Macular Degeneration

What is Macular Degeneration?

Vision with macular degeneration simulation

Macular Degeneration is a deterioration or breakdown of the macula. The macula is a small area in the retina at the back of the eye that allows you to see fine details clearly and perform activities such as reading and driving. When the macula doesn’t function correctly, your central vision can be affected by blurriness, dark areas or distortion. Macular Degeneration affects your ability to see near and far, and can make some activities-like threading a needle or reading difficult or impossible.

Although Macular Degeneration reduces vision in the central part of the retina, it does not affect the eye’s side or peripheral vision. For example, you could see the outline of a clock but not be able to tell what time it is.

Macular Degeneration alone does not result in total blindness. Even in more advanced cases, people continue to have some useful vision and are often able to take care of themselves. In many cases, Macular Degeneration’s impact on your vision can be minimal.

What causes Macular Degeneration?

Many older people develop Macular Degeneration as part of the body’s natural aging process. There are different kinds of macular problems, but the most common is age-related Macular Degeneration. Exactly why it develops is not known, and no treatment has been uniformly effective. Macular Degeneration is the leading cause of severe vision loss in people over 65.

Eye Diagram with Macula Highlighted
Macular Degeneration Diagram

The two most common types of age-related Macular Degeneration are “dry” (atrophic) and “wet” (exudative): Dry Macular Degeneration (atrophic) Most people have the “dry” form of Macular Degeneration. It is caused by aging and thinning of the tissues of the macula. Vision loss is usually gradual. Wet Macular Degeneration (exudative) The “wet” form of Macular Degeneration accounts for about 10% of all Macular Degeneration cases. It results when abnormal blood vessels form underneath the retina at the back of the eye. These new blood vessels leak fluid or blood and blur central vision. Vision loss may be rapid and severe.

What are the symptoms of Macular Degeneration?

Macular Degeneration can cause different symptoms in different people. The condition may be hardly noticeable in its early stages. Sometimes only one eye loses vision while the other eye continues to see well for many years. But when both eyes are affected, the loss of central vision may be noticed more quickly. Following are some common ways vision loss is detected:

  • Words on a page look blurred
  • A dark or empty area appears in the center of vision
  • Straight lines look distorted
Woman testing her vision with Amsler Grid

How is Macular Degeneration diagnosed?

Many people do not realize that they have a macular problem until blurred vision becomes obvious. Dr. Paveloff can detect early stages of Macular Degeneration during a medical eye examination that includes the following:

  • A simple vision test in which you look at a chart that resembles graph paper (Amsler Grid)
  • Viewing the macula with an ophthalmoscope
  • Sometimes special photographs of the eye called fluorescein angiographs are taken to help detect abnormal blood vessels under the retina. Fluorescent dye is injected into a vein in your arm and your retina is photographed as the dye passes through the blood vessel in the back of the eye.

How is Macular Degeneration treated?

Despite ongoing medical research, there is no cure yet for “dry” Macular Degeneration. Recent research has shown that supplements may slow the progression of Macular Degeneration. Antioxidants like Ocuvite, I-caps or I-sense are encouraged for Macular Degeneration patients.

Laser Surgery, Photodynamic Therapy (PDT) and Anti-VEGF Medications

Certain types of “wet” Macular Degeneration can be treated with laser surgery, a brief and usually painless outpatient procedure. Laser surgery and photodynamic therapy use a focused beam of light to slow or stop leaking blood vessels that damage the macula. The procedure may preserve more sight overall, though it is not a cure that restores vision to normal.

Anti-VEGF medicationsstop the abnormal blood vessels leaking, growing and then bleeding under the retina. Vascular endothelial growth factor (VEGF) is a protein that promotes the growth of new blood vessels. It also makes the blood vessels leak more. Anti-VEGF medicines stop the growth of these new blood vessels.

Despite advanced medical treatment, many people with Macular Degeneration still experience some vision loss. To help you adapt to lower vision levels, Dr. Paveloff can prescribe optical devices or refer you to a low-vision specialist or center. A wide range of support services and rehabilitation programs are also available to help people with Macular Degeneration maintain a satisfying lifestyle.

Because side vision is usually not affected, a person’s remaining sight is very useful. Often, people can continue with many of their favorite activities by using low-vision optical devices such as magnifying devices, closed-circuit television, large print reading materials as well as talking or computerized devices.

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Santa Barbara, CA

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