Macular Degeneration FAQ

What is the macula?
The macula is the center of the retina which is the lining of the inside of the eye. It contains the most sensitive photoreceptors that convert light into eyesight. The macula is what allows us to see very fine details. We use our macula all day every day to see the details of the world around us.

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What is macular degeneration?
Macular degeneration is a broad term describing the deterioration of the central retina and the loss of the central part of vision. The term most commonly refers to “age-related macular degeneration” (abbreviated as AMD). AMD is the most common cause of vision loss due to aging. People with AMD may lose their ability to read, drive, or recognize their friends as a result of their visual impairment.

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What are the different types of AMD?
AMD is classified as either dry or wet. The dry form is more common than the wet (about 90 percent of patients). It may result from the aging and thinning of macular tissues, depositing of pigment in the macula, or a combination of the two.

In the wet form, new blood vessels grow beneath the retina and leak blood and fluid. This leakage causes retinal cells to die and accelerates the degeneration. Permanent scarring results.

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What are the important risk factors for AMD?
Age, smoking, and family history of AMD are the most important risk factors. Smoking is the only one of the three you can change. Smoking triples the risk of AMD!

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Will I develop glaucoma if I have increased eye pressure?
What you eat also affects your macula. Antioxidants (vitamins A, C and E), zinc, lutein, zeaxanthin and essential fatty acids all can aid in preventing macular degeneration.

UV protection is theoretically helpful. Life-long exposure to the sun may play a role in AMD. Quality sunglasses are recommended.

Eating a heart-healthy diet with a lot of green leafy vegetables, exercising, and quitting smoking are also advisable.

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What are the signs and symptoms of macular degeneration?

Early signs include: straight lines appearing wavy, fuzzy vision, and shadowy areas in your central vision. Your eye doctor may find indicators before you have any symptoms, so regular eye exams can mean an early diagnosis.

One way to discover if you are having these vision problems is to view an Amsler grid, which is a chart of black lines arranged in a graph pattern.

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Is macular degeneration curable?
No, but treatment can slow or even stop the progression of the wet form, so the earlier you’re diagnosed, the better.

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What macular degeneration treatments are currently available?
Dry AMD is treated only with diet and vitamins. A very long, comprehensive study proved the benefits of anti-oxidants and vitamins (AREDS study). Patients who took large doses of these supplements were 28% less likely to get worse. PreserVision and ICaps are two commonly recommended AREDS vitamins.  AREDs therapy is not recommended for people who smoke.

Wet AMD is treatable. Ideally treatment would begin soon after wet AMD begins. Over the past decade the trend is to inject medicines inside the eye instead of doing laser surgery. The medicines work better and do not cause the scarring associated with laser treatment. Although most people cringe when they are told about treatments involving a needle injection into the eye, the treatments are well-tolerated by the vast majority of patients.

There are a few commonly used medicines for wet AMD—Eyelea, Lucentis and Avastin. They are designed to prevent the formation of abnormal blood vessels associated with wet AMD. A series of three injections, one a month for three months, is typically recommended. Maintenance injections may also be recommended every 2-3 months.

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Can anything else be done? Will it cause blindess?
Although macular degeneration may cause one to become visually impaired or “legally blind,” it does not cause complete loss of vision. Even in severe cases of AMD, people retain peripheral vision and may be able to function quite well.

Special optical aids may help those impaired with AMD. These devices—magnifiers, telescopes, computers, to name a few—may help these people use remaining vision more effectively. Doctors who specialize in such “low vision services” can demonstrate these and help select devices that may work best for each patient.

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