First and foremost, macular degeneration is a disease of aging.
Most of us have known someone who has been diagnosed with this common condition – and maybe even experienced a loss or change in vision. For this reason, the mere mention of macular degeneration can sometimes make patients feel anxious or scared.
To better understand macular degeneration, let’s consider the two terms individually:
- “Macular” refers to the macula, or the center portion of the retina that is responsible for our good central vision. (For a reminder about basic eye anatomy, click here!)
- “Degeneration” refers to a condition where the structure or function of the eye has changed from its previous form.
Why does macular degeneration occur?
As mentioned above, macular degeneration is primarily a disease of aging. Over the course of a lifetime, our bodies experience a fair amount of stress from the metabolic processes that keep our tissues functioning. In the eye, this “wear and tear” can cause deposits of a pigment called lipofuscin to collect under the retina. When these pigment deposits are noted on a dilated eye exam, we call them drusen.
It is important to note that not everybody will have drusen appear as they get older. Just like some people develop wrinkled skin or gray hair while others don’t, everyone’s eyes show the signs of aging a little bit differently. It is well understood, though, that the risk of developing macular degeneration increases as we age.
Does macular degeneration affect the vision?
Sometimes yes, often no.
It is quite possible for an ophthalmologist to find signs of macular degeneration in a patient who has no complaints about his or her vision. In fact, many of my patients with this condition can easily read the 20/20 line of the eye chart!
As the findings of macular degeneration increase or worsen, it is more likely that the vision may seem blurry or distorted. The way that we treat macular degeneration is unique to the way that the disease presents in each individual patient.
Are there different types of macular degeneration?
There are two types of macular degeneration that are relevant to this article.
“Dry” macular degeneration occurs when drusen form in the eye as discussed above. This is the most common form of the disease. By definition, there is an absence of bleeding or swelling in the macula.
“Wet” macular degeneration occurs when drusen are accompanied by bleeding or swelling of the retina. These additional changes occur when leaky, fragile blood vessels break through the tissue layer that normally protects the retina (called the retinal pigmented epithelium). While research is constantly improving our understanding of this disease, it is known that these changes are mediated by a chemical called VEGF (vascular endothelial growth factor).
What are the risks of developing macular degeneration?
The number one risk for developing macular degeneration is getting older. (Just like life’s other problems, right?)
Other risks that may predispose to this condition include:
- Family history
- History of heavy sun exposure
- Poor diet
- Caucasian race
Can macular degeneration be prevented?
While it is probably impossible to completely eliminate the risk of this condition, a person can take certain precautions to lower their risk of developing vision loss from macular degeneration.
These recommendations include:
- Having a regular dilated eye exam as you age, particularly if a family member has had this condition
- Avoiding smoking
- Eating a well-balanced diet that includes omega-3 fatty acids and leafy green vegetables
- Wearing sunglasses
What should I do if I have been diagnosed with macular degeneration?
In cases of “dry” macular degeneration, often the recommendations are directed toward reducing the risk that the disease will progress. Your ophthalmologist may recommend certain vitamins that have been proven to help some patients lower their risk of worsening.
Additionally, your doctor may offer you an Amsler grid. With this simple test, a patient can screen him or herself at home for changes in the vision that may require treatment. For instructions and an Amsler grid that you can download, click here!
Most important, if you smoke, please consider quitting! The health benefits of stopping tobacco are numerous. This one is a real no-brainer.
If you have been diagnosed with “wet” macular degeneration, often the need for treatment is more urgent. Please click here for another article on how this condition is treated in the office.