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Macular Degeneration

Macular degeneration,also known as age-related macular degeneration (AMD), is a disease that destroys an individual’s sharp, central vision and is the number one cause of vision loss in Americans who are 60 and older.

The macula, located near the center of the retina, is the part of the eye that allows a person to see objects straight ahead. Macular degeneration causes the cells of the macula to die. As a result, an individual’s central vision becomes blurred and blind spots may develop. Although the specific cause of macular degeneration is unknown, doctors do know that this condition can develop as part of the natural aging process.

What are the different types of macular degeneration?

Macular degeneration can present itself in two different types: dry and wet. Dry macular degeneration is the more common of the two and is characterized by the deterioration of the macular over time. Wet macular degeneration occurs when blood vessels grow under the retina of the eye, leaking blood and fluid.

What are the symptoms of macular degeneration?

Symptoms of macular degeneration include the following:

  • Blurred central vision
  • Appearance of a blind spot in a person’s central vision
  • Difficulty recognizing faces
  • Dulled color vision
  • Increased blurriness of printed words
  • Needing bright light when reading or completing close work
  • Difficulty adapting to dim or low light levels

What are the risk factors associated with macular degeneration?

Factors that can increase an individual’s risk of developing macular degeneration include:

  • Smoking
  • Age
  • Obesity
  • Family history of the disease
  • Unhealthy diet
  • Cardiovascular disease
  • Elevated cholesterol levels

How is macular degeneration diagnosed?

Macular degeneration is diagnosed through a series of tests performed by an ophthalmologist.

Examination of the Back of the Eye: The back of the eye will be examined through use of eye drops and a special instrument to look for yellow deposits of a substance called drusen. Drusen can affect the appearance of the retina and indicates the presence of macular degeneration.

Amsler Grid Test: The doctor may also use anAmsler grid to detect any flaws in the patient’s central vision. Individuals with macular degeneration often see a distorted or faded appearance to the lines on the grid.

Optical Coherence Tomography (OCT): This test records images of the retina which are then analyzed to detect any abnormal changes. Such changes include a thinning, thickening or swelling of the retina caused by fluid accumulation. It is a non-invasive test and is also used to monitor the retina during treatment for the disease.

Flourescein Angiogram: This test is used to examine the blood vessels of the eye. A colored dye is injected into the vein of the patient’s arm and travels to the blood vessels of the eye. A special camera is used to record images of the blood vessels found near the retina and will show any abnormalities.

How is macular degeneration treated?

There is no current treatment or cure for dry macular degeneration but patients should continue to see their ophthalmologist for routine screenings to monitor their condition.

There are a variety of treatments used to treat wet macular degeneration. Although these treatments may not restore a person’s vision completely, they can be successful in slowing or preventing further vision loss.

Injectable Medication: Several medications have been found to be successful in treating wet macular degeneration. Each of these medications is injected into the eye to prevent the growth of leaky blood vessels. The most common medications used in these injections are Lucentis, Eylea and Macugen.

Laser Photocoagulation: Laser photocoagulation is another type of treatment used to treat wet macular degeneration. A laser is used to destroy the blood vessels responsible for leaking fluid under the macula. This treatment, however, can cause scar tissue to form on the retina, creating blind spots. Although this is an undesirable side effect, without treatment vision loss would progress much more quickly.

Photodynamic Therapy (PDT): Photodynamic therapy is a treatment that uses a drug called Visudyne, which is injected into the patient’s arm and then activated by a laser light. The combination of Visudyne and exposure to a laser light creates a chemical reaction that destroys the abnormal blood vessels leaking into the eye. Since Visudyne is light-sensitive, patients must stay out of the sun or bright light until the dye has left their system. This treatment may need to be repeated on a regular basis, since abnormal blood vessels may continue to grow, despite treatment.

Telescopic Lens: For some individuals who have advanced macular degeneration, a telescopic lens may be surgically implanted in the eye to improve central vision. This lens is used to magnify the individual’s vision and can be used to improve both close-up and distance vision.

Dietary Changes: Doctors often recommend that patients with macular degeneration increase their vitamin intake and make alterations to their diet. Such alterations include eating a wide range of fruits and vegetables, choosing healthy fats, increasing intake of Omega-3 fatty acids found in fish, and choosing whole grains rather than refined carbohydrates. These steps will not cure macular degeneration, but can have a huge impact in slowing the disease process and preventing vision loss.

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