My aunt told me that my grandmother is struggling with something called macular degeneration. What is macular degeneration?
Macular degeneration is the most common cause of vision loss in seniors. A special area inside the eye called the macula, is affected. When the macula does not perform properly, sharp, central vision is lost.
How vision works
Light enters the eye through the clear outer covering called the cornea. The light travels into the area we call the pupil, which contains the lens of the eye and the lens focuses light on the back inside of the eye. The sensitive back area of the eye that receives the focused light is called the retina. The retina converts the light signals into nerve signals. These nerve signals travel from the retina to the brain via the optic nerve.
The retina contains a very small and specialized area called the macula. The macula is the most sensitive area of the retina and is responsible for very fine, clear, sharp central vision. As you can imagine, if there are problems with the macula, then there are very severe problems with maintaining proper vision. When such visual problems arise in the macula, it is termed “macular degeneration.”
There are two types of macular degeneration, “dry” and “wet.”
Dry macular degeneration:
Dry macular degeneration results from deterioration of the macula that comes with time and age. The progression can be slow, and many can function with this visual disturbance for quite some time before it becomes limiting. It can, at times, rapidly transform into “wet” macular degeneration.
Wet macular degeneration:
This is a more severe form of vison loss that can come on suddenly. Wet macular degeneration results when blood vessels grow into the back of the eye leak into the macular area and cause damage. In this form of the disease, blood vessels grow under the retina in the back of the eye, leaking blood and fluid and damaging the macula.
It is not completely clear what triggers the growth and leakage of the blood vessels. The majority of patients who experience wet macular degeneration start with dry macular degeneration. Unfortunately, at this time, it is impossible to predict who will develop wet macular degeneration and who will not.
Signs and symptoms of macular degeneration
The need for bright light when reading or working closely with objects
Difficulty seeing at low-light levels
Newsprint appears blurry
Noticing that colors do not appear as bright as they once did
Trouble recognizing faces
Decreased/blurry central vision or even a blind spot in one’s central vision
Distortions in vision: straight lines look wavy or objects look uneven
Dry macular degeneration usually progresses slowly. Many people who have it can live relatively normal, productive lives, especially if only one eye is affected. In the case of wet macular degeneration, early diagnosis may slow its progression and reduce the amount of vision loss.
Dry macular degeneration can develop slowly and may need very little intervention. This is especially true if only one eye is involved. With wet macular degeneration, detection and early intervention are important to limit vision loss.
Nutrition: a nutritious diet rich in fruits and vegetables, fish and Omega-3 fatty acids is important to maintain good eye health. Also, your doctor may recommend a combination of vitamins, minerals, and nutrients that are rich in antioxidants to slow the progression of macular degeneration.
Surgery: in some cases of macular degeneration a special magnifying lens can be implanted that improves vision.
Medication: there are a number of prescription medications used to treat macular degeneration. The goal is to prevent or slow the growth of blood vessels near the retina/macula, so they don’t leak and cause damage. Most of these medications are injected directly into the inside of the eye.
Laser/medicine surgery: this is also called photodynamic therapy. A special medication is introduced into the blood, and a laser is directed at the areas of blood vessel growth near the retina. The laser stimulates the medication to help close down the unwanted blood vessels in the area of the retina called the macula. This can prevent or stop the blood from leaking and damaging the macula. The laser can be used directly to target and close down abnormal blood vessels in the retina, without the use of medicine, too. This direct laser treatment is reserved for special cases and is not appropriate for everyone with wet macular degeneration.
Your vision directly affects the quality of your life. Coordinate with your primary care doctor and your ophthalmologist a plan to best maintain your eye health. You should also discuss and decide with them how often you should have regularly scheduled eye examinations.
If you are experiencing any of the symptoms listed above related to macular degeneration, or any other eye problem, contact your doctor immediately. You can play a major role in maintaining your own excellent vision and eye fitness and health.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.