Macular degeneration is a chronic, progressive disease that gradually destroys sharp central vision due to a deterioration of the macula, a tiny spot in the central portion of your retina comprised of millions of light-sensing cells. Because it is so commonly associated with aging, it is also known as age-related macular degeneration (ARMD). There are two forms of ARMD called “dry,” most common and with no known treatment, and “wet,” less common and treated with laser procedures. Genetic testing is now available to help identify those most likely to develop “wet” macular degeneration.
In most cases, reversing damage caused by ARMD is not possible, but supplements, protection from sunlight, eating a balanced diet and quitting smoking can reduce the risk and progression of macular degeneration. For suggestions, speak with your eye care provider.
Advanced Vision Clinic has the experience and equipment necessary to diagnose and often treat the eye diseases detailed above, as well as many other eye diseases, at our office in Oakdale. For more information please schedule an appointment with your optometrist, and we’ll be in touch with you shortly.
Risk factors
Factors that may increase your risk of macular degeneration include:
- This disease is most common in people over 60.
- This disease has a hereditary component. Researchers have identified several genes that are related to developing the condition.
- Macular degeneration is more common in Caucasians.
- Smoking cigarettes or being regularly exposed to smoke significantly increases your risk of macular degeneration.
- Research indicates that being obese may increase your chance that early or intermediate macular degeneration will progress to the more severe form of the disease.
- If you have had diseases that affected your heart and blood vessels, you may be at higher risk of macular degeneration.
Symptoms
Dry macular degeneration symptoms usually develop gradually and without pain. They may include:
- 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-up work
- Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant
- Increased blurriness of printed words
- Decreased intensity or brightness of colors
- Difficulty recognizing faces
- A well-defined blurry spot or blind spot in your field of vision
Diagnosis
Your doctor may diagnose your condition by reviewing your medical and family history and conducting a complete eye exam. He or she may also do several other tests, including:
- Examination of the back of your eye: Your eye doctor will put drops in your eyes to dilate them and use a special instrument to examine the back of your eye. He or she will look for a mottled appearance that's caused by drusen — yellow deposits that form under the retina. People with macular degeneration often have many drusen.
- Test for defects in the center of your vision: During an eye examination, your eye doctor may use an Amsler grid to test for defects in the center of your vision. Macular degeneration may cause some of the straight lines in the grid to look faded, broken or distorted.
- AdaptDx: The AdaptDx measures the number of minutes it takes your vision to adjust to darkness, your dark adaptation speed. This number provides your doctor with critical information to help determine if you have AMD. The screening takes only about 6.5 minutes. You’ll wear a headset and press a button every time you see a green flashing light. Your doctor will review the results with you.
- Optical coherence tomography (OCT): This noninvasive imaging test displays detailed cross-sectional images of the retina. It identifies areas of retina thinning, thickening or swelling. These can be caused by fluid accumulation from leaking blood vessels in and under your retina.
Treatment
As of now, there's no treatment for dry macular degeneration. However, there are many clinical trials in progress. If your condition is diagnosed early, you can take steps to help slow its progression, such as taking vitamin supplements, eating healthfully and not smoking.
Low vision rehabilitation
Age-related macular degeneration doesn't affect your side (peripheral) vision and usually doesn't cause total blindness. But it can reduce or eliminate your central vision — which is necessary for driving an automobile, reading and recognizing people's faces. It may be beneficial for you to work with a low vision rehabilitation specialist, occupational therapist, your eye doctor and others trained in low vision rehabilitation. They can help you find ways to adapt to your changing vision.
Surgery to implant a telescopic lens
For selected people with advanced dry macular degeneration in both eyes, one option to improve vision may be surgery to implant a telescopic lens in one eye. The telescopic lens, which looks like a tiny plastic tube, is equipped with lenses that magnify your field of vision. The telescopic lens implant may improve both distance and close-up vision, but it has a very narrow field of view. It can be particularly useful in an urban environment to aid in identifying street signs.
We now offer genetic testing!
Most people are unaware they have Age-Related Macular Degeneration (ARMD) until they start to lose central vision in one eye. Vision loss can happen quickly and without warning. The importance of early detection and treatment is crucial.
With current treatments, ARMD may be arrested and in some cases improved. At-risk patients may benefit from frequent monitoring by their eye care physician an by taking appropriate eye vitamin supplement.
Many new discoveries in technology and nutrition are proving beneficial for a patient with ARMD. Determining a patient's genetic profile through DNA testing has shed light on the way we treat, manage and make nutritional recommendations to help preserve vision.
Macula Risk is a DNA test intended for patients who have a diagnosis of early or intermediate ARMD. Combines with a routine clinical eye examination, results of the Macula Risk test will determine your risk of progression to advanced ARMD with vision loss over 2, 5 and 10 years.