Education: Macular Degeneration

Macular degeneration is the leading cause of vision loss in individuals over 65. Get regular eye exams to detect it as early as possible.

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Macular Degeneration

What is a Macular degeneration?
Macular degeneration is the deterioration of the central portion of the retina, known as the macula. This area of the eye is responsible for focusing central vision in the eye. It controls our ability to read, drive a car, recognize faces or colors, and see in fine detail. Macular degeneration is the leading cause of vision loss and blindness in individuals over age 65.

Macular degeneration affects both distance and close vision. It reduces vision in the central part of the retina. However it does not affect the eye's side, or peripheral, vision. Macular degeneration alone doesn’t result in total blindness. People continue to have some useful vision and are able to care for themselves.

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There are two forms of macular degeneration:

  • ”Dry" macular degeneration (atrophic). This is the most common form. It is caused by aging and thinning of the tissues of the macula with gradual vision loss. Despite ongoing medical research, there are no FDA-approved treatments for "dry" macular degeneration. Some recommend nutritional supplements as a way to slow down macular degeneration. However these have not yet been proven to be effective. Your doctor will focus treatment on helping you find practical ways to cope with visual impairment.
  • "Wet" macular degeneration (exudative). This is a less common form, yet typically more damaging. It results when abnormal blood vessels form at the back of the eye and leak fluid or blood which blurs central vision. Vision loss can be more rapid and severe. In some instances, the dry type of macular degeneration can progress into the wet type.

Who gets macular degeneration and what are the symptoms?
Age-related macular degeneration is a progressive deterioration of the central regions of the retina known as the macula. Vision is affected as the tissue ceases to function properly.

Macular degeneration affects different regions of the macula from person to person, so the symptoms tend to vary. The condition may be hardly noticeable in the earlier stages. Symptoms often associated with macular degeneration include:
  • A gradual loss of ability to see objects clearly
  • A gradual loss of clear correct colors
  • Vision that is noticeably distorted
  • Straight lines appear wavy
  • A dark or empty area appearing in the center of vision
  • Difficulty reading or seeing objects up close

These symptoms may not necessarily mean that you have macular degeneration. However, if you are experiencing one or more of these symptoms, contact us for a complete exam.

What treatment options are recommended for macular degeneration?
In all stages of macular degeneration, antioxidant therapy would appear to have a role in slowing the progression of the degeneration. There are antioxidant vitamins that have been investigated by the AREDS (Age-Related Eye Disease Study). These taken one to four times a day may slow the progression of some forms of macular degeneration by nearly 40%. Dietary additions such as fish, especially the oily fish eaten twice a week, can in some studies slow the progression as much as 38%. Green leafy vegetables, such as spinach, kale, broccoli, and fruits such as blueberries and prunes, have been shown to be very high in antioxidants and specifically lutein, and play a role in slowing the progression of macular degeneration. The yellow squash and carrots may play a role. All of these dietary changes would be those recommended for patients of any age, and especially in those in whom a family history of macular degeneration is present.

The first step is a medical evaluation to determine if you have macular degeneration. It will include an examination of your eye and a simple vision test.

Dry age-related macular degeneration is the aging process in the retina of the eye. At the present time, there is nothing that has been found to stop this progression. As mentioned above, nutritional supplements may slow it down and keep vision better longer. Revolutionary advances in the past five years have dramatically improved the outlook on wet macular degeneration. In the past we were limited to straight forward laser therapy that often left the visual acuity worse after laser than before but destroyed the blood vessels creating the bleeding or leakage. We now have an array of treatments possible, including intraocular injections and light cold laser therapies that have substantially improved the long-term prognosis of these eyes. Though they require repeated visits and re-injection, they often can result in mild improvements in visual acuity and stabilization of the wet macular degeneration to the level that was present before the blood vessels developed. For many of these therapies you may be referred to a retinal specialist whose specialty is dealing with just this type of problem.