With aging and exposure to ultraviolet light, the protein fibers of the lens, normally arranged in a precise latticework fashion, become oxidized and clump together. This clumping causes the lens to become increasingly cloudy. The lens itself has no nerve connections or blood vessels and is dependent on the liquid around it, called the aqueous humor, to get nutrients and remove waste products. This fluid is connected to a vascular network and contains very high levels of certain antioxidants that help nourish the lens as well as absorbing and detoxifying harmful substances. Lack of these antioxidants can cause cataracts to occur more frequently.

Cataracts are the leading worldwide cause of vision impairment and blindness. Cataracts are common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. A cataract can occur in either or both eyes, but cannot spread from one eye to the other.

What are the symptoms?
Cataracts tend to grow slowly, causing subtle changes in vision at first and progressing over time. Difficulty with contrast and color interpretation or loss of distance vision can be early signs of cataract formation. As the lens becomes cloudier or the cataract gets bigger, vision becomes more blurry. One may experience difficulty reading signs or written material, have problems with night vision or suffer from a painful glare around lamps, headlights and light from the sun. Loss of depth perception, double vision and seeing halos or multiple images in one eye can often prompt a visit to the eye doctor.

Primary physicians can often diagnose cataracts using a handheld opthalmoscope. However, definitive diagnosis of cataracts is often done by an eye care professional who will do a comprehensive exam that usually includes drops to dilate your pupil and allow better visualization of eye anatomy, including the lens.

Detecting a cataract early is good news. Since they grow slowly, early intervention can stop or significantly delay further clouding of the lens.

What are the causes?
In general, poor eye health is related to a number of risk factors: exposure to ultraviolet light, poor nutrition and other lifestyle habits, stress, and chronic disease. The risk of cataract formation varies with these, as well as increased age, but getting a cataract is not inevitable as we age. Factors that can increase the risk of cataract formation include:

• Trauma – even years after an eye injury
• Surgery – especially on or around the eye
• Smoking and excessive alcohol consumption
• Medications – especially photosensitizing agents that increase exposure of the lens to UV damage
• Steroids – especially eye drops
• Chronic diseases such as obesity, hypothyroidism and diabetes
• Congenital disorders in children
• Welding, glassblowing and ironwork – any occupation where workers are exposed to increased heat or other types of radiation
• Living at increased altitudes

What is the conventional treatment?
The first cataract treatment is ensuring adequate eye protection. Parents should encourage their children, even infants, to wear sunglasses and other forms of eye protection. Wearing wide-brimmed hats and visors have long been suggested to block ultraviolet sunlight. Workers with hazardous occupations should always wear protective shielding and eye protection.

If you smoke or drink, find ways to stop or significantly moderate your consumption. Chronic diseases need to be aggressively treated, especially weight gain and diabetes. Patients with diabetes have three-to-five times higher risk of cataract formation than does the general population. Effective management includes avoiding both chronically high and low blood sugar, as each can injure the lens.

Medications should be assessed to see which ones might be photosensitizers, and steroid eye drops should be used for as brief a period as possible.

At age 50 or older, it is important to have a comprehensive eye exam at least once every two years. In addition to cataracts, your eye doctor can evaluate for age-related macular degeneration, glaucoma, and other vision problems. Early detection and treatment is the key.

Surgery is the only effective treatment for advanced cataracts that cause visual impairment. The procedure involves removing the cloudy lens and inserting an artificial implant. The complications of cataract surgery include infection, dislocation of the lens, retinal detachment and hemorrhage. However, with modern technology, this surgery is an exceptionally safe procedure. Most people notice an improvement in vision almost immediately after surgery. If both eyes have cataracts that require surgery, it usually will be performed on one eye at a time, with a four-to-eight week between operations.

What therapies does Dr. Weil recommend for cataracts?
The best thing you can do to prevent eye disorders is to make sure that your diet contains a variety of antioxidants found in fruits and vegetables. Both the lens of the eye and the aqueous humor contain protective enzymes that breakdown the damaged proteins that clump together and cause cataracts. Antioxidants keep these enzymes from being destroyed. Vitamin C, vitamin E (mainly tocopherols), glutathione, and a variety of carotenoids are present in lens tissue and in the fluid that surrounds it.

