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Symptoms and Treatment of Macular Degeneration

In today’s developed world, as life expectancy approaches 80 years, macular degeneration has become the most frequent cause of severe vision loss among people over 65. This condition is also known as age-related macular degeneration and, as its name suggests, its odds increase with age. Although only about 3% of people in their 50s show any signs of degeneration of the macula, those older than 75 have nearly 30% chance of developing this condition. Other risk factors include ethnicity (whites are at much higher risk than blacks), family history of the condition, smoking and certain other health problems, such as eye trauma or hardening of the arteries.

This eye disorder affects macula, a small area of the retina responsible for central vision. The macula enables you to see fine detail needed for example for reading. The early manifestation of macular degeneration is blurred or distorted central vision but, as the condition progresses, the patient may lose their central vision completely. Since the macula does not control peripheral vision, no one goes completely blind from this condition. There are some special devices that can be used to help patients with macular degeneration to use their remaining peripheral vision to keep up many of their daily activities.

Types of Macular Degeneration

There are two types of macular degeneration. The “dry type” is by far the more common form of the disease. It is characterized by the disintegration of the layer of cells that nourish the macula, which leads to the degeneration of the macula cells as they lose their nutrition. In the beginning, only few small drusen develop, causing no noticeable trouble. But, as these yellow deposits beneath the retina grow in size and number, the patient may notice a distortion of vision and may later develop blind spots in the centre of vision. The last stage of the dry type is permanent loss of central vision. Symptoms of dry macular degeneration tend to come on gradually. The dry type is closely associated with advancing age as it begins on average at age 65.

The “wet type” of macular degeneration is a more serious condition and, although it only accounts for about 10% of cases of the disease, it produces most cases of legal blindness (a visual acuity of 20/200 or less) caused by macular degeneration. This condition is characterized by the growth of new, abnormal blood vessels under the macula. These new blood vessels tend to leak and the fluid causes the macula to separate from the layer of cells that provides it with nourishment. Such repeated bleeding causes scarring, which eventually leads to complete loss of central vision. Unlike the dry form of the disease, the wet type may come on suddenly. The wet form of macular degeneration usually starts earlier in life than the wet form as it typically affects people 50 and over.

Symptoms of Macular Degeneration

Macular degeneration is not associated with causing any pain and its only symptoms are those related to your vision. Some of the most common symptoms include:

  • Straight lines seem bent, broken, wavy or distorted.
  • Objects in the center of your vision may appear abnormally small or large.
  • Dark or black areas appear in front of you as you look straight ahead.
  • Blurry areas that may have dark or empty spaces block the center of the visual field.
  • Changed color perception as certain colors do not look the same as you remember them.

Detecting Macular Degeneration

The simplest test for macular degeneration that you can do at home is to use the Amsler grid. You should be viewing this grid of fine lines with one eye at a time. Anyone at an increased risk for macular degeneration should use it periodically as vision may deteriorate within days of noticing distortion, therefore, prompt action is important.

Treating Macular Degeneration

Dry Form. Unfortunately, no treatment is currently available to reverse the progression of the dry form of macular degeneration. The only recommended course of action is to increase your intake of certain antioxidants and carotenoids. These include vitamins C and E, zinc, copper, lutein and zeaxanthin (alternatively also beta-carotene if you are not a smoker as beta-carotene has been associated with an increased risk of lung cancer in smokers). For further information regarding nutrition and eye health read about saving your eyesight with diet. Some doctors also recommend their patients to buy supplement pills, such as Ocuvite, that were specifically designed to address the needs of patients with macular degeneration.

For watching television, reading or engaging in other activities requiring close vision, magnifying lenses and bright lighting may help. A good way to compensate for loss of sight are low vision aids. These devices with special lenses or electronic systems help people with advanced macular degeneration to make the most of their remaining vision. A surgery may also be used to implant a telescopic lens in one eye.

Wet Form. There are several treatments focusing on blocking the leakage from the abnormal vessels inside the eye and stopping their growth or destroying them:

  • Injections of anti-angiogenesis drugs into the abnormal blood vessels inside the eye with the aim to block their further development and leakage of fluid. Multiple injections once a month are usually needed to contain the growth of these problematic blood vessels.
  • Photodynamic laser therapy in which a light-sensitive drug is first injected into a vein in your arm and, once absorbed by the abnormal blood vessels within the eye, a cold laser beam is aimed at your eye to activate the drug, which results in closing these troublesome blood vessels.
  • Laser therapy can be used to destroy abnormal, leaking blood vessels and to reattach the retina to the layer of cells that nourish it. However, this treatment is rarely used as it may also destroy surrounding healthy tissue and cause a blind spot due to scarring the retina.

Where to Find More Information and Help:
American Macular Degeneration Foundation
Macular Degeneration Foundation