Thursday, March 27, 2014



  Early detection and treatment of macular degeneration reverses vision loss and improves vision. Wet Macular Degeneration (WMD) causes vision loss in the macula, the center of the eye’s vision field. Dry Macular Degeneration (DMD) is more common and less severe. Symptoms of both include vision distortion, such as as straight lines appearing wavy or crooked, and decreased color intensity. A doorway or street or sign might appear lopsided. Objects appear smaller or further away than they really are. WMD often begins as the dry type. 

Early diagnosis and treatment reduces vision loss and, in some instances, improves vision. WMD is more severe and progresses more rapidly than the dry type.   It is most common in those older than sixty five and in Caucasians.

WMD risk factors include smoking, obesity, high blood pressure, elevated cholesterol, a diet lacking fruits and vegetables, and heart disease.  Macular degeneration doesn't affect side (peripheral) vision. It usually doesn't cause blindness. It can, however, diminish central vision, crucial for driving, reading, and recognizing faces. 

Diagnostic testing includes a dilated eye exam and an Amsler Grid test, both of which detect central vision distortion. A fluorescein angiogram involves injecting dye into an arm vein to identify leaking blood vessels. The procedure identifies blood vessels that could be associated with WMD.
First line treatment includes Bevacizumab (Avastatin), a prescription cholesterol lowering medicine. It prevents growth of new eye blood vessels.  Ranibizumab (Lucentis), Pegaptanib (Macugen), and Aflibercept (Eylea) are medicines injected into the eye. They partially recover vision loss and allow retinal vision cells to regain function. 

Photodynamic therapy includes injection of verteporfin (Visudyne) into an arm vein. Laser light is then administered to the affected eye blood vessels.  This activates the Visudyne  and causes the abnormal blood vessels to close and stop leakage. Sometimes photodynamic therapy requires repeat treatment.   

Laser photocoagulation is a high-energy beam that destroys abnormal blood vessels under the macula.  It prevents further macula damage and slows vision loss.
Non-invasive ways to improve vision includes use of magnifying devices, enlarging computer font size, and brighter lights in the home. 

Additional vision aids include focusing attention while driving. Use of public transportation is helpful when it’s available. Consider asking family members to help for for night driving.  
Smoking cessation, taking prescribed medicines, regular exercise, and hypertension treatment are crucial. A healthy diet with fruits and vegetables provide antioxidants that reduce macular degeneration risk. These include Omega-3 fatty acids, fish, and nuts.  
Ask your eye doctor how often you should have periodic eye exams. A dilated eye exam can identify macular degeneration.
Stop smoking. Smokers are more likely to develop macular degeneration than nonsmokers.

For further information or questions, contact Dr. Clem at  clementhanson.blogspot.com.