Macular Degeneration

Macular Degeneration is an age related vision problem and is of 2 types: Dry and Wet Macular Degeneration. The latter condition comprises of growth of blood vessels beneath the retina in the posterior region of the eye leading to fluid and blood leakage. Dry macular degeneration is more common than wet macular degeneration. It is characterized by macular deterioration in the center of the retina resulting in central vision loss or a blind spot in the central vision. Dry macular degeneration is a chronic condition which affects a person's quality of life, as you need unobstructed central vision for daily tasks like driving, reading, writing etc. Treatment for dry macular degeneration is done by consuming a healthy diet, vitamin supplements and surgery.

Macular Degeneration: Wet, Dry, Stages, Causes, Signs, Treatment

Stages of Dry Macular Degeneration

  • Early Stage of Dry Macular Degeneration: In this stage, many small and medium-sized drusen (yellow deposits) are present beneath the retina. Patients usually won't have any vision loss in this stage.
  • Intermediate Stage of Dry Macular Degeneration: There are many medium-sized drusen or a couple of large drusen present either in one or both the eyes. Symptoms may not be present in this stage; however, there may be blurriness of the central vision.
  • Advanced Stage of Dry Macular Degeneration: In this stage there are many large drusen along with vast cell breakdown in the macula. There may be a distinct region of blurring in the central vision, which slowly grows bigger.

Causes of Dry Macular Degeneration

The cause of dry macular degeneration is not known, but it is a chronic condition which develops as you age. The macula is affected in this condition. The function of the macula is giving clear vision in your central line of vision. As the eye ages, the macular tissue becomes fragile and tends to tear.

Risk Factors for Dry Macular Degeneration

  • The risk for developing dry macular degeneration increases with age, particularly after crossing 50 years.
  • Having a family history of macular degeneration increases your risk for developing it.
  • Caucasians are more prone to suffering from macular degeneration.
  • Being overweight or obese increases the chances of progression of early or intermediate macular degeneration to severe macular degeneration.
  • Following an unhealthy diet increases the risk of dry macular degeneration.
  • Smoking increases the risk of developing macular degeneration.
  • Having other medical conditions such as cardiovascular disease and hypercholesterolemia puts you at a higher risk for having macular degeneration.

Signs and Symptoms of Dry Macular Degeneration

Symptoms of Dry Macular Degeneration Develop Gradually and Include:

  • Patients are not able to see clearly when reading or performing close work and need stronger light.
  • Difficulty in adjusting to dim or low lit areas or environment.
  • Patients with advanced dry macular degeneration experience visual hallucinations because of sight loss consisting of flashes of lights, colors and shapes.
  • Increased blurry vision while reading fine prints.
  • Patient has difficulty in identifying people or recognizing faces.
  • Patients start experiencing gradual increase in the blurriness with their central vision.
  • Patient experiences decrease in the brightness or intensity of colors.
  • There is presence of a blind spot in the central vision.

Diagnosis of Dry Macular Degeneration

Medical history and family history along with comprehensive eye exam consisting of various tests such as the following:

  • The doctor examines the posterior region of the eye with a special instrument to check for yellow deposits which appear under the retina to confirm macular degeneration.
  • Ambler grid test is used to check for defects in the central vision. Patients with macular degeneration will visualize the straight lines in the grid as broken, faded or distorted.
  • Fluorescein angiography is a test where a colored dye is injected into a vein in your arm. This dye travels to the eye and emphasizes the blood vessels present in the eye. Various pictures of the blood vessels are taken by a special camera revealing any abnormalities in the blood vessels or retina, if any.
  • Optical coherence tomography (OCT) is a noninvasive imaging test, which shows cross-sectional images of retina in detail, thereby helps in identifying regions where the retina has become thin, thick or swollen. OCT is also used to assess retina's response to treatment for macular degeneration.

Treatment for Dry Macular Degeneration

Dry macular degeneration cannot be reversed; however, as this condition develops gradually, with proper treatment and care, its progression can be halted and patients can enjoy a relatively good quality of life, particularly if one eye is affected.

  • Increasing your vitamin intake, such as taking antioxidant vitamins and zinc, helps in slowing the advancement of dry macular degeneration and vision loss. There may be some side effects or complications with a few of the vitamin supplements. You have to discuss with your doctor who will decide the best combination of vitamins for you.
  • Beta carotene supplements are thought to increase the risk of lung cancer in smokers and also may increase the risk of having CAD/coronary artery disease.
  • Vitamin E taken in high doses of may increase the risk of having heart failure.
  • Lifestyle and dietary changes are important and patients should include lots of fruits and vegetables to improve their eye health.

Surgery for Dry Macular Degeneration

For certain patients, who have advanced macular degeneration in both the eyes, surgery is done for improving the vision by implanting a telescopic lens in a single eye. The telescopic lens resembles a small plastic tube and is fitted with lenses which help in magnifying the field of vision. This telescopic lens also helps in improving both close as well as distant vision.

Lifestyle Changes for Dry Macular Degeneration

  • Include lots of fruits and vegetables in your diet for better eye health.
  • Consume healthy fats such as found in olive oil, instead of butter and trans-fats, as they help in protecting as well as improving your vision.
  • Eat whole grains such as oats, whole wheat, barley etc. and avoid refined grains.
  • Try to consume fish, such as salmon, tuna and sardines, regularly as it contains omega-3 fatty acids which cut down the risk of macular degeneration related vision loss.
  • Nuts, like walnuts, also contain omega-3 fatty acids.
  • Have regular eye exams.
  • If you are suffering from other medical conditions, such as hypertension and cardiovascular disease, then they should be well managed and medications for the same should be taken regularly.
  • Quit smoking, as smokers are at a higher risk for developing macular degeneration.
  • Exercise regularly and lose excess weight.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: April 17, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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