Q. What are your feelings regarding shingles shots and eye vitamins for our seniors?

A. Shingles is a painful rash with blisters caused by the chicken-pox virus. It stays in the body and can cause shingles years later.

Anti-viral drugs given within three days help somewhat, but steroids like prednisone won't reduce long-term pain and may even spread the virus. It's a good idea to get the shingles vaccine at or after age 60.

On your other query, folks older than 65 can get permanent loss of central vision from age-related macular degeneration, which affects the central area of the retina (back of the eye). The retina can deteriorate with age, and the highly regarded Cochrane Collaboration found that in those with age-related macular degeneration, taking antioxidants and zinc might be of modest benefit, with a risk reduction of about 20 percent to 25 percent, although long-term harm from these supplements was also deemed a possibility.

This was because the best study, known as AREDS, used 500 mg of vitamin C, 400 International Units of vitamin E, 15 mg of beta-carotene, 80 mg of zinc as zinc oxide, and 2 mg of copper as cupric oxide. But high-quality studies show that in general, beta-carotene, vitamin A or vitamin E, given singly or combined with other antioxidant supplements, actually increases death rates from all causes, including cancers and heart disease.

But since little else works, folks with intermediate or worse age-related macular degeneration may still decide to take the AREDS formulation. Vitamin E and beta-carotene risks are higher in smokers, diabetics and those with vascular disease.

And for general eye health? In the Oct. 13 British Medical Journal, Elaine Chong and others from the University of Melbourne looked at all studies ever done on whether antioxidants can prevent age-related macular degeneration.

Looking at more than 149,000 subjects, they found that supplements like vitamin A, vitamin C, vitamin E, zinc, lutein, zeaxanthin, alpha carotene, beta carotene, beta cryptoxanthin and lycopene did not prevent age-related macular degeneration.

The Cochrane group has confirmed these findings.

Stop smoking and correct obesity because both increase the risk of age-related macular degeneration. Eat more leafy greens, wear a hat and sunglasses with UV protection, and start exercising. A longitudinal study found a protective effect of increased physical activity.

Dr. Landis Lum is a familypractice physician for Kaiser Permanente. Send your questions to: Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Honolulu, HI 96802; islandlife@honoluluadvertiser.com; or fax 535-8170. This column is not intended to provide medical advice.