What is macular degeneration?
Macular degeneration is a breakdown of the retinal tissue in the macula due to premature aging. Macular degeneration is referred to as AMD or ARMD, which refers to age related macular degeneration. The macula is a small area in retina that allows a person to see fine detail. The breakdown of the macula causes decreased central vision, which can affect our distance vision for driving and near vision for reading. Age related macular degeneration is often seen in patients over the age of 60 who are of northern European ancestry. Risk factors include age, light colored eyes and a family history of AMD. Smoking is the only patient habit known to make macular degeneration worse.
Types of macular degeneration
There are two types of macular degeneration: “dry” (atrophic) and “wet” (exudative).
Dry macular degeneration is caused by the degeneration of the retinal tissue within the macula as you age. Approximately ten percent of the population will develop dry AMD. Vision loss in dry AMD is typically gradual. When advanced AMD is diagnosed, your doctor will often request you to take vitamins that are for your eyes. These vitamins help to slow down the rate at which your AMD gets worse. Refraining from smoking or being around second hand smoke will also prevent your AMD from getting worse.
Wet AMD occurs when there is new blood vessel growth behind the macula caused by the degeneration process. These new blood vessels leak in the back of the eye. Vision loss from this type of macular degeneration is often more rapid and severe. Your doctor will likely give you a grid to monitor your vision. A change in the grid may mean you have developed wet macular degeneration. Wet AMD can be treated with and injection in the eye, but treatment is urgent. If your grid changes, you should contact your doctor within one week.
Treatment of macular degeneration
Studies have shown that a specific combination of vitamins, known as the AREDS vitamin formula, can be useful in reducing the severity of AMD. This combination of vitamins, named for the Age Related Eye Disease Study, can be purchased over the counter or at any of the Eye Clinic of Wisconsin locations. There are many brands of AREDS vitamins, however, if the bottle says AREDS, it is safe and effective for the treatment of AMD. The staff at the Eye Clinic of Wisconsin can help you choose your vitamins and our doctors recommend the vitamins that are sold at the Eye Clinic of Wisconsin locations. Please check with your eye care professional or medical doctor for additional information on the use of these vitamins.
Wet macular degeneration responds best when treated in its early stage. There are a number of treatments available, including injections, cold laser or PDT, and thermal laser. However, injections are the gold standard of treatment. Studies have shown the injections to be superior to laser treatment.
Intraocular injections are the newest treatment available. This treatment involves injecting a drug into the eye. The injection can be performed at the Eye Clinic of Wisconsin on the day of your office visit. Injections are performed under clean conditions in a procedure room with the assistance of our trained staff. Prior to an injection, numbing medicine will be place in the eye in the form of a drop. The skilled assistant will then clean the eye to help prevent infections. The doctor will then open the eye and measure the site of the injection, which is located in the corner of the eye. Injections are described as a slight pressure by patients, but rarely is there pain associated with the injection. Patients who have an injection can return to their daily activities immediately after the injection including driving, reading, and working. Unfortunately, the injections do not last forever, and often repeat examinations and injections are required.
Defining success in treatment is also important. Every current treatment for wet AMD is used in an attempt to maintain the patient’s vision at the level at which they present when they are first seen by the doctor. Although some success has been achieved in improving patients’ vision with treatment, the true goal of treatment is to stop vision loss.
Prevention of macular degeneration
Unfortunately, macular degeneration is not wholly preventable. The use of AREDS vitamin therapy is a good start at trying to limit this disease process. Avoiding smoking or tobacco exposure has also been shown to slow progression. Daily use of the Amsler Grid for those who have been diagnosed with AMD is a measure to help detect early visual distortion related to wet AMD.
Patients over 60 should receive regular eye exams and be vigilant for signs of cataracts, glaucoma, macular degeneration and other age-related vision problems, because the key to preventing vision loss is early detection and treatment.
Normal Amsler Grid
Abnormal Amsler Grid