Eye diseases can have a genetic or multifactorial origin.
Genetic (or hereditary) diseases, such as Leber congenital amaurosis, retinitis pigmentosa, Stargardt disease, choroideremia, X-linked retinoschisis, cone dystrophies, Usher syndrome, achromatopsia, etc., are caused by the presence of one or more defects (mutations) in the DNA, inherited from one or both parents. For this type of disease, the onset is determined solely by the genetic factor.
Multifactorial diseases, on the other hand, owe their onset to a combination of factors, which can be genetic, environmental, and behavioral. For this type of pathology, the concept of “co-responsibility” must be considered between the overall structure of the genetic heritage, the possible genetic predisposition (or genetic susceptibility) to a disease, environmental factors, and behavioral factors: all these factors – and none alone – influence the onset of the disease.
Most eye diseases are multifactorial, for example age-related macular degeneration (or maculopathy), glaucoma, dry eye syndrome, central serous chorioretinopathy, etc. This means that to preserve eye health, it is fundamentally important to control modifiable risk factors (environmental and behavioral), taking into account the risk associated with non-modifiable factors (age and genetic predisposition).
Environmental risk factors include the presence of sunlight (UV radiation), wind, dust, chemical contaminants, etc. (these may play an important role in particular geographical areas or in certain professions); behavioral risk factors, on the other hand, are harmful and incorrect habits, such as an unbalanced diet (too rich in sugars and fats and low in vitamins and minerals), lack of physical exercise, cigarette smoking, sun exposure (and thus UV rays) without protection, etc.
Adopting healthy behaviors from childhood significantly lowers the risk of onset of many diseases. Attention to correcting modifiable risk factors becomes even more important with age and when there is or is suspected to be a genetic susceptibility. In these cases, in fact, the adoption of a correct lifestyle must aim to lower the overall risk of disease onset by compensating for the genetic and age-related risk.
It is very important to inform your ophthalmologist if there is a recurrence of a multifactorial eye disease in the family, as this will help to assess the genetic risk. Nowadays there are also DNA tests capable of verifying the existence of genetic susceptibility to certain diseases (for example, age-related macular degeneration, keratoconus, etc.).
The presence of genetic susceptibility to a given eye disease does not indicate with certainty that the disease will occur. The patient can request the advice of an expert geneticist who, after assessing the overall situation, can provide the patient with a personalized prevention protocol aimed at lowering the overall risk for that disease. The protocol will be based on modifying (correcting) certain lifestyle parameters.
“Better safe than sorry” is a popular saying that expresses a simple yet truly valuable concept in medicine. Prevention is indeed today the most effective weapon to fight many diseases, especially those that can cause even very serious damage to vision and for which there is still no definitive treatment.
Adopting a virtuous lifestyle from a young age helps to stay healthy even in later years. Choosing a balanced diet, exercising regularly, controlling body weight, blood pressure, blood sugar, and cholesterol levels, not smoking, not overdoing alcohol, avoiding drugs, etc., significantly contributes to lowering the risk of onset of most eye diseases, ensuring better vision – and therefore quality of life – for many years.
Before surgery, it is necessary to perform a series of eye examinations aimed at measuring certain parameters of the eye, in order to establish the most appropriate surgical technique and choose the most suitable intraocular lens.
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