Macular Degeneration

Age-related macular degeneration is a condition occurring in the macula (central part of the retina), in which the pigment layer of the retina becomes progressively damaged. It is more common with advancing age and will commonly lead to loss of central vision.

Early in the disease there may be no symptoms, but it may be detected by your optometrist or ophthalmologist during a routine examination. Later you may begin to notice a subtle blur to your central vision, or you may notice distortion of your vision, with objects that may be straight (such as telegraph poles) being curved instead. At this stage, patients may feel that their glasses need changing, however, this will rarely help as the problem is not with the lens of the camera, it is with the film of the camera; therefore simply changing the lens will still yield a bad photograph.

There are two main types: Dry age-related macular degeneration occurs in 90% of cases. It is a slow progressive wearing-out of the pigment layer in the macula over many years. Early in the disease, the macula accumulates a waste-product called ‘drusen’, which appear as small yellowish deposits.

Early Macular Degeneration: courtesy of National Eye Institute, National Institutes of Health

Over time these deposits increase in size and the pigment layer in the macula begins to wear away, reducing central vision and making reading very difficult. The only treatment available is dietary (eat a diet rich in green leafy vegetables) and lifestyle (don’t smoke). In moderate and severe cases there is evidence that taking two Macu-Vision tablets per day can reduce the risk of blindness. Your ophthalmologist or optometrist should also give you an ‘amsler grid’ which you should put on you fridge and observe it with each eye separately every morning. The amsler grid has many small squares on it, but if you notice that the squares are no longer regular, this could indicate that a blood vessel is leaking in the macula, meaning that you might have developed wet macular degeneration.

Dry Macular Degeneration: courtesy of National Eye Institute, National Institutes of Health

Wet macular degeneration occurs in 10% of cases and is associated with much more rapid vision loss. Dry macular degeneration can also become wet macular degeneration therefore it is important to check your amsler grid with each eye every morning. If you notice a new change in your vision, then you should contact your ophthalmologist so that you may be examined and treatment can be started if need. Treatment will usually involve intravitreal injections (into the eye) of medications such as Lucentis or Eylea. These medications are the latest treatments available and can stabilise vision and even improve vision in some cases.

Wet Macular Degeneration: courtesy of National Eye Institute, National Institutes of Health