Lifestyle Guide for Retinal Patients

Oxidative stress has been recognised as a common pathway in many forms of retinal degeneration. It occurs when there are too many free radicals in the body (highly reactive molecules) and the body’s natural antioxidant defences are unable to keep up. Over time, this imbalance can contribute to cell damage.

Reducing exposure to oxidative stressors may help support overall retinal health.

Key steps include:

• Avoiding smoking and vaping
• Limiting overexposure to sunlight and blue light from electronic devices
• Following a largely plant-based diet rich in antioxidants

Leafy green vegetables contain the carotenoids lutein and zeaxanthin, which are important for supporting central vision.

A balanced, nutrient-rich diet can support overall health and eye health.

• Regular junk food and highly processed foods
• Foods with artificial colours, preservatives, sweeteners, and flavour enhancers (e.g. MSG, cyclamates)
• Fizzy drinks and energy drinks, which often contain high levels of sugar and colourants

Frozen or tinned foods may contain fewer additives but should still be checked for added sugars, especially for people with diabetes.

People with inherited retinal degeneration linked to an ABCA4 mutation, or those with unknown genetic mutations, should avoid all animal liver products. These foods are high in vitamin A, which may contribute to retinal damage in these conditions.

Foods containing beta-carotene (such as carrots and other yellow or orange fruits and vegetables) may be eaten in moderation.

• Green leafy vegetables such as spinach, kale, herbs, eggs, and corn (sources of lutein)
• Yellow and red vegetables
• Nuts, seeds, high-fibre foods, and fresh fruit
• Oily fish such as sardines, pilchards, tuna, and salmon (rich in omega-3 fatty acids)

Potatoes and rice can be cooked, refrigerated overnight, and reheated the next day. This converts carbohydrates into a form that may be easier to manage metabolically.

People with diabetes should follow the guidance of their nutritionist regarding all forms of sugar, including fructose.

For parents and caregivers:

• Add chopped spinach or herbs to sauces, soups, pizzas, and salads
• Include green leafy vegetables in everyday meals in simple, familiar ways

For children, it may not always be possible to control diet in social settings. Children still need to enjoy everyday experiences, and occasional indulgence is part of life. Caregivers can then be more mindful of dietary choices at home.

Important:

People with Juvenile Macular Dystrophy (including Stargardt Disease), Cone Dystrophy, Cone-Rod Dystrophy, and smokers should not take supplements containing vitamin A or beta-carotene.

All supplements should be discussed with your eye specialist before use.

Depending on the retinal condition, supplements may be recommended that include:

• Lutein
  
• Zeaxanthin
  
• Alpha-lipoic acid
  
• L-glutathione
  

New antioxidants such as N-acetyl cysteine (NAC) are currently being researched. For people with AMD, condition-specific supplements may be advised by a healthcare professional.

Protecting your eyes from environmental damage is important.

• Wear sunglasses with UVA and UVB protection
• Use a hat or cap when outdoors for added protection
• Monitor blue light exposure from screens

Follow the 20–20–20 rule when looking at screens.

• Every 20 minutes, look at least 20 metres away
• For 20 seconds
• Blink 20 times

This exercise helps change focus, strengthens the eye muscles, and blinking helps lubricate the cornea.

Children should be encouraged to spend time outdoors and limit excessive screen use. Prolonged screen fixation, particularly on mobile devices, has been linked to an increased risk of myopia (short-sightedness) and other long-term vision problems.

• Engage in regular physical activity such as walking, swimming, yoga, or chair-based exercises
• Avoid smoking and vaping, which significantly increase oxidative stress
• If alcohol is consumed, it should be done in moderation, in accordance with general health guidelines, as excessive intake can contribute to oxidative stress and affect overall health.
• Attend regular eye examinations
• Children and adults with retinal conditions should consult a low vision optometrist and see their eye specialist regularly

Retina South Africa provides guidance and support across all aspects of living with retinal vision loss, including:

• Accessibility and assistive technology
• Rehabilitation and low vision services
• Peer mentoring and support
• Referrals to specialist service providers
• Genetic testing information
• Digital support groups