Many eye and systemic diseases can be caught early with routine eye examinations. Macular degeneration is one such condition that many people fear might steal their vision as they grow older.
We perform complete eye examinations in our clinic and have the advanced technology necessary to diagnose and manage macular degeneration. This article will explain the basics of macular degeneration and how we look for it in your appointment with us.
What is Macular Degeneration?
Age related macular degeneration, abbreviated ARMD or AMD, as a condition where cellular waste material – called drusen – builds up underneath the retina, which is the layer of light sensing cells at the back of the eye. This can block these cells from receiving adequate nourishment from the underlying blood vessels of the choroid, and impair their function and health.
Over the long term, this buildup of waste material can lead to various consequences. Dry AMD is when this waste material causes damage to the overlying retinal cells, gradually reducing central vision.
The end stage of dry AMD is geographic atrophy, when vast areas of the retina die off and lead to profound visual impairment in the affected eye. Only a minority of patients progress to this stage or to wet AMD, whereas most patients with AMD suffer only mild-moderate vision effects.
Wet AMD is when new, fragile, and leaky blood vessels grow within the drusen underneath the retina where they normally should not be. This can cause drastic damage to the overlying retinal cells, including scarring and swelling of this tissue, and lead to profound vision loss.
Examinations for Macular Degeneration
AMD might make objects appear a bit blurrier or more dim, and patients often notice these symptoms or they are found during an eye examination. In addition, the drusen of early AMD and more severe signs can be easily spotted by looking at the back of the eye during your visit.
Other tests might be performed to fully evaluate the condition. An Amsler grid can be used to determine whether vision changes besides blur have occurred, like distortion of vision, blind spots, etc. and these are often sent home with patients to monitor their own vision over time.
OCT (ocular coherence tomography) is a scan that takes a cross section of the retinal layers, making it very easy to see disruption of these layers and the presence and severity of dry or wet AMD. If wet AMD is suspected, angiography might be performed, which is when a special dye is injected into a patient’s arm and images of the back of the eye are captured as the dye enters the retinal blood vessels.
Management of Macular Degeneration
In the early stages of AMD, emphasis is on the prevention of its progression to geographic atrophy or wet AMD. A patient will be told to stop smoking, adequately control blood pressure and other cardiovascular disease, wear sunglasses, and focus on getting green, leafy vegetables in the diet.
In moderate-advanced stages of AMD, certain mixes of vitamins and antioxidants have been found to be effective in reducing risk of progression to severe forms. These are usually taken twice a day by mouth.
In wet AMD, medicines that stop the blood vessel growth are injected into the eye to limit the damage. This is typically carried out every few weeks at first and can be slowly tapered to longer intervals of monitoring if the condition improves.
Finally, low vision rehabilitation can be undertaken in patients who have suffered vision loss from AMD that begins to limit their ability to perform daily tasks. This can take the form of training to use other parts of the visual field that have not been damaged, optical devices like telescopes and magnifiers, and electronic devices that enhance contrast and lighting.