Macular degeneration is most often related to aging and hereditary. It usually starts with the appearance of spots in the macula, called “drusen.” Drusen do not usually change vision very much, and only a few people with drusen will develop severe macular degeneration with loss of vision.
When macular degeneration does cause a loss of vision, it usually only happens in one eye. Later, it may affect the other eye, but not necessarily. Often, when a person has severe macular degeneration in one eye, the loss of vision isn’t even noticed because the healthy eye can still see detail. It is only when macular degeneration severely affects both eyes that the person will find it difficult to do things that require central vision.
This is why it is so important to have regular eye exams. Changes in vision are more receptive to treatment during the early stages of any problem. Once the macula has been severely damages, treatment is usually no longer possible.
Symptoms of Macular Degeneration
In the earliest stages of macular degeneration, vision may become blurred for distance or for reading or both.
A very important symptom, however, is distortion. Straight lines (like telephone poles or door frames) may appear slightly bent. You may also see a dark gray spot or notice that the sizes or colors of objects don’t appear the same for each eye. Anyone who has these symptoms should see their doctor promptly.
Types of Macular Degeneration
Dry Macular Degeneration: When drusen are present for a long time, the macula may thin and stop working. This is considered dry or atrophic macular degeneration, which often causes a slow loss of vision.
Dry macular degeneration may cause people to see blank areas in their central vision.
Currently there is no medical or surgical treatment for dry macular degeneration. Certain lenses and counseling, however, may help those who are affected by training them to use their peripheral vision for everyday tasks.
It is important for anyone with the dry form to monitor their central vision carefully and see an eye doctor regularly, because the dry form can change into the wet form, which can be even more severe.
Wet Macular Degeneration: In the wet form of macular degeneration, abnormal blood vessels (called choroidal neovascularization, or CNV) grow under the retina and lift the retina up, often leaking fluid and bleeding. When this happens, central vision is distorted.
An eye with the wet form of macular degeneration will usually lose its ability to see detail. Additionally, if CNV occurs in one eye, there is an increased chance it will occur in the other eye. In some cases, laser treatment done promptly may stop or minimize loss of vision. The earlier the CNV is diagnosed, the better the chances for saving the central vision are.
Treating Dry Macular Degeneration
Unfortunately, there is no cure for macular degeneration. Prevention and monitoring are the best medicines.
Prevention: A healthy lifestyle can be important in reducing the risk of macular degeneration. A healthy diet rich in green leafy vegetables and fish, supplemented with vitamins high in specific antioxidants (A, C. E and beta-carotene with zinc) can significantly reduce the risk of macular degeneration.
Monitoring: One way to test the central vision in order to detect small changes when they first appear is to use the Amsler grid.
Instructions on using the Amsler grid:
- Wear your reading glasses.
- Cover one eye.
- Look at the center dot and keep your eye focused on it at all times.
- While looking directly at the center, and only the center, be sure that all the lines are straight and all the small squares are the same size.
- If you should notice any area on the grid that becomes distorted, blurred, or discolored, call Virginia Eye Consultants right away.
- Do this test for each eye separately.
Treating Wet Macular Degeneration
Intravitreal injections are a way to treat wet macular degeneration. Special drugs are injected into the eye to help slow down vision loss from macular degeneration and in some cases improve sight.
- Lucentis is a drug that causes shrinkage of the abnormal blood vessels when it is injected into the eye. The shots need to be repeated every 1 to 3 months. Lucentis can maintain vision in most patients and improve vision in many patients.
- Avastin (also called Bevacizumab) is an anti-growth factor drug, used to reduce the fluid at the back of the eye caused by wet macular degeneration. It also reduces new vessel growth.
- Eylea (also called Aflibercept) works by keeping new blood vessels from forming under the retina.
Photo dynamic therapy (PDT) is a two-part process. First, a drug is injected over several minutes into a vein in the arm. It travels through the body and localizes in the CNV. Then a laser is directed toward the CNV through a contact lens placed on the front of the eye. The light from the laser activates the injected drug, which closes the abnormal blood vessels.
PDT infrequently results in improved vision, but often reduces the loss of vision. After several months, the CNV usually reopens and the treatment needs to be repeated. Retreatment may be necessary every three months for at least one year to maintain the benefit.
Learn More Today
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