Macular Degeneration

The macula is a small, yet very important area of the retina.  We use it to see very fine detail.  It’s our 20/20 vision area.  The vision receptors, our rods and cones are tightly packed into this tiny area.  Damage to this area can be devastating, like a burn from staring at a lunar eclipse. 

Macular degeneration is the number one cause of vision loss in the western world.  It causes the receptors to be moved out of place and can even totally scar over the receptors.  Because the macula is so small, it doesn’t take much to cause severe vision loss.

Prevention
Just like with cataracts, UV protection and nutrition are critical.  Lack of UV protection and poor nutrition, resulting  in free radicals, damage receptor function.  Again, cigarette smoking is very harmful.  A balanced diet with emphasis on antioxidants like Beta carotene and lutein, along with zinc and  omega 3 fatty acids help to prevent, stop or in some instances, mildly reverse the condition.  It goes without saying, UV blockers are critical for protection. 

What happens if you have it?  There are clinically proven vitamin formulas AREDS, that help stop or reduce further degeneration.

The early form of the disease is called “Dry” because no fluid is involved.  Unfortunately, it can progress to the “wet” form, where fluid leakage causes swelling and then scarring. 

There have been excellent advances in treatment of “wet” in the past 15 years.  First came Visudyne, an agent that is activated by laser light at the point of leaking.  And now there is Lucentis, a drug injected into the eye that reduces the eyes ability to build new blood vessels, which unfortunately result in more leakage and scarring.  Lucentis reduces the chance of scarring and further fluid build-up.  A combination of both treatments can be used.  When dry ARMD (Age Related Macular Degeneration) is present we take digital fundus photographs of the macula to check for changes and, when necessary, we will use an optical coherence tomographer, that will detect even more subtle changes, telling us when wet ARMD is starting.