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Age-Related Macular Degeneration Awareness Month

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over age 50. The Centers for Disease Control and Prevention estimate that 1.8 million people have AMD and another 7.3 million are at substantial risk for vision loss from AMD. Caucasians are at higher risk for developing AMD than other races. Women also develop AMD at an earlier age than men. This eye disease occurs when there are changes to the macula, a small portion of the retina that is located on the inside back layer of the eye. AMD is a loss of central vision that can occur in two forms: “dry” (atrophic) and “wet” (exudative). Most people with macular degeneration have the dry form. While there is no specific treatment for dry AMD, studies have shown a potential benefit from vitamin supplements, a Mediterranean diet, protection from the ultraviolet light of the sun and cessation of smoking. The less common wet form may respond to intraocular injections of anti-VEGF medications if detected and treated early.

Causes & risk factors

  • Heredity.
  • UV Light exposure.
  • Smoking.
  • Poor nutrition.
  • Lack of exercise.


In its early stages, the following signs of macular degeneration can go unnoticed.

  • The gradual loss of ability to see objects clearly.
  • The shape of objects appears distorted.
  • Straight lines look wavy or crooked.
  • Loss of clear color vision.
  • A dark or empty area in the center of vision.


If experiencing any of the above signs or symptoms, contact a doctor of optometry immediately for a comprehensive eye examination. Tests will determine if one has macular degeneration or any other eye health problems. A doctor of optometry can also provide a simple take-home screening test called an AmLer Grid. Central vision that is lost to macular degeneration cannot be restored. However, low-vision devices, such as telescopic and microscopic lenses, can maximize existing vision.


With “dry” macular degeneration, the tissue of the macula gradually becomes thin and stops working properly. There is no cure for dry AMD, and any loss in central vision cannot be restored. However, researchers and doctors believe there is a link between nutrition and the progression of dry AMD. Making dietary changes and taking nutritional supplements can slow vision loss. Less common, “wet” macular degeneration occurs when fluids leak from newly formed blood vessels under the macula. This leakage blurs central vision. Vision loss can be rapid and severe. If detected early, wet AMD can be treated with intraocular injections of anti-VEGF medications. Researchers have linked eye-friendly nutrients such as lutein and zeaxanthin, omega 3 supplements or consumption of fatty fishes, vitamin C, vitamin E and zinc to reducing the risk of certain eye diseases, including macular degeneration. For more information on the importance of good nutrition and eye health, please see the diet and nutrition section.


  • UV protective glasses.
  • Cardiovascular health and exercise.
  • Properly controlling and monitoring diabetes and hypertension.
  • No use of tobacco products (cigarettes, cigars, vapes, etc.)

Nutrition and AMD

There’s no substitute for the quality of life good vision offers. Adding certain nutrients to a diet every day—either through foods or supplements—can help save the patient’s vision. In a large human clinical trial, AgeRelated Eye Disease Study (AREDS2) by the National Eye Institute Researchers, linked lutein and zeaxanthin, omega 3, vitamin C, vitamin E and zinc to reducing the risk of AMD.

Lutein and Zeaxanthin—Need 10 mg lutein and 2 mg zeaxanthin per day to slow AMD progression

Lutein and zeaxanthin are found in green leafy vegetables as well as other foods such as eggs. Many studies have shown that lutein and zeaxanthin reduce the risk of chronic eye diseases, including AMD.

Vitamin C—Need 500 mg per day to slow AMD progression

Scientific evidence suggests vitamin C, when taken with other essential nutrients, can slow the progression of AMD and visual acuity loss. The first AREDS clinical trial, AREDS1, established AMD as a “nutrition-responsive disorder.” The study showed that taking 500 mg/day of vitamin C, along with antioxidants beta-carotene, vitamin E and zinc, slows the progression of AMD by about 25%. Seven smaller studies have confirmed these results.

Vitamin E—Need 400 mg per day to slow AMD progression

AREDS showed that taking 400 IU/day of vitamin E, along with antioxidants beta-carotene, vitamin C and zinc supplementation, slows the progression of AMD by about 25% in individuals at high risk for the disease.

