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Macular Degeneration

What is macular degeneration?

The finest details of visual images occur in the center of the retina. This area is referred to as the macula. If the cells in the macula degenerate, images become blurred and distorted. Small, dark areas may also appear. This condition may advance until substantial vision loss occurs. The gradual disappearance of sharp, clear images on the macula is referred to as age related macular degeneration (AMD).

At what age does age related macular degeneration occur?

Macular degeneration onset usually occurs near the age of 65.

Are there other risk factors besides age?

Yes. Dry AMD occurs most often in Caucasian women over the age of 60. A family history of macular degeneration is also a significant predictor.

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What is dry AMD?

There is a severe form of macular degeneration referred to as “wet”. Dry AMD means the macular degeneration is not associated with hemorrhage from leaking blood vessels. Instead, dry AMD occurs as the cells in the retina age and, like other cells throughout the body, begin functioning at less than 100%. Sub-optimal cell performance is a natural process that occurs as we age.

Will everyone eventually acquire dry AMD?

No. Many people live long lives and only have slight degeneration of retinal cells.

Can dry AMD be corrected with surgery?

Unfortunately, no.

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Can the degeneration process be stopped with surgery?

Not at this time.

How do you treat dry AMD?

Clinical studies have shown a formulation of vitamins A, C, E, magnesium and zinc can significantly delay and, in some cases, prevent continued deterioration of the macula.

Should everyone be taking this eye vitamin formulation?

No. There is no evidence that this special formulation of vitamins and minerals prevents macular degeneration from occurring in people who have no symptoms. There are, however, specific ways – behaviors – you can initiate or modify that will reduce your risk of developing age related macular degeneration.

What are those helpful behaviors?

Avoid cigarette smoke – first and second hand. Exercise. Consume a low fat diet that emphasizes fish and vegetables, especially those rich in carotenoids and lutein like carrots, tomatoes, spinach, broccoli, dark lettuce, collard greens and kale. Oranges are good as well.

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When you say exercise, do you mean eye exercises?

No. Exercise means cardio-vascular workouts. Aerobics. Four specific conditions have consistently been associated with AMD: high blood pressure, high cholesterol, being overweight and inflammation. Exercise can lower every one of them.

We can’t modify our age or our genetics but we can modify diet and lifestyle.

What is the difference between wet macular degeneration and dry AMD?

Wet macular degeneration occurs in about 10% of macular degeneration patients. Macular cells rapidly and severely degenerate as a result of hemorrhaging vessels behind the retina. Leakage of blood and fluid from these fragile, weakened vessels causes vision loss much faster than the gradual degeneration associated with aging.

How is wet macular degeneration treated?

Traditional treatment of wet macular degeneration involves identifying and cauterizing hemorrhaging vessels with a laser. Recent ophthalmic research has produced new drugs that inhibit the growth of fragile retinal vessels that hemorrhage causing the “wet” condition. These medications are injected directly into the eye causing hemorrhaging vessels to regress. Vision improves in many patients when the hemorrhages resolve. More than one injection is usually required to treat the wet macular degeneration.

Why would a doctor recommend cataract surgery if the patient has AMD?

An ophthalmologist has determined the patient’s decreased vision is because of cataracts and not AMD. The patient will experience improved vision following cataract surgery. We cannot predict at what time AMD will cause problematic vision loss.

We do know that if the patient has advanced macular degeneration, cataract removal usually does not improve the patient’s vision. An experienced ophthalmologist will help the patient understand the prognosis.

What can a patient expect from an office visit if experiencing symptoms of macular degeneration?

The patient will receive a comprehensive, completely comfortable eye examination with special attention focused on the retina and macular cells. Pupils may be dilated and numbed with drops for optimal observation. Arrangements for a driver may be necessary. Following the examination, I will discuss the patient’s condition and thoroughly explain all treatment options. Most importantly, I will take whatever time the patient needs for me to answer their questions and feel comfortable with our treatment plan.

We practice our philosophy of “Personalized Eye Care” with every patient I see.

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