
5) Keep hydrated with additional water, and consume fish / fish oil / borage oil especially if you have dry eyes and skin.
6) Get an important blood test done: The “25 OH Vitamin D3” liver reserve status can be checked at your next doctors’ visit to determine exactly the dose of vitamin D3 you need to optimize your immune system, and ward off cardiovascular disease and cancer. Vitamin D3 intake is especially important in the winter for people living in northern climates such as Illinois, is especially crucial for people of color and for those people taking chronic acid blocking medications.
7) Learn everything you can about how the medications you are taking could possibly deplete the vitamins and minerals you are taking in, and the effects this might have on your eyes and brain. Suzy Cohen, PharmD has written several consumer books on this topic as well as the website Public Citizen.
What is your favorite part about being in the Optometry practice?
The privilege and opportunity to impact the lives of so many individuals on a case-by-case basis is very rewarding. More so as our patient population includes those who directly defend our freedom – military personal, their families and retired veterans.
Can you talk about your expertise in antioxidant research, and how it relates to vision solutions for seniors?
I have spent the better part of 2 decades involved in the clinical application of using the diet and nutritional supplements to enhance the structure and function of the retina, the light sensitive tissue in the back of the eye. Many readers may not appreciate that your eye doctor can change how the eye sees through specific dietary and supplement recommendations. For example, humans have a tiny specialized area of the retina called the fovea that is responsible for sharp central vision. It is heavily protected with a carotenoid dietary pigment that provides each eye with sharp vision, and protection against degenerative disease such as AMD (macula degeneration). Over the years we have published the results of careful experiments involving either protecting this retinal area or enhancing its function, by building up macular – pigment – density with nutrition or supplements – in elderly subjects.
Because of this research, our older veterans and military retirees benefit from improved quality of vision especially when driving their automobiles at night. This includes better contrast discernment, better recovery from blinding headlight glare, less light sensitivity (called photophobia), less disabling windshield glare, faster reaction time etc.
What have been some of the biggest changes in the Optometry Profession over the last 20 years?
The largest change in the profession is the emergence of technology in the form of a suite of opto-electronic instruments that are faster, better and can be delegated to technicians. The optometrist of today interprets data, more so than performing the tests themselves.
The second largest change is the emergence of widespread pharmaceutical use for both diagnostic and therapeutic application, such as treatment of infections and glaucoma.
The third biggest change in the profession is the emergence of women optometrists. They were somewhat of a rare phenomenon when I graduated in 1981 (perhaps 15%). Today, 2 out of 3 graduating optometrists are females. As with many professions, females are simply more qualified than before.
About Dr. Stuart P. Richer OD, PhD, Director, Ocular Preventive Medicine, Captain James A Lovell Federal Health Care Facility
Dr. Richer earned his undergraduate degree in 1977 from the Rochester Institute of Technology, after which he completed a dual OD MS (physiological optics) program at the University of California at Berkeley in 1981. A one-year residency in low vision / hospital based optometry followed at the Kansas City, Missouri DVA Medical Center. He has been Chief of Optometry at DVA Medical Center, North Chicago, IL since 1983. He has been actively involved in teaching optometry and medical students as well as postdoctoral fellows of all disciplines.
In 1996 Dr. Richer earned his PhD in human physiology and biophysics from Chicago Medical School following 15 years of practice. He’s an associate professor of Family and Preventative Medicine at Chicago Medical School and Clinical Optometry at ICO and UMSL. Dr Richer has authored papers in Current Eye Research, Experimental Eye Research, FASEB, Vision Research, Optometry & Vision Science, Optometry, and International Ophthalmology Clinics. He has presented his research to the US Department of Defense, the Spanish Ophthalmologic Congress (Granada, Spain 1996), Schepens Eye Institute Retina (Harvard, 2000 meeting), the Peking University Eye Center / ILSI Focal Point (Beijing, 2002 & 2009), ARVO Retinal Section (Ft Lauderdale 2003), and the Canadian Society for Cataract and Refractive Surgery (Montreal 2003, Ottawa 2005), Euro Press Conference (Frankfurt, Germany 2004), Spanish Retinal Society Madrid (2005), Italy Fermo (2005), Japanese Ophthalmologists (Sapporo 2005), EU Retina (Lisbon, Portugal 2006), The Technion, Israel (Haifa 2006) and ARVO SERC (USA 2006), Japan Kemin Lutein Symposium (Tokyo 2007). He is the principal investigator of the Veterans Lutein Antioxidant Supplementation Trial (LAST), the first US randomized double masked placebo controlled clinical trial of lutein and visual function published in the Journal Optometry April 2004 and the FDA/DVA approved Zeaxanthin and Visual Function Study (ZVF). He is a Fellow in the National Academy of Practices in Medicine and his Team was announced as Service to America Medal finalists in Science and Technology at the US Senate Hart Bldg, June 2006.
Actively involved in primary care optometry and clinical antioxidant research, Dr. Richer has special interests in aging, prescribing nutrients in the intervention of age related macular degeneration, low-tension glaucoma, diabetic macular edema, prevention of cataracts and dry eye.
About Captain James A Lovell Federal Health Care Facility, North Chicago, IL
The Captain James A. Lovell Federal Health Care Center (FHCC) is a first-of-its-kind partnership between the U. S. Department of Veterans Affairs and the Department of Defense (DoD), integrating all medical care into a fully-integrated federal health care facility with a single combined VA and Navy mission.
Located in North Chicago, Illinois, the Lovell FHCC was established on Oct. 1, 2010. The arrangement incorporates facilities, services and resources from the North Chicago VA Medical Center (VAMC) and the Naval Health Clinic Great Lakes (NHCGL). A combined mission of the health care center means active duty military, their family members, military retirees and veterans are all cared for at the facility. The health care center ensures that nearly 40,000 Navy recruits who transition through Naval Station Great Lakes each year are medically ready. We care for nearly 67,000 eligible military and retiree beneficiaries each year, and bring Veterans throughout Northern Illinois and Southern Wisconsin first-rate care.