Zinc—Need 40 to 80 mg daily to slow AMD progression

AREDS showed that taking 40-80 mg/day of zinc, along with antioxidants beta-carotene, vitamin E and vitamin C, slows the progression of AMD by about 25% and visual acuity loss by 19 % in individuals at high risk for the disease. Higher levels of zinc may interfere with copper absorption, which is why the people in the AREDS study also took a copper supplement. Omega 3s need study data for recommended dosage and types.

Contact Lens Health Week and COVID

August 17-21st is Contact Lens Health Week and as members of the American Optometric Association (AOA), we want to is reinforce that with proper hygiene practices, contact lenses can continue to be worn safely during the COVID-19 pandemic.
Guidance for safe contact lens wear during the pandemic has been issued by the Centers for Disease Control and Prevention (CDC) during the seventh annual Contact Lens Health Week, August 17-21, 2020.
This year, the CDC, along with the AOA, wants to emphasize the importance of healthy contact lens hygiene practices in protecting against serious eye infections and other illnesses. Now more than ever, it’s important to wash your hands before handling your contact lenses. Handwashing is an essential first step in the fight against not just infections, but COVID-19 transmission.
Failure to wear, clean, and store lenses as directed increases the chance of getting germs in your eyes and causing complications. Contact lens-related eye infections can lead to long-lasting damage but often are preventable. Even minor infections can be painful and disrupt day-to-day life. Your contact lens wear and care habits, supplies, and us, as your eyecare provider are all essential to keeping your eyes healthy.
We recommend the following tips to help ensure proper wear and care for contact lenses:
• Always practice good hygiene and follow proper safety precautions when handling lenses. It has been noted that contact lens wearers touch their faces and eyes when inserting and removing lenses, which can spread germs.
• Exercise proper hand washing. When using contact lenses or spectacles, wash your hands carefully and thoroughly with soap and water often for at least 20 seconds, followed by hand drying with unused paper towels. This should occur before every contact lens insertion and removal. People should avoid touching their face, including their eyes, nose and mouth, with unwashed hands.
• Disinfect contact lenses. Contact lens wearers should either dispose of their daily disposable lenses each evening, or regularly disinfect non-disposable lenses according to instructions from the manufacturer and one’s eye doctor.
• Discontinue lens wear if sick. Consistent with recommendations for other types of illness, those who feel ill with cold or flu-like symptoms should cease contact lens wear.
The AOA and CDC make it clear that there is currently no evidence to suggest contact lens wearers are more at risk for acquiring COVID-19 than eyeglass wearers.
If you have questions regarding your contact lenses, please call.

Phase 2 Re-Opening begins June 15th

We are happy to report that we are expanding our hours of operation beginning June 15th.

We have implemented numerous safety measures at the direction of the CDC, AOA, MOA and State of Michigan Department of health. We are following the measures provided in CMS recommendations set forth in the “Opening Up America Again Recommendations for Re-Opening Facilities to Provide Non-Emergent, Non-COVID-19 Health Care Phase 1”

Things will look a bit different at our office. Please click the link on our home page to learn more about the steps we are taking and the expectations for patients and staff in coming into the office.

Appointments are recommended for all visits so that we may maintain proper social distancing.


Phase 1 Re-Opening begins May 13th

Vision care is essential! We will be resuming part-time office hours this week! Full-time hours will resume on May 28th, 2020.

Pursuant to Governor Whitmer’s Executive Order E) 2020-77 and EO 2020-72, we will not be fully open but resume some critical services with limited hours and staff.

We have implemented numerous safety measures at the direction of the CDC, AOA, MOA and State of Michigan Department of health. We are following the measures provided in CMS recommendations set forth in the “Opening Up America Again Recommendations for Re-Opening Facilities to Provide Non-Emergent, Non-COVID-19 Health Care Phase 1”

Things will look a bit different at our office. Please click the link on our home page to learn more about the steps we are taking and the expectations for patients and staff in coming into the office.

An appointment will be required to enter the office, so please call ahead.


