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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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My dad is 82 yrs old. He has been told he has dry optic

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My dad is 82 yrs old. He has been told he has dry optic nerve deterioration by an opthamologist. He was given eye drops to keep his eyes moist. Is there anything he can be doing to help himself other than just eye drops? His eyes sometimes look very tired when he comes home from work. He reads blueprints at work. He does not know what is causing it. Should he see a neuro opthamologist? If so, how do we find one in El Paso?
Doctor DanB :

Hello and thanks for your question. Are you available to chat?

Doctor DanB :

Was he diagnosed with macular degeneration or an optic nerve problem? It sounds as though he was maybe diagnosed with age-related macular degeneration (ARMD) which is the most common form of blindness among elderly individuals in developed countries.

Doctor DanB :

Are you there?

Doctor DanB :

There are typical spots found in the retina of patients who are diagnosed with macular degeneration, and these spots are called drusen. Drusen are collections of metabolic byproducts of the retina; they are yellowish spots as seen on exam by the ophthalmologist which collect underneath the retina. The retina overlying these drusen has the potential to waste away and lose function as well as having leaking of fluid, blood, and/or cholesterol through these spots. Drusen are a fairly generic feature of many retinal diseases such as age-related macular degeneration (ARMD), in addition to retinal dystrophies and other retinal degenerations.

There is a dry form of ARMD, that 90% of those with ARMD have, and a wet form (which 10% of those with ARMD have). Fortunately, of those that lose significant vision, only 10% have the dry form and 90% have the wet form. The bottom-line is the dry form is best and most people with that form don't lose significant vision.

However, it is possible to convert from dry to wet. For that reason there are a few things that can be done to help decrease those chances and to help catch it if it does happen.

The things we know for sure that affect the course of macular degeneration are as follows:

1. Eating a well-balanced, healthy diet and exercising regularly provide the best lifestyle protection against age-related macular degeneration (ARMD) worsening.

2. Taking an AREDS vitamin supplement is also crucial to slowing the progression of vision loss and decreasing the incidence of severe vision loss from ARMD. However, it is important to take the supplement (# of pills and # of times per day) as it states on the supplement bottle; some people take less # of pills or take it less times per day than is recommended, but with an altered regimen, the efficacy of these vitamins may be suspect. Additionally, if he has ever smoked before, it is important to make sure that you're not taking an AREDS supplement with vitamin A or beta-carotene (those are synonyms) in it; this can increase your risk of lung cancer if you've smoked and are taking this vitamin.

3. Also, smoking increases your risk of worsening ARMD so stopping smoking would be important.

4. Lastly, protect your eyes from UV exposure by wearing sunglasses while outside in the sun.

5. It is important for him to monitor his vision on a regular basis (1-2x/week) with an Amsler grid. The instructions and a copy of the grid can be found online with a simple google search. This will enable him to catch any possible changes to the vision which could herald a conversion from dry to wet ARMD. If this were to happen it would be vital to his vision that he see his ophthalmologist right away to get this treated because if it is caught in time, the changes can be stopped and in some cases reversed. However, if these vision changes are ignored for a week or more, then they can scar over and become permanent.

Those are the only things that have been proven to affect the course of ARMD.

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

Doctor DanB :

I'm still here to answer your questions you have about what I've written or to receive further direction if what I've said is not in-line with your concerns.

Doctor DanB :

Are you there to chat?

I switched to this Q&A format because I haven't heard from you and didn't know if you were not able to see my answers or to respond in the chat format (it gets kind of squirrely sometimes). But I am still here to help you with your concerns.
Customer: replied 6 years ago.
Finally, the right window appears! As far as I know he was not told he had macular degeneration but it does make sense. The vitamins, where do we find the correct ones? He smoked a lot 25 years ago. He has not smoked since. His doctor gave him eye drops and that's it. Not too proactive, any thoughts on finding a doctor more proactive like yourself in El Paso or even San Antoinio? He is a medicare patient if that makes any difference. I would pay for his health care but he is very independent still. I APPRECIATE your help so much.

I'm sorry we had window problems with this system, but I'm glad we're communicating now.

As far as the correct vitamins, there are many different brands of AREDS vitamins, what most people will commonly call "eye vitamins." But it is important to follow the directions on the back of whatever bottle of supplements you get. Many supplements will have him using 6-8 pills a day, but the supplement called PreserVision only has him using two pills/day so most of my patients pick that one. You should be able to find them in any drug store and you can even get them at CostCo.

As far as a doctor who is proactive as myself, I'm sorry I can't comment on El Paso, but I used to live and work as a physician in San Antonio so I can definitely refer you to someone there who I know very well. Grace Lindhorst, MD (can find her at the University of Texas Health Science Center at San Antonio, medical school) is an excellent ophthalmologist who I know and trust implicitly.

Does that help address your concerns?

Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?

I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.

If you would be so kind, please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.

Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!

My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

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