Anatomy of the eye


You may have friends that say “I have macula.”  What they mean is they have macular degeneration.  Symptoms include:

  • Shadows, blurriness, or holes in the center of vision.
  • Straight lines appear wavy.
  • Trouble seeing details both up close and at a distance.
  • Difficulty telling colors apart, especially ones close in hue.
  • Vision can be slow to come back after bright light exposure.
    People with severe macular degeneration lose their central vision and see the world as depicted below.

In macular degeneration, there is scarring and bleeding in the macula area of the retina.  There  is a spectrum of macular degeneration.  Some patients who have it do not have any visual symptoms at all.  There are two types – dry and wet.  The dry form of macular degeneration, is less severe, yet there’s also no real treatment for it.  It’s considered the early stage of macular degeneration and the only form of treatment is preventative (no smoking, take vitamins such as Ocuvite, which is available at Costco).  The Age-Related Eye Disease Study (AREDS for short) is one of the few studies which proves a beneficial effect of taking a combination of vitamins (Vitamin C, E, beta carotene, zinc and copper) in preventing the progression of macular degeneration.

The wet form, is the more advanced form of macular degeneration.  It’s called “wet” because the blood vessels leak and cause bleeding underneath the macula.

Though this is the worse form of macular degeneration to have, there is treatment for it.

  1. Laser treatment  used to seal off the leaky blood vessels.
  2. Anti-angiogenesis agents – The newest form of treatment are injections (anti-VEGF) which work by slowing the growth of the leaky blood vessels.  Examples of these injections include – Avastin and Lucentis.  Typically, these injections must be performed every 1-2 months or the blood vessels will regrow.

Now to the food part. Some research suggests that a diet rich in those antioxidants may be linked to a lower risk for eye diseases. One recent large study found that people whose diets were high in lutein and zeaxanthin were at lower risk of developing age-related macular degeneration (AMD) and of progression to advanced AMD, the vision-threatening form.  Another large study found that people with high lutein and zeaxanthin dietary intake were at lower risk for cataracts.

Patients always ask if dietary changes will help improve cataracts and macular degeneration.  And, while a healthy diet cannot reverse these changes, it may be able to help prevent macular degeneration and cataracts from becoming significant.  Lutein and zeaxanthin are found in dark, green leafy vegetables like spinach, kale and collard greens. The yolks of eggs also contain lutein. The antioxidants are also present in yellow and orange vegetables and fruits, like sweet potatoes, carrots and peaches. National health organizations recommend from five to 13 servings of vegetables and fruits per day, depending on age and gender. One serving equals one cup of salad greens, or one half a cup cooked vegetables or cut fruit, or one medium-size piece of fruit, or six ounces of juice.

So far, the jury is still out as to whether high dietary levels or supplements of these substances prevent or just slow the progression of age-related eye diseases.  More than one study has shown that vitamins, minerals and phytonutrients found in food offer advantages that are not available in pill form.  Still, eating fresh, whole foods supports a person’s general health, and taking a balanced multivitamin supplement is usually considered a good general health “insurance” practice.

Below are a couple recipes from our family to yours, to maximize your intake of spinach, kale and collard greens.

Now, I am not a huge kale fan, or at least I wasn’t.  But, my mother-in-law made this salad and it fast became one of my favorites.  The recipe is originally from her friend Joan Namkoong.

print recipeKale Salad


  • Fresh kale
  • Sliced red onion
  • Kalamata or picholine olives, pitted and halved
  • Dried cranberries
  • Walnuts, broken into pieces
  • Balsamic dressing


Use a mixture of regular kale, Red Russian kale, lacinato or other varieties and try to get young (small leaves) kale which is more tender.  Remove the leaves from the stems as you wash it; discard stems.  Stack the leaves and cut into fine shreds.  Use about 1 cup of shredded leaves per person.  Place in a salad bowl.

Add the onion, olives, cranberries and walnuts; toss with dressing.  You can toss this ahead of time and let it sit – the kale won’t wilt like other salad greens, making this a great salad for a buffet

Balsamic dressing


  • ½ cup balsamic vinegar
  • 1 cup olive oil
  • 1 tablespoon honey or sugar
  • 2 teaspoons Dijon mustard
  • 1 teaspoon salt
  • ½ teaspoon black pepper


Whisk all the ingredients together

Note:  3:1    oil : acid

Below is a recipe for a popular Indian dish you may have tried in an Indian restaurants.  This recipe is from my mother.

print recipeSaag Paneer (Indian spinach-cheese curry)



  • 1 bag fresh spinach (frozen spinach can be substituted)
  • 1/2 large onion, chopped
  • 1/2 medium tomato, chopped
  • 2 cloves garlic, chopped
  • 1 inch ginger, finely chopped
  • 1/4 tsp turmeric
  • 1/4 tsp salt
  • 1/2 tsp ground coriander
  • 1/2 tsp ground cumin
  • 1 tsp garam masala
  • 1 Tbsp butter
  • 1 Tbsp oil
  • 1/3 package of paneer, cut into cubes.  (Paneer is simply home made cheese and can be bought frozen in any Indian grocery store, if you don’t want to go through the trouble of making it yourself.  There’s even one here in Hawaii.  Click here for the address.


Heat the oil in a large saucepan.  Once warm, add the ginger and garlic and cook for one minute.  Add the onion and reduce the heat to low, cooking for 5 minutes.  Then, add the salt, cumin, coriander, and turmeric to the onion-garlic mixture, cooking for about 2-3 minutes.  Next, add the tomato, cooking it for an additional 2-3 minutes until the tomato begins to soften.  Add garam masala along with 1/4 cup water and cook for 5 minutes.

Add the spinach with 1 cup of water and saute until the spinach begins to wilt, turning off the heat.  Puree the spinach mixture with a hand held blender or remove from heat and blend in a food processor.

In a separate saucepan, heat the butter and paneer, turning constantly so it does not stick to the pan.  Add a pinch of turmeric, garam masala and salt to the paneer while frying.  When golden brown, turn off the heat and combine the paneer with the spinach mixture.


print recipeKale Smoothie (Our 2 year old drinks this!)


  • 2 stems of kale
  • 1 cup of orange juice
  • 1 cup of frozen peaches
  • 1 cup of frozen pineapples
  • 1 6 ounce cup of yogurt (we use blueberry because it was in the fridge)
  • 5 ice cubes


Blend together and serve

And, see, even our 2 year old likes it!


© 2011 Honolulu Eye Doctor & Mom Suffusion theme by Sayontan Sinha