DISEASES OF THE MACULA

Age-Related Macular Degeneration

The macula is a small area in the retina responsible for central vision. Far more sensitive than the rest of the retina, it allows for seeing fine details clearly. The peripheral retina is associated with the peripheral or side vision. Age-related macular degeneration (AMD) is a deterioration of the eye’s macula. Many older people develop macular degeneration as part of the body’s natural aging process. Although there are different kinds of macular problems, the most common is age-related macular degeneration.

Most people who have macular degeneration have the dry form. This is caused by aging and thinning of the tissues. Dry macular degeneration is subject to gradual vision loss so patients must be consistent in the monitoring of their central vision. There are no medications or treatments for dry macular degeneration but some patients may find benefit from a vitamin therapy (see Treatment Options below).

About 10 percent of those with macular degeneration have the wet form. It tends to cause more damage to central vision than the dry form. Wet macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina. This blood vessel growth is called choroidal neovascularization (CNV) because the vessels grow from the layer under the retina called the choroid. These new blood vessels may leak fluid or blood, blurring or distorting central vision. Vision loss from this form of macular degeneration may be faster and more noticeable than from dry macular degeneration. The longer these abnormal vessels leak or grow, the more risk there is of losing more detailed vision. If abnormal blood vessels develop in one eye, the risk is greater for it to occur in the other eye.

The Symptoms of Macular Degeneration

With macular degeneration, the symptoms may include blurriness, dark areas or distortion or even permanent loss in the central vision. It usually does not affect side, or peripheral vision. An example of advanced macular degeneration is at left: the outline of a clock is visible, but not the hands. Causes of macular degeneration include the formation of deposits called drusen under the retina. In some cases, abnormal blood vessels grow under the retina. With or without treatment, macular degeneration almost never causes total blindness. People with advanced cases of macular degeneration continue to have useful vision using their peripheral vision with the help of low vision aids. Often, macular degeneration has an impact on vision. When macular degeneration does lead to vision loss it usually begins in one eye and migrates to the other. Many people are unaware that they have macular degeneration until vision problems arise or when it is diagnosed through an eye examination.

What are the Treatment Options?

The Age-Related Eye Disease Study showed that among people at high risk for developing late-stage, or wet macular degeneration, taking a dietary supplement of vitamin C, vitamin E and beta carotene, along with zinc, lowered the risk of macular degeneration by 25%. Supplements do not appear to provide benefit for people with minimal macular degeneration. Here is the nutrient supplementation shown to be beneficial in lowering the risk of macular degeneration:

  • Vitamin C – 500 mg
  • Vitamin E – 400 IU
  • Zinc oxide – 80 mg
  • Beta carotene – 15 mg (25,000 IU)
  • Copper (as cupric oxide) – 2 mg (to prevent copper deficiency, from taking high amounts of zinc)

By far, the simplest and best plan for those with macular degeneration or those that suspect they might have it, is to have an eye examination first. Have a frank discussion with Dr. Alejandro about macular degeneration and what is right for you.

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Macular Holes

A macular hole is a small break or tear in the macula, the most light sensitive tissue at the center of the retina. The macula is responsible for the most acute vision of the human eye.

The most common cause of macular holes is the shrinking of the vitreous fluid which fills the inside of the eye.  As we age this normally clear gel like liquid begins to shrink and as it contracts its fibers can remain connected to the retinal surface. As these fibers pull  the increased tension can result in a macular hole.

When the macula tears fluid can seep through the macular holes and into the macula, this usually results in blurring and distortion of the patients central vision.  While most macular holes can be treated with surgery all cases will progress and may result in total loss of sight if left untreated.  While macular holes can occur at anytime it is important to have your eyes checked regularly as early detection is key to affective treatment.

Call Newsom Eye and let our doctors help keep your eyes healthy and strong for as long as you live.  Most age related eye problems can be easily corrected or prevented with regular annual eye exams and honest self-screening.  If you see a problem, see a doctor.

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Macular Membranes

Macular Membrane or Macular pucker occurs when microscopic damage to the macula occurs and then heals.  The resulting scar tissue creates macular pucker which can be similar although not a serious as macular holes.

Macular pucker like a macular hole can result in distortion and/or blurring of the fine central vision.  Macular pucker and macular holes are usually the result of the same thing a shrinking of the vitreous which causes a increased tension on the retinal tissue. When this tension creates minor damage which heals macular puckering is the result. Macular puckering will not usually develop into a macular hole.  No matter what your symptoms or diagnosis the professionals at Newsom Eye will help you better understand your condition and the many cutting edge solutions available to you.

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