Age-related macular degeneration of the retina

What is Macula Degeneration?

Age-related macular degeneration causes damage to the part of the eye responsible for central vision. It tends to affect people in later life, usually those over 65 years of age, although symptoms can appear in the 50s or early 60s. It does not necessarily cause total blindness, but can affect both near and distant vision and, if left untreated, can seriously affect daily activities, such as reading and recognizing faces. There are two types of macular degeneration: dry and wet.

Around 90% of all those affected suffer from the former. In dry age-related macular degeneration, sometimes called non-neovascular AMD or non-exudative AMD, the macula (part of the retina) becomes progressively thinner, causing visual changes that include blurring, decreased central vision, reduced color intensity, and less ability to focus on low light.

Macula Degeneration - eye clinic
Before the treatment of macular degeneration

Your vision is blurred with shadowy spots towards the center of the eye.

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After treatment of macular degeneration

You no longer see shadowy spots and vision is improved.

How do I know if I need to find a doctor who specializes in macular degeneration?

The natural aging process means that almost anyone over 50 years of age will have a slight deterioration in the macula. Dry macular degeneration causes a lesion of the retina that forms small deposits beneath the macula. These are called drusen, most people aged 50+ will have at least one small drusen. Very often the condition doesn’t progress past this stage and there will be little or no symptoms.

This is one reason why everyone over 50 years of age may need the services of a medical retina specialist. In the early stages, there may not be noticeable or very few signs.

The condition affects central vision (not peripheral) and can be in one or both eyes. Some of the early signs include:

  • A blurred or distorted area in the center of your vision
  • Colors appearing less bright
  • Straight lines look to be wavy or crooked
  • Objects look smaller than normal
  • Hallucinations

If the early stages are detected during a routine ophthalmological examination, it is vital that the condition is monitored regularly. There are many tests that an ophthalmologist can use to determine any development, such as:

  • Vision tests: These involve looking at a grid (called the Amsler Grid) consisting of straight lines. If any are missing or appear wavy, this may be a sign of macular degeneration.
  • Angiography or OCT: Dye will be injected into the vascular system of the body and the medical retina specialist will monitor its progression through the blood vessels of the eye.
Macula Degeneration - eye clinic
Macula Degeneration - eye clinic
Macula Degeneration - eye clinic
Macula Degeneration - eye clinic

What happens during the treatment of macular degeneration?

Treatment for age-related macular degeneration depends on the type you have.The dry AMD is usually treated with visual aids, dietary choices and vitamin supplements.

 

Wet AMD can be treated with eye injections, photodynamictherapy/laser therapy.

 

  • Eye injections: Your eye will be numbed before treatment so that you do not feel anything or have minimal discomfort. Injections are given directly into the eye every 1 or 2 months (or for as long as necessary). The success rate is high, preventing further deterioration in 9 out of 10 people. 3 out of 10 find that their vision improves.
  • Photodynamic therapy/laser treatment: This is used to seal or destroy the blood vessels that have formed behind the retina. This is sometimes used in combination with eye injections and is repeated every few months. There are two types of laser treatment—hot laser and cold laser. The hot treatment seals the abnormal vessels and discourages further growth. Cold lasers will be used if there’s an opportunity to destroy the vessels.
  • Hot laser treatment can cause a tiny blind spot in your vision, as it can affect the surrounding tissue, as well as the abnormal vessels, however, if this happens, most people adapt well and learn to ignore it.

Cold laser treatment is used for vessels that have formed in or near the center of the macula.

Both procedures are performed under local anesthesia, with drops and / or injections used to numb the eye. The laser then targets the blood vessels for their treatment, sealing and/or destruction. With cold laser treatment, a light-reacting drug will be injected into your arm and the laser will be used when it passes through your cardiovascular system and reaches the eye.

After the procedure it is common to have temporary vision problems and you should avoid bright sunlight. Your medical retina specialist will advise you on the exact duration of the recovery time and how to take care of yourself before returning to normal activities.

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