Monthly Archives: February 2015
By Dr. David F. Box, Ophthalmologist
Macular Degeneration is a common diagnosis for patients over age 50. The incidence increases in each subsequent decade of life. Patients who receive this diagnosis often become emotionally distraught because they believe it always results in blindness.
While it is true that some cases can lead to central loss of vision, that is not true the majority of the time. Although there is still much to be learned about this ocular disease, active research is making progress and the overall prognosis is improving.
New medications have been developed and risk factors are being identified. There are several promising new treatments on the horizon that should improve the prognosis even more. The information for this article was obtained from the National Eye Institute.
The disease causes damage to the macula, which is a small area located in the central portion of the retina. The macula contains a high density of the visual nerves needed for sharp central vision. Patients with damage in the macular region of the eye will notice blurring and distortion of central vision. Sometimes this damage can be spotty and not all areas of the macula are equally involved.
In more severe cases, all of the macular cells are damaged and the patient will completely lose central vision in the affected eye. A person with loss of macular function would still have peripheral visual input but would lose ability to read, drive and recognize faces. Most of the cases involve both eyes, but the degree of severity between the two can vary significantly.
Another variable among patients is the rate of progression. The disease does not spontaneously improve and usually worsens gradually. Some patients have much faster progression than others. The rate of progression can also differ between eyes in the same patient.
There have been risk factors identified in macular degeneration patients. In general, age seems to be the most important risk factor. Often you will see the disease identified by the acronym AMD, which is an abbreviation for Age-Related Macular Degeneration.
Researchers are trying to learn more about the specific age changes occurring in the retinas of affected patients. Smoking has been shown to double the risk of AMD. People with a family history of AMD are also at a higher risk. AMD is more common among Caucasians than among African-Americans or Hispanics/Latinos.
Researchers have found links between AMD and some lifestyle choices. Patients may be able to reduce their risk of AMD or slow its progression by making these choices: avoid smoking, exercise regularly, maintain normal blood pressure and cholesterol levels, eat a healthy diet rich in green leafy vegetables and fish.
AMD can only be detected by a comprehensive dilated eye exam performed by an eye care professional. As in many medical conditions, an accurate and early diagnosis of AMD is important in developing a proper treatment plan and providing appropriate counseling to the patient tailored to their specific findings.
Unfortunately, AMD shares symptoms with many other eye conditions. Misdiagnoses can occur. A delay in the proper diagnosis could have a significant impact on the course of the disease. If a patient receives an improper diagnosis of AMD, then this can lead to avoidable anguish and fear for the patient and their family.
It is very important to make the proper diagnosis as early as possible in the course of AMD. Proper grading and staging of the severity of the disease in each eye is valuable for many reasons. In order to accomplish this objective, eye care professionals must possess proper training and experience in managing AMD. They must also have access to additional diagnostic tests and equipment.
At the Indiana Eye Clinic, all of our eye physicians are well-trained in the diagnosis and management of AMD. We also have the most advanced equipment currently available onsite to assist us in caring for our AMD patients.
In subsequent articles, I will discuss some more specific details about various types of AMD and current treatment options available.