Macular Degeneration

What is macular degeneration?

Macular degeneration is a disease associated with aging and occurs when the macula degrades, or degenerates, causing a progressive loss of vision.

Macular degeneration occurs in two forms: dry and wet.

The "dry" form of macular degeneration occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As the dry form gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision is gradually lost in the affected eye.

The "wet" form occurs when fluid starts to collect behind the retina under the macula. Sometimes new blood vessels start growing in these areas. These blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye. The blood causes scar tissue to grow producing irreparable damage. With the wet form, loss of central vision can occur quickly. It does not have stages like the "dry" form. Overall symptoms include a gradual loss of ability to see objects clearly, a gradual loss of color vision, distorted vision, or a dark or an empty area appearing in the center of vision.

Who gets macular degeneration?

Macular degeneration is the leading cause of severe vision loss in people over age 60. Macular Degeneration is uncommon in people younger than 55. If you are over 65, macular degeneration may already affect your central vision-the vision you need for close work like reading and sewing.

How is macular degeneration diagnosed?

Macular Degeneration is detected during a comprehensive eye exam that includes:

  • Visual acuity test. This eye chart test measures how well you see at various distances.
  • Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of Macular Degeneration and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
  • OCT imaging and angiography. Spectral domain optical coherence tomography (Cirrus HD-OCT) allows your doctor to obtain a virtual histology of your retina utilizing a relatively new laser interferometry technology allowing better detection and manage macular degeneration. Fluorescein angiography is also helpful in assisting your doctor in determining the location of abnormal leaking blood vessels.

During an eye exam, you may be asked to look at an Amsler grid. The pattern of the grid resembles a checkerboard. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of Macular Degeneration.

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Macular Degeneration Treatment

Once dry macular degeneration reaches the advanced stage, no form of treatment can restore vision loss. However, treatment can delay and possibly prevent intermediate macular degeneration from progressing to the advanced stage, in which vision loss occurs. The treatment consists primarily of high dose vitamin therapy. Omega 3 fatty acids may be recommended as well.

Wet macular degeneration can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for this disease. The disease and loss of vision may progress despite treatment. Fortunately, newer treatments have given patients much more hope of saving their sight than in years past.