Macular degeneration is typically a slowly-progressing degenerative eye condition that affects the central and detailed portion of the visual field. Most often, this condition manifests later in life. This disease is commonly referred to as AMD (age-related macular degeneration) because it develops as a person ages. It is the leading cause of severe vision loss in those over 60 years old. Macular degeneration can severely affect vision, but is it usually never completely blinding. There are two forms of macular degeneration, dry and wet.
Dry macular degeneration, a deterioration of the macula (part of the retina responsible for central vision and detail), is the more common form of the disease. It may affect one or both eyes. The appearance of yellow deposits called "drusen" at the macula (as observed by the optometrist) indicates dry macular degeneration. Symptoms of dry AMD include a gradual dimming of vision and/or vision distortion. As the disease progresses, symptoms worsen.
Wet macular degeneration is characterized by leaking blood and fluid into the retina, which is caused by abnormal blood vessel growth at the macula. Symptoms of wet AMD include a more sudden change in central vision such as distorted vision, blind spots and loss of central vision.
During a comprehensive eye exam Dr. Dold will be able to determine if you have signs of macular degeneration. If your eyes show signs of the disease, Dr. Dold will perform additional tests to diagnose the condition.
Examining the back of your eye allows Dr. Dold to look for the presence of drusen, indicating dry macular degeneration. This will involve dilation of your eyes. Another test involves an Amsler grid. This test isolates the macula and detects defects in the center of your vision. If the lines on the grid look distorted, blurry or broken you may be exhibiting symptoms of AMD.
Other tests for detecting and managing AMD are available, but would be performed on a referral basis. They are described here. A third, more invasive test for macular degeneration is an angiogram. A colored dye is injected into a vein in your arm in order to view and highlight bloodflow through retinal blood vessels. A camera will take a picture of these highlights and will indicate if you have abnormal blood vessels or abnormalities in your retina. The final test is called optical coherence tomography, a noninvasive imaging test. Retinal thinning, thickening or swelling can be identified through this test because it is a cross-section view of the retina.
The exact cause of macular degeneration is unknown. However, the disease is more common in adults over 60, indicating age plays a role in the development of the condition. It may also be hereditary, as it is most prevalent in more fairly-pigmented populations. Additional factors that may increase your risk of developing macular degeneration:
Smoking
High blood pressure
High cholesterol
Obesity
Race – this disease is more common in Caucasians
Unhealthy diet
Cardiovascular disease – a disease that affects your heart and blood vessels
Exposure to ultraviolet light
In the early stages of macular degeneration the symptoms may be non-existent. The first sign is usually a dim, blurry spot in the middle of your vision. If you find yourself needing brighter light for reading, if youo are having difficulty adapting to low light levels or if you are struggling to recognize faces, you should see an eye doctor. Other symptoms include increased blurriness of words, decreased intensity of colors' brightness, gradual increased haziness of your central or overall vision, increased distortion of your central vision. In advanced stages of AMD, hallucinated geometric shapes or human faces may be observed. Most often when these images are observed by the patient, they are non-threatening and pleasant. This phenomenon is called Charles-Bonnet Syndrome. A low-vision specialist, Dr. Lylas Mogk, explains Charles-Bonnet Syndrome.
No cure for macular degeneration exists. Treatments are designed to slow the progression of this disease and prevent severe vision loss. The following treatments are prescribed based on the form and stage of your disease:
Medication: Anti-Angiogenesis Drugs
Blocking new blood vessel development and leakage from existing abnormal blood vessels, anti-angiogenesis drugs treat wet macular degeneration. This treatment is performed by a retinal specialist.
Vitamin Regimen
Certain individuals with intermediate to advanced dry macular degeneration can decrease their risk of vision loss with a series of vitamin supplements.
Laser Therapy & Photodynamic Laser Therapy
Laser therapies attack abnormal blood vessels to stop the progression of wet macular degeneration. This treatment is performed by a retinal specialist.
Low-Vision Aids
Special devices exist to encourage patient's use of remaining vision after loss from macular degeneration. Low-vision specialists make recommendations for devices to keep the patient able to perform daily activities. They then train the patient how to effectively use the recommended devices.