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Macular Degeneration

What is Macular Degeneration?

Macular degeneration, or age-related macular degeneration (ARMD or AMD), is a disease of the center part of the retina called the macula. The macula controls our central vision and enables us to see fine details clearly. It is what allows us to read, drive a car, and recognize faces or colors.

 

The specific factors that cause macular degeneration are not specifically known; however, as people get older, the chances for developing the eye disease increases. In fact, ARMD is the leading cause of blindness for Americans over the age of 60.

Macular degeneration usually affects both eyes; however, the severity of the disease can differ greatly between the two eyes. In some cases, ARMD can advance so slowly that people notice little change in their vision. In others, the disease can progress so fast that it can lead to a loss in vision in both eyes. With this in mind, macular degeneration occurs in two forms: dry and wet.

Macular Degeneration


Types of Macular Degeneration

Dry Macular Degeneration

Dry macular degeneration is the more common form of ARMD. It is the slow advancing form that occurs when the light-sensitive cells in the macula begin to gradually break down. As more of these cells continue to break down, central vision becomes blurrier. In its advance stages, dry ARMD can cause a dark blurred spot in the center of your vision.

Wet Macular Degeneration

Wet macular degeneration differs from dry macular degeneration in that it involves the growth of abnormal blood vessels underneath the macula. Wet ARMD occurs aggressively and exists only in the advance stage of macular degeneration. Because of this, the wet form leads to significantly more vision loss than the dry form.

Dry ARMD can turn into wet ARMD. In fact, all people who have wet ARMD had the dry form at one point, but dry ARMD does not necessarily have to progress into the wet form. Currently, there is no certain way to predict if or when dry ARMD will turn into wet ARMD.


What are Common Symptoms of Macular Degeneration?

Neither dry nor wet macular degeneration cause any eye pain.

Symptoms of dry ARMD progress gradually and usually do not end in total blindness. Blurred vision is the first symptom that you may start to notice. Tasks such as driving, reading and even recognizing people’s faces may start to because more difficult as your macular degeneration worsens. In the advance stages, a large area of grey blocking your central vision may start to develop. People can often have completely obscured central vision, but still have clear peripheral vision.

The same symptoms mentioned above are also encountered in wet macular degeneration. In addition, the most common symptom in wet ARMD is straight lines appearing crooked or wavy. This occurs in wet ARMD because blood vessels under the macula begin to leak and lift the macula, causing a distortion in your vision.

healthy
Healthy vision
ARMD
As viewed by a person with ARMD
 

Your doctor may give you something called an Amsler Grid to monitor the progression of your macular degeneration. This grid is a pattern that resembles a checkerboard. You will be asked to cover one eye and stare at a black dot in the center. You may notice that the straight lines in the pattern appear wavy or even missing. This distortion in the Amsler grid is abnormal and may indicate the beginning of wet macular degeneration.

healthy
How an Amsler grid looks to a person with healthy vision
ARMD
How an Amsler grid looks to a person with ARMD
 

Can Macular Degeneration be Cured?

There is no permanent cure for either dry or wet macular degeneration. However, there are treatment therapies that can delay the progression of ARMD.

Retinal Injections

The most common treatment to slow down the progression of wet macular degeneration is the injection of drugs into the eye. These drugs inhibit the growth of new blood vessels. Dilated eye examinations are required to keep close observation of the macula’s response to the medication. These examinations can be as frequent as every month, and injections may be repeated over the course of this time depending on the effectiveness of the treatment. With retinal injections, visual loss can be slowed or even halted, and some patients may even experience some improvement of vision.

Laser Treatments

Lasers can also be used to treat wet macular degeneration. During laser treatment, a high energy light beam is directed at new and leaky blood vessels in order to completely destroy them. However, the laser beam may also destroy surrounding healthy tissue and because of this, laser treatments are usually less favored over injections.

AREDS Therapy

The National Eye Institute's Age-Related Eye Disease Study (AREDS) found that taking a specific formulation of antioxidants and zinc significantly reduces the risk of vision loss from advanced ARMD. Studies show that these vitamins were most beneficial for people who had intermediate dry ARMD in one or both eyes and for people with advanced ARMD (either wet or dry) in only one eye. Unfortunately, studies have not shown any proof that people with early stage dry ARMD benefit from taking AREDS formulation. It is important to understand that AREDS therapy may only delay the onset of advanced macular degeneration. It is not a cure and it cannot restore vision already lost by the disease.


Living with Macular Degeneration

The idea of life with age related macular degeneration can be upsetting upon first diagnosis due to the fact that there is no cure for this disease. Despite the danger of this disease, patients rarely lose all of their vision from macular degeneration. In most cases poor central vision is a problem but functioning with normal daily tasks is possible. If you feel that you may be experiencing any of the warning signs of macular degeneration mentioned above, our office is willing to offer you not only medical consultation but also emotional support. Our doctors will discuss your options and attempt to prevent permanent vision loss.

*As with any surgical procedure there are risks along with benefits. It is important to discuss your surgical procedure with your surgeon to fully understand the risks and benefits.