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Macular Degeneration

Macular Degeneration

Age Related Macular Degeneration (AMD) is a progressive retinal disease that is generally divided into two categories: wet and dry. The dry form may involve the formation of scarring and calcifications on the retina surface; consequently, the retinal cells begin to lose their function through a process called atrophy or degeneration.  The wet form involves new blood vessels growing under the retina, which lead to swelling, scaring and bleeding of the retinal tissues.

What causes Macular Degeneration?

Macular degeneration typically causes a persons vision to become gray or hazy, and may lead to serious permanent vision loss in some cases. It is the most common cause of permanent visual loss in senior citizens in the United States.  The exact reason for the breakdown in the macula is unknown.  Why some patients have macular degeneration in their 40's and others have essentially no changes in their 80's or 90's is baffling.  We realize there is an association, however, between macular degeneration and smoking, diabetes, elevation of blood pressure and serum cholesterol.  Also, genetics plays a role in the acquisition of maucular degeneration. 

Macular degeneration will cause objects to appear less colorful, and objects will become blurry. This is because the retina is an important part of the vision process, and the decreased function of the central retina is a direct result of macular degeneration.

What are the symptoms?

Symptoms of macular degeneration are myriad.  They typically involve some degree of loss of clarity and discrimination in the patient's central vision.  The macula, the center of our retina, is an important part of the retina.  It plays a critical role in central vision processing.  Once macular degeneration begins to affect this very critical portion of the retina, patients often initially notice that objects simply do not appear as colorful, clear and sharp as they once did.  And as the disease causes more damage to the macula, objects will appear increasingly distorted, gray or at times totally absent. 




Treatment Options

amsler gridUnfortunately, there is currently no available cure for this all too common disease.  However, as with most maladies associated with modern medicine, the earlier the condition can be diagnosed, will yield the best likelihood of successful treatment.  Dry macular degeneration may be unassociated with any other symptoms (asymptomatic) and as such may require no additional testing or treatment.  Oftentimes, the earliest stages of macular degeneration are found in the course of a routine eye examination by us; these findings would therfore be referred to as incidental in nature.  We know that there are several risk factors for development and progression of macular degeneration and these include: smoking; diabetes; uncontrolled hypertension (high blood pressure) and a family history.  Certain vitamin supplements may have a beneficial impact upon macular degeneration.  We often recommend AREDS formula, multivitamins for our macular degeneration patients.  (AREDS refers to Age Related Eye Disease Study).   The treatment of wet macular degeneration has come a long way in the past few years.  Typically, in the past, when a patient developed wet macular degeneration there was little to be offered.  On some occasions, laser therapy would help but not all the time; photodynamic therapy is another intervention that has not really stood the test of time as well.  However, currently we have available intraocular shots of Lucentis and Avastin which are referred to as "anti-VEFG" medications which can have a substantial benefit in slowing or even on occasion reversing the serious damage that can be wrought by wet macular degeneration. 

The grids above on the right are referred to as the Amsler grid.  It is commonly used to follow macular disease including AMD.  You should check each eye individually with your reading glasses on.  Any distortions in the grid pattern should be reported to your eye doctor promptly.

Click Here to read some frequently asked questions about Macular Degeneration.

If you are suffering from macular degeneration, please contact us to schedule an appointment for a comprehensive eye exam.

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