How do I keep my eyes healthy and prevent cataracts or macular degeneration?

Cataracts and macular degeneration (AMD) are the two leading causes of blindness worldwide. In 2020, cataracts were estimated to affect 15.2 million people over the age of fifty. That same year, AMD caused blindness in 1.8 million people. Early detection is crucial for both conditions, so regular eye check-ups are not a luxury.

The most important risk factors for cataracts are ageing and oxidative stress, confirmed by multiple large systematic reviews. UV radiation and diabetes also increase the risk. Wear UV-filtering glasses on sunny days and keep your blood sugar under control. Diabetes also raises the likelihood of diabetic retinopathy, a retinal condition that led to severe vision loss in 2.6 million people worldwide in 2015.

Diet also plays a role, although these are associations rather than proven causal relationships. A pattern high in vegetables, fruit, legumes, nuts and fish is associated with a lower risk of cataracts; this was analysed across 24 studies. Lutein and zeaxanthin, colour pigments in the macula of the eye that you obtain from dark green leafy vegetables such as kale and spinach, appear to slow the progression of both AMD and cataracts. Large supplementation studies show mixed results. The strongest evidence supports a varied, antioxidant-rich diet, not any single specific supplement.

Once cataracts have developed, they cannot be reversed through diet or medication. Surgery in which the cloudy lens is replaced by an artificial lens is the only proven effective treatment. It is one of the most cost-effective procedures in medicine and delivers rapid, good visual recovery for most people. Blurry or glaring vision therefore does not have to be accepted as inevitable.

The practical message: combine lifestyle measures, protection and monitoring. Wear UV-protective glasses outdoors, eat a varied diet rich in vegetables and fruit, keep your blood sugar in check if you have diabetes, and have your eyes examined regularly, especially after the age of fifty. Both early cataracts and AMD are often discovered incidentally, and early intervention really does make a difference.