Macular Degeneration

The diagnosis of macular degeneration is becoming increasingly more common due to patient awareness, physician access, and new groundbreaking improvements in treatment. Due to new treatment available, the odds of going blind have decreased.

“My grandmother has macular generation, she is legally blind. We have to do everything for her. My mother cleans her house, my uncle takes her shopping and I do her finances”, says, Dr. Todd Gillihan.

Age-related macular degeneration is a common eye disease associated with aging. It blurs the sharp, central vision you need for activities in which you have to look straight ahead in order to perform. Such activities include reading, computer work, washing dishes, eating and driving for example. “We even had to buy her all white plates, just so she could see her food to eat”, says, Dr. Gillihan.

In some cases, this disease progresses so slowly that it really has little effect on ones vision as they age. However, in others, the disease can vastly progress and it can lead to a loss of vision in one or both eyes.

About 1.7 million Americans have some form of macular degeneration. “It is the leading cause of vision loss among Americans ages 65 and over”, says Dr. Arnold Bulos, O.D.

In order to understand macular degeneration, it is helpful to understand the parts of your eye involved with sight. These structures include the cornea, iris, pupil, lens, macula, and retina.

Your cornea is a thin, clear layer on the outside of your eye. The iris, or the colored part of your eye, is a muscle that controls the amount of light going through your pupil, which is the round opening in the center of your eye. Behind the iris sits the lens, which is just larger than your pupil. The iris is enclosed by a thin, clear capsule that holds the lens in its proper place.

When light enters your eye, the cornea and lens form the light rays into a beam of light that is focused directly onto your retina -- the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses. The retina then sends these impulses, or nerve signals, to the brain through the optic nerve. The optic nerve is a bundle of more than one million nerve fibers connecting the retina to the brain.

The macula is located in the center of the retina. It is made up of millions of light-sensing cells that help to produce central vision. This is why blindness occurs, due to the deterioration in the macula, says, Dr. Todd Gillihan, O.D.

There are two types of age-related macular degeneration: Dry (atrophic) form: This type results from the gradual breakdown of cells in the macula, resulting in a gradual blurring of central vision. Single or multiple, small, round, yellow-white spots called drusen are the key identifiers for the dry type. These spots are located in the back of the eye at the level of the outer retina and are detected by examination of the retina with specifically engineered lenses, a slit-lamp biomicroscope, or an ophthalmoscope. Spots typically become visible when a person reaches his or her late 30s or older but are much more common in people over the age of 70. People with these spots may have excellent vision and no symptoms. Most people with age-related macular degeneration begin with the dry form. The dry form of macular degeneration is fortunately much more common than the wet form. Advanced dry macular degeneration, known as geographic atrophy, is the culmination of prolonged, progressive wasting changes in the nerves and sensory retina. Geographic atrophy is the main cause of vision loss in dry AMD, not drusen.

Wet (exudative or neovascular) form: In the wet form of macular degeneration, newly created abnormal blood vessels grow under the center of the retina. These blood vessels leak, bleed, and scar the retina, distorting or destroying central vision. Vision distortion usually starts in one eye and may affect the other eye later. In contrast to the dry type, vision loss may be rapid in the wet type of macular degeneration.Wet macular degeneration affects only about 15% of people who have age-related macular degeneration but accounts for two-thirds of the people who have significant visual loss.
However, there are preventative measures that take place at the eye doctor’s office. “We at Pearle Vision make sure we take steps to help in the preventative measures in eye care” says, Christina, Store Manager of Pearle Vision. When a patient first walks in our store, they must fill out a health form. This allows them to see past history that may help in the process of providing and treating patients accurately. The second step is to be seen by a technician who then pretests and then by the doctor.
“There is an option for patients to have an optomap done, this is when we take pictures of the retina and check the health of the eye”, says, Dr. Bulos.
As you can tell, this is why it’s important to be seen by an optometrist or ophthalmologist once a year. Make sure you don’t forget to get that appointment scheduled today.