COVID-19 Office Closure Notice Announced April 1st, 2020

Effective 3/31/2020 at 5:00 pm we regret that all the Smoke Vision Care locations will be closed through April 13th at a minimum. With a more likely re-open date of April 30th based on the President’s most recent recommendation of extending social distancing. Last week our Buchanan office alone remained open on a limited basis to serve the urgent needs of our patients while taking extreme precautionary measures to keep everyone safe.

With the growing number of cases in the counties we serve and the Executive Orders in place by our governor we have made the difficult decision that closing all offices completely, would be in the best interest of patients, staff and the community.

If you have a non-urgent issue, please leave a message on our machine at 269-695-3434. You may also email our locations through the link on our website or message us through our Facebook page. We plan to be checking these messages minimally several times per week. You can use these means to request eyewear reorders, contact lens orders, repairs or general questions.

All urgent and sight threatening issues will be triaged via our emergency number. If you have an ocular emergency, please call our Buchanan location at 269-695-3434 for instructions on how to reach our on- call doctor.

May God Bless you all and keep you safe and healthy during this very difficult time

COVID-19 reduced care and office hours announced

Effective immediately and through April 6th, 2020 our New Buffalo and Dowagiac location will be closed to patient care visits.

The Buchanan office will be open Monday – Friday from 9:00 am – 5:00 pm with controlled access and a focus on urgent care. Please know, that while we remain open for care, it will not be business as usual, we are taking all necessary and extra precautions to limit patient volume and exposure of our staff and patients to COVID-19.

We ask that all patients contact our office for proper screening and advice prior to visiting our office.

We appreciate your cooperation as we try to provide care in a controlled environment, minimizing risk to our patients and staff while providing only the most essential care and services.

A message to our patient regarding COVID-19


Dear Patients of Smoke Vision Care,

We want to assure you that we are here to provide you with the highest quality of care as we continue to monitor reports of the potential impact of the Coronavirus (COVID-19). During this time, our top priority is the health of our staff and patients.

Please see our policy below:

Smoke Vision Care COVID-19 policy

March 17, 2020

Because changes are occurring rapidly with the COVID-19 pandemic, this policy will be reviewed daily and revised as recommended by public health and government officials.

Our offices are currently remaining open and taking the following measures. As of this writing, there are no confirmed cases in SWMichigan The number of people in our office at one time remains under the volume recommended by officials. Less than 10 at any time.

If you are not feeling well, have had a fever, cough, been in close contact with other having potential symptoms, are in a high risk group for infection or been out of the country in the last 14 days we ask you to not come to the office. We will be available for phone and if needed video consultations to evaluate urgent eye care needs in patients who are at risk for carrying or being infected by COVID-19

To schedule a phone consult with clinical advice with one of our doctors please call any of our offices to make arrangements.

What we know about COVID-19:

  • This virus is primarily spread through respiratory droplets. It can also remain on surfaces and be transmitted from hand to mucus membrane (nose, mouth, or eyes).
  • Most patients have flu-like symptoms. There is some disease spread by people with minimal to no symptoms. Patients with more symptoms are likely more contagious.
  • 80% of our patients are at increased risk of death (over 60 years of age) from COVID-19.
  • We can slow the process with social distancing, thereby reducing the chance our hospital system becomes overwhelmed by doing our part to “flatten the curve.”
  • Our services are vital for preserving vision.
  • Coronaviruses, as a group, are seasonal, historically abating in summer months. This is our hope and prayer for COVID-19, hence it is a reasonable estimate that we will return to “normal” by that time.
  • A vaccine is potentially on the way.

Actions we are taking:

