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What is macular degeneration?

Macular degeneration is a disease that affects a person’s central vision and is the most common cause of severe loss of eyesight among people ages 60 and older. Only the center of vision is affected with this disease. People rarely go completely blind from it. However, this disease can make it difficult to read, drive, or do other daily activities that need fine, central vision.

Macular degeneration happens when the macula begins to break down. The macula is located in the center of the retina and provides us with sight in the center of our field of vision. With less of the macula working, central vision begins to get worse.

 


What causes macular degeneration?

The 2 primary types of macular degeneration have different causes:

  • Dry. This type is the most common. Its cause is unknown. This happens as the light-sensitive cells in the macula slowly break down. It generally happens in both eyes. It is thought that the age-related thickening of the tissue under the retina contributes to dry macular degeneration.
  • Wet. This type is less common and accounts for the most severe loss of eyesight. Wet macular degeneration happens when new blood vessels behind the retina start to grow beneath the retina. They leak fluid and blood and can create a large blind spot in the center of the visual field.

 


Who is at risk for macular degeneration?

Possible risk factors are:

  • Being female
  • Ages 60 and older
  • Smoking
  • Family history
  • Uncontrolled high blood pressure or hypertension
  • Cardiovascular disease
  • Obesity
  • High blood cholesterol levels

 


What are the symptoms of macular degeneration?

The following are the most common symptoms, however, each individual may experience symptoms differently. Symptoms may include:

  • Blurry or fuzzy vision
  • Difficulty recognizing familiar faces
  • Straight lines appear wavy
  • A dark, empty area or blind spot appears in the center of vision
  • Rapid loss of central vision, which is necessary for driving, reading, recognizing faces, and performing close-up work

The presence of drusen, tiny yellow deposits in the retina, is one of the most common early signs of macular degeneration. It may mean the eye is at risk for developing more severe macular degeneration. These will be visible to your healthcare provider during an eye exam.

The symptoms of macular degeneration may look like other eye conditions. Talk with an eye care professional for diagnosis.

 


How is macular degeneration diagnosed?

In addition to a complete medical history and eye exam, your eye healthcare provider may do the following tests to diagnose macular degeneration:

  • Visual acuity test. The common eye chart test, which measures vision ability at various distances.
  • Pupil dilation. The pupil is widened with eye drops to allow a close-up exam of the eye’s retina.
  • Amsler grid. Used to detect wet macular degeneration, this test uses a checkerboard-like grid to determine if the straight lines in the pattern appear wavy or missing to the patient. Both indications may signal the possibility of AMD.
  • Fluorescein angiography. Used to detect wet macular degeneration, this diagnostic test involves a special dye injected into a vein in the arm. Pictures are then taken as the dye passes through the blood vessels in the retina, helping the healthcare provider evaluate if the blood vessels are leaking and whether or not the leaking can be treated.

 


How is a macular degeneration treated?

Specific treatment will be determined by your healthcare provider based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Treatment for wet macular degeneration usually involves injections of medicines into the eye to stop the growth of the abnormal blood vessels. These injections are typically painless. It may also include one type of laser surgery in which a high-energy beam of light is aimed directly onto the leaking blood vessels to deter further leaking, although this is usually not necessary.

Currently, there is no treatment for dry macular degeneration. This does not, however, indicate that sight will automatically be lost. This is particularly true if the macular degeneration affects only one eye. Central vision may eventually be lost or reduced. Generally, the rate of loss is slow. There are nutritional treatment choices that may slow the progression of the disease.