Macular degeneration is the leading cause of severe vision impairment in adults over the age of 60. The patient’s vision decreases as the macula deteriorates.
Although there is no cure for macular degeneration, early diagnosis is key for mitigating its effects and successfully managing the condition. We diagnose and treat macular degeneration at Wilkinson Eye Center.
What is Macular Degeneration?
Macular degeneration is a degenerative disease that affects a person’s eyesight through deterioration of the macula, the central part of the retina. The retina is the light-sensing nerve tissue at the back of the eye. The condition is often called “age-related” macular degeneration because it progresses as a person ages. There are two forms of macular degeneration, dry and wet.
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What are the Types of Macular Degeneration?
There are two main types of age-related macular degeneration:
By far the most common, the “dry” form of macular degeneration is characterized by the presence of yellow deposits in the macula. These are called drusen. In early stages, a few small drusen don’t cause vision deterioration. But as they grow in numbers and size, these lead to dimming or distortion of vision that is most noticeable when reading. In atrophic dry macular degeneration, patients develop blind spots in the center of their vision. This advances to losing all central vision. Also, in advanced stages of dry macular degeneration, there is a thinning of the light-sensitive layer of cells in the macula, leading to tissue death atrophy.
Only about 10 percent of people develop the “wet” form of macular degeneration, but these people make up the majority of those who suffer serious vision loss. The wet form is characterized by the growth of abnormal blood vessels from the choroid underneath the macula. This is called choroidal neovascularization. These blood vessels leak blood and fluid into the retina. This distorts the person’s vision, as straight lines look wavy and blind spots develop. The bleeding of these abnormal blood vessels creates scar tissue that leads to permanent loss of the patient’s central vision.
What Causes Macular Degeneration?
The name “age-related” macular degeneration points to the fact that this condition is more common in older people. In early stage macular degeneration there are often no noticeable symptoms. Our Wilkinson ophthalmologists can detect little white spots, the drusen, in the retina. As we get older the retinal cells become less efficient at cleaning away these deposits that are thought to develop from oxidative stress and inflammation.
Oxidative stress is a disturbance in the balance between the production of very reactive oxygen-containing molecules that can adversely interact with other molecules inside our cells. Oxidative stress can be caused by bright light, a poor diet low in antioxidants, and too much iron in the retina.
There is also an inherited gene that makes a person more prone to this inflammation in the retina.
Late stage macular degeneration shows itself in the two types described above: dry and wet. The exact causes of the dry form are not fully understood. But research indicates it may be related to a combination of heredity and environmental factors, including smoking and diet. It is surely a factor of age, as dry macular degeneration is far more common in those over age 50. Other risk factors are family history, race (more common in Caucasians), obesity, and cardiovascular disease.
As with dry macular degeneration, the wet for is not fully understood. To develop the wet form, a person first has the dry form. The development of abnormal blood vessels that grow into the macula isn’t understood. All of the same risk factors with dry macular degeneration apply to the wet form.
What are the Early Signs of Macular Degeneration?
The first signs of dry macular degeneration are slightly blurred central vision, both for up close and distance vision. The center of vision may become fuzzy or shadowed, and this area grows larger as the disease progresses. Blind spots may develop, and the person will have more difficulty seeing color and fine detail.
What are the Symptoms of Macular Degeneration?
One of the worst things about this condition is that in the early stages you may not experience any symptoms, but your vision is being damaged just the same. The first sign you may notice is when straight lines appear distorted or a gradual or sudden change in the quality of your vision.
These are the symptoms:
- Visual distortions, such as straight lines seeming bent
- Reduced central vision in one or both eyes
- The need for brighter light when reading or doing close work
- Difficulty adapting to low light situations, such as entering a dimly lit room
- Decreased intensity of colors
- Increased blurriness when seeing printed words
- Difficult recognizing faces
How Long Does it Take to Lose Vision with Macular Degeneration?
The American Macular Degeneration Foundation recognizes three phases of macular degeneration: early, intermediate, and late. In the early stage, the patient may not have any noticeable symptoms or vision issues. In the intermediate stage, you’ll likely begin to experience difficulty with your central vision. In the late stages, you’ll have difficulty seeing clearly and surgery may be necessary.
On average, it would take about 10 years for a patient to move from an initial diagnosis to legal blindness.
How is Macular Degeneration Treated?
Unfortunately, there is no cure for age-related macular degeneration. Early treatment with the team at Wilkinson Eye Center can slow the progress of the disease. There are more treatments to address the abnormal blood vessels with the wet form than the drusen of dry macular degeneration.
Here are some treatment methods we may use:
- Anti-angiogenic drugs — For wet macular degeneration, injections of these drugs are made into the eye. They stop new blood vessels from forming and block the leakage from already existing abnormal vessels. In some patients, these injections can allow them to regain some vision that has been lost.
- Laser therapy — Lasers can be used to destroy the actively growing abnormal blood vessels, also from the wet form. Also, photodynamic laser therapy uses a light-sensitive drug that is activated to damage the abnormal blood vessels.
- AREDS2 vitamins — Research from AREDS (Age-Related Eye Disease Study) has shown some success in reducing the risk for vision loss in some patients with intermediate to advanced dry age-related macular degeneration.
- Low vision aids — Magnification can be a key to maintaining independence. Special lenses or electronic systems can magnify nearby objects, especially smaller type.
Can Macular Degeneration Go Away on its Own?
Research is ongoing and is showing promise in potential treatments for macular degeneration but waiting for the condition to go away is no way to save your sight. The best course of action is to come see the professionals at Wilkinson Eye Center and to get started on a course of treatment. This gives you the best chance at slowing the progression of the disease. If you have any of the above signs or symptoms of macular degeneration we need to see you.