Macular Degeneration

Macular degeneration is the breakdown and damage of the central retina, or macula.
The central retina, or macula, is responsible for crisp, detailed vision. If there is damage to the macula, the central part of our vision becomes distorted, blurry, or dark leading to difficulty reading, watching TV, driving, identifying faces, doing detailed work, and other daily tasks. It is the leading cause of vision loss in people over the age of 65 in the United States. Macular degeneration affects both near and distant vision. Although macular degeneration affects the central part of vision, it does not affect peripheral vision. As a result, macular degeneration alone does NOT lead to total blindness. People continue to have some useful vision and are able to take care of themselves.

DRY (ATROPHIC) MACULAR DEGENERATION

This is the most common type and is seen in 90% of cases. It is caused by aging, degeneration, and thinning of the tissues of the macula. It is associated with the development of large numbers of drusen (a fatty protein called lipids) and occasionally thinning (atrophy) of the central retina. Vision loss is usually gradual and not as severe. The loss of vision is related to the amount and location of the retinal thinning. There are no good treatments for this condition. This type only accounts for 10% of blindness related to macular degeneration.

WET (EXUDATIVE) MACULAR DEGENERATION

This is present in about 10% of cases, but is responsible for 90% of the blindness associated with macular degeneration. It results when abnormal blood vessels leak fluid or blood under the central retina. These changes can cause rapid and severe vision loss with possible permanent scarring and the creation of blind spots. The onset and progression of macular degeneration does not follow any pattern. Also, it is possible to develop both forms at the same time, in one or in both eyes.
macular degeneration illustration

Symptoms

  • Dark or empty areas (blind spots) in the central part of vision
  • Straight lines appear distorted and wavy
  • Words appear blurred when reading
  • Symptoms vary from person to person

Risk Factors

  • Age
  • Smoking
  • Heredity
  • Obesity
  • High fat diet
  • Prolonged sun (ultraviolet light) exposure
  • Light eye color
  • High blood pressure

Treatment

Despite extensive research, there is still no cure for macular degeneration. The best treatment depends on the severity and type of the condition, as well as how much, vision loss has occurred. The Age Related Eye Disease Study (AREDS and AREDS II) demonstrated a benefit in slowing the progression of macular degeneration by taking antioxidants, minerals and vitamins. Specifically, they used vitamins C and E, beta carotene, zinc and copper. Other newer studies suggest that lutein may also be beneficial. A variety of vitamin formulations are available over-the-counter or by mail order. “Wet” macular degeneration can be treated with special intraocular injections that are often successful in stopping abnormal blood vessel growth. These regular injections can control, and in some cases improve, the damage from wet macular degeneration. In addition, lasers can sometimes be combined with these intraocular treatments to try and improve the results. Despite proper medical treatment, many people with macular degeneration still experience vision loss. A wide range of support services and rehabilitation programs are available. Since peripheral vision is usually unaffected, this remaining vision is very useful. Often, people can continue with many of their favorite activities by using low vision optical devices.
jump to the top