Lutein is one such carotenoid. It is a major component of the yellow and orange pigment found in many fruits and vegetables including mangoes, corn, sweet potatoes, carrots, squash, tomatoes and dark, leafy greens such as kale, collards and bok choy. There is very good evidence that the lutein in food helps protect against cataracts and macular degeneration, two common, age-related eye disorders. Lutein and another carotenoid, zeaxanthin, form the yellow pigment of the retina and help absorb ultraviolet blue light, a harmful component of sunlight.

You can get zeaxanthin in orange bell peppers, oranges, corn and honeydew melon. Egg yolks also contain both lutein and zeaxanthin, but if you have high cholesterol, you’re much better off getting the yellow nutrients from fruits and vegetables.

In addition to eating these foods, Dr. Weil recommends taking a good multivitamin-mineral that contains vitamin C, vitamin E in the form of mixed tocopherols and tocotrienols, mixed carotenoids (including lutein and zeaxanthin as well as beta-carotene) and the B-complex vitamins. He also recommends an anti-inflammatory diet, including essential fatty acids such as fish oil, and herbs like turmeric and ginger.

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What are the symptoms of conjunctivitis?
The symptoms are redness in the whites of one or both eyes or inner eyelids, itching, irritation and excessive tearing. Your vision may be blurred and you may be sensitive to light. Your eyes may feel gritty, and there may be a discharge in one or both eyes that forms a crust during the night.

What are the causes?
Sometimes conjunctivitis occurs as an allergic reaction to pollen, dust or other foreign material in the eye – such as contact lens solution. When this is the case, the itching and irritation may be severe, the eyes may be very watery and even painful. Sometimes ordinary household chemicals and personal-care items such as spray perfumes and deodorants cause the irritation.

Conjunctivitis can also be due to a bacterial infection. This is more common among children than it is among adults and often is associated with a cold or sore throat. With bacterial infections, both eyes usually are affected, and you may notice a thick yellow discharge crusting over the eyelashes, especially when you wake up in the morning.

Finally, conjunctivitis can be caused by viruses, particularly those associated with colds as well as measles and other childhood illnesses. Viral conjunctivitis is very common. Onset is abrupt and usually in one eye, with the other eye becoming infected a day or two later. Excessive tearing and redness without pus-filled discharge are the usual symptoms.

What is the conventional treatment of conjunctivitis?
If the cause is known to be a chemical of any type that has gotten into the eye, flush the eye with water and call your physician. If a child gets a chemical product into his or her eye, follow the medical advice given on the package, go to the nearest hospital emergency room and be sure to tell the doctors what the substance was.

Bacterial conjunctivitis usually is treated with antibiotic eye drops or ointment but is contagious as long as there is discharge from the eye. Viral conjunctivitis usually clears up on its own within a week and is contagious while symptoms last. To avoid spreading the infections, don’t share towels, cups or drinking glasses; wash your hands after applying eye drops or ointment to your eyes (or your child’s eye); and don’t use eye drops in a non-infected eye that were used in an infected one. Also, don’t send children with viral or bacterial conjunctivitis back to school or day care until they are no longer contagious.

To relieve any discomfort of pink eye, apply warm compresses (use a clean, link-free cloth soaked in warm water and wrung out) to closed eyelids. Use cool compresses for allergic conjunctivitis and avoid rubbing your eyes. Over-the-counter eyedrops such as Naphcon-A or Opcon-A, which contain an antihistamine and an agent that constricts blood vessels may help.

To avoid reinfection don’t touch your eyes with your hands, wash your hands often (and thoroughly), change your towel and washcloth daily and make sure that no one else uses them, change your pillowcase often, throw away eye makeup (particularly mascara) and don’t use anyone else’s eye makeup or any type of cosmetic or skin care item that touches the face.

What therapies does Dr. Weil recommend?
Follow conventional medical advice for treating conjunctivitis and take the precautions recommended in the section above to avoid spreading the infection.

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