Age-related macular degeneration is the leading cause of vision loss among Americans age 65 and
older, according to the American Macular Degeneration Foundation. More than 10 million people suffer
from the disease, in which the portion of the retina responsible for capturing fine details and
color suffers pathological changes. As the macula deteriorates, it causes blurred or reduced central
Macular degeneration is best evaluated and treated by retina specialists, who are ophthalmologists
with special training and expertise in disorders of the retinal region. Anyone that has suffered the
visual effects of macular degeneration should seek out an experienced retina specialist for their
medical and surgical care.
There are two types of macular degeneration:
Dry (non-neovascular) macular degeneration is the earlier and
more common form of the disease.
Between 85 and 90 percent of cases are the dry type. In dry macular degeneration, the layers of the
macula gradually thin and atrophy. Yellowish spots called drusen start to accumulate in and around
the macula. Drusen are tiny piles of debris from the deteriorating tissues that sometimes cause
further retinal deterioration and atrophy.
People with dry macular degeneration may experience gradual loss of central vision, but it is
generally not as severe as that of the wet form of the disease.
Wet (neovascular) macular degeneration is more
likely to lead to serious vision loss. People with wet macular degeneration grow new blood vessels
in their retina; the vessels are weak and leak blood and other fluids in between the layers of the
retina. The leakage can cause scar tissue to form — creating a dark spot in the vision — and the
retina cells stop functioning. About 10 percent of cases advance to the wet form of the disease.
Depending on the stage of the disease, symptoms can include:
- Blurred or fuzzy vision
- Straight lines that appear wavy
- Objects appearing smaller than they actually are
- The appearance of a gray, dark or blind spot in the center of the field of vision
- Colors looking paler than normal
Macular degeneration is detected in an eye exam. The doctor dilates the eyes to get a closer look at
the retina and the macula. In the early stages of the disease, the doctor can spot drusen or other
particles on the surface of the retina. People with macular degeneration may have many drusen. The
color of the macula may also look different if it has started to degenerate.
In addition to looking at the back of the eye, the doctor also tests for visual distortions using an
Amsler grid. The grid is composed of straight lines; to someone with macular degeneration, the lines
can look wavy, distorted or have blotchy or blank spots.
The doctor may perform a fluorescein angiography, in which a colored dye is injected into the arm
and travels to the eye, highlighting the blood vessels. The images from the test show abnormalities
in the blood vessels and changes in the retina. Another imaging test that is used to diagnose
macular degeneration is an optical coherence tomography, which shows cross-sectional images of the
retina, identifying areas that are thinning, thickening or swelling.
If a macular degeneration diagnosis is confirmed, the doctor can outline the macular degeneration
treatment options. There is no cure for macular degeneration, but there are ways to manage it. At
the Cataract Care Center, we have an eleven-point plan that can greatly reduce the rate of
progression of macular degeneration, especially with dry macular degeneration. With wet macular
degeneration we offer injections to try to help prevent or stop toxic leakage in addition to our
eleven-point plan. In the later stages if vision is severely impacted, working with a low vision
rehabilitation specialist can help the patient adapt to vision changes.
If you have questions about macular degeneration, its causes or symptoms, we invite you to contact
us today. Request an appointment at our practice to speak with a member of our team.