Disorders

MACULAR DEGENERATION is a disease characterized by loss of central vision from deterioration of the central retina (macula), which usually starts after the age of 55. The exact cause is not known. However, genetics, UV exposure, and tobacco are known risk factors. It is the leading cause of vision loss among patients 65 and older.

Patients may develop drusen, small, yellow flecks in the macula. These patients may experience blurred vision if the drusen degenerate further and turn into macular degeneration. This blurred vision is due to retinal cell atrophy and is termed dry macular degeneration. New blood vessels may grow underneath the retina, which can bleed and scar. This is called wet macular degeneration.

Dr. Streiff checking for macular degeneration






 


TWO TYPE'S:

A. DRY FORM:

  • The dry form is usually less severe.
  • The progression of the disease is slower (years).
  • The first sign may be the formation of small yellow flecks called drusen (SEE PICTURE).
  • There is no actual treatment. Special eye vitamins have shown to slow progression.
  • To prevent from developing into the wet form, both office and home monitoring are used.
  • Special magnifiers to aid vision can be prescribed.

Normal eye. The macula is colored spot to the right of the lighter circle (optic nerve). It is darker because there is a second source of blood flow.

 

Early dry macular degeneration. View from eye doctor's perspective. Note yellow flecks over macula.

 

Advanced dry macular degeneration (photo taken at Skowron Eye Care)

 

B. WET FORM:

  • The wet form is usually more severe due to bleeding.
  • The progression is faster.
  • TREATMENT is available with laser or eye injections. The outcome is better if caught early.
  • The patient needs to be closely monitored both in the office and at home (with a special chart).
  • Special magnifiers to help vision can also be prescribed.

Wet macular degeneration. Notice the hemorrhage or bleeding over the macula.

 

SIGNS OF MACULAR DEGENERATION:

  • Blurred vision
  • Distorted or "wavy" vision
  • Noticeable blind spot in one's vision, usually central (PICTURE)
 
    Patients are given this chart to self monitor at home by ensuring that all the lines remain straight. If they appear to be bending or distorted, this could indicate progression of macular degeneration.

RECOMMENDATIONS TO MINIMIZE THE DEVELOPMENT OR PROGRESSION OF MACULAR DEGENERATION:

  • Patients 55 and older should be examined for signs of advanced macular degeneration (AMD) yearly.
  • Eat a balanced diet rich in fruits and vegetables.
  • If signs of AMD are present, a combination of antioxidant vitamins and zinc may be helpful. Consult with your doctor to determine which is right for you. Smokers should not take supplements of beta carotine as this can increase the risk of lung cancer.
  • Stop smoking (definite link between smoking and Macular Degeneration)
  • If outdoors a lot, wear a hat with a brim to avoid direct sunlight, and wear sunglasses with UV protection.
  • Patients are often given an "Amsler Grid" (PICTURE) for self monitoring at home.

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