  • Maintaining in-office volume to less than 10 persons allowing us to keep up with needed sanitization
  • Streamline exams to limit exposure time of our patient and staff to a minimum, doctors may be performing pre-testing and health histories themselves foregoing a visit with the tech prior to the doctor
  • Eliminate hand-shaking and hugging
  • Eliminate use of slit lamp by technicians (reduce exposure to the “T-zone” and reduce patient contact points).
  • Manage high risk patients remotely by calling symptomatic patients for clinical reviews
  • Wipe all surfaces (including the door handle, patient chair, and slit lamp) after each patient.
  • Remove shared items around the office, including pens, coffee centers, patient refreshments (cookies), container of mydriatic glasses, multi-use lens cloths, toys, magazines, etc.
  • Instruct all staff members with any upper respiratory infection symptoms or flu-like symptoms to stay home until those symptoms resolve.
  • Instruct all staff members who have had confirmed or suspected exposure to a person diagnosed with COVID-19 are to stay home until the recommended time to return (currently 14 days from exposure).
  • Ask patients to space themselves in the waiting room at least 1 meter apart.
  • Disinfect all waiting room chairs after each use.
  • Patients are limited to one visitor/companion who is providing transportation to the patient receiving care. If the patient is capable of being alone, we will ask the visitor/companion to wait in the car.
  • Insist that patient refrain from handling any frames on our board and have optician bring frames to the patient
  • Clean all frames in optical after contact with patients before placing back on board




Smoke Vision Care celebrates one year as ambassador for the Red Glasses Movement

What does the Red Glasses Movement have to do with Smoke Vision Care? In so many ways we see this message as perfectly fitting to our practice, patients and community. So much so, we decided to become an ambassador to help spread the message.

The Red Glasses Movement was started in honor of a very special 5-year old girl, Audrey Jandernoa, who passed away on Friday, January 26, 2018. Audrey was born with Down syndrome and a congenital heart defect, but these were not things that defined her.

Audrey was defined by her bright Red Glasses, her contagious smile, and her lack of inhibitions. She went through life like a little bulldozer, pushing her way through every door possible to achieve her goals again and again beyond the expectations of others. She had a way of loving indiscriminately and without restrictions. She was a shining example of love, kindness, and courage in this world.

We feel our practice is a perfect place to start sharing the message for many great reasons. First, we love glasses!! Especially big bold glasses that make a statement. Second, we love caring for patients who have special needs. Down’s Syndrome is associated with a high incidence of ophthalmic conditions that can negatively impact the life of these patients if they are not diagnosed or left untreated. Our practice is uniquely suited to spend the time and attention to the specific needs of Down’s Syndrome patients. Thirdly, the way Audrey lived was a great example to all of us. It can inspire each and every one of us to Live Boldly. Love Big and Pass it on.

The Red Glasses Movement is Audrey’s living legacy. We’re glad we get to share it with you.

Stop by any of our offices to pick up your FREE pair of Red Glasses so you can show your support for the power of this positive message or share with someone you love who needs a little motivation to keep living, loving and passing it on.

To learn more about the Red Glasses Movement or help spread the message please visit the Red Glasses Movement Website

Like the Red Glasses Movement Facebook Page to become inspired by the stories of other who are living and spreading the message!!

Our tools for early detection and proper treatment of AMD

Age-related macular degeneration is one of the number one causes of vision loss. Early diagnosis and intervention can help a patient retain vision but a majority of cases are diagnosed too late. Many others simply start taking “vitamins” they heard are good for the eyes when in fact, standard AREDS/AREDS2 formulas are not safe and may cause progression in some AMD patients.

Our comprehensive eye health and vision exams will help detect AMD in the earliest stages. We have the most advanced technology to evaluate the health of the macula through Optical Coherence Tomography (OCT) , a quick and safe test enables an in-depth assessment of the retina to detect warning signs before they affect vision. Similar to an ultrasound or MRI examination,an OCT scan is a quick, easy, and comfortable experience. The images below show that OCT instrument and example of a scan of a macula with and without AMD changes.

oct machineoct amd and normal

We also offer a genetic test to patients who have a diagnosis of early or intermediate AMD. Using the complete combination of AMD genes and smoking history, the test identifies those most likely to progress to advanced AMD with vision loss. The test is a simple cheek swab that gets sent to a testing lab, and the results are returned to our office within four weeks. Most healthcare insurers including Medicare reimburse the test.

The test allows us to identify whether you are at an elevated risk of advancing to the more severe form of the disease because of a genetic predisposition and which if any nutritional supplements are right for our type of AMD. Knowing your risk of progression can help us better monitor and manage your disease with the goal of protecting your vision long term. Click the image below to visit the macula risk genetic testing website and learn more.

predict and protect


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