A leading cause of blurry vision and a very serious threat to the well being of our older white patients in this country is macular degeneration. This is a scarring condition that can occur in an area in the back of the eye known as the retina, specifically the part of the retina called the macula.
The macula is a very delicate tissue that absorbs light through rods and cones; these are light receptors that turn the light energy into electricity, which passes from the optic nerve to the striations in the brain that give us the wonderful sense of vision.
Once again, we typically see macular degeneration in our older patients that may have a relative such as a mother, father, aunt, or uncle that has had this condition prior to them, and additionally those also at risk can include blue-eyed individuals, those who have hypertension, those who are exposed to light without sunglasses, as well as those who have poor nutrition.
Presently, there are two forms of macular degeneration, one wet and one dry. The dry form is the more common of which, but can eventually turn into the wet form later in life. This exudative or wet macular degeneration can steal away the patient’s reading vision very quickly, but typically does not harm the peripheral vision. Therefore, in its worst form, macular degeneration never causes complete blindness, but can make reading extremely difficult.
As for the dry form of macular degeneration, typically the eye doctors of the Eye Care Center recommend age-related macular degeneration vitamins where studies have shown a reduction in the chance of macular degeneration worsening. These vitamins typically include vitamin A, E, C, zinc, and copper, as well as lutein. There are ongoing studies for other antioxidants in the future that might be helpful in preventing macular degeneration as well.
We also, at the Eye Care Center, recommend sunglasses when going outside and avoiding smoking and controlling hypertension conditions.
Even Dr. Norris and Dr. Collier have begun using a yellow tinted intraocular lens during cataract surgery, which, in some studies, suggest that blocking harmful blue light can be helpful in preventing worsening of macular degeneration as well.
The other form of macular degeneration, the wet or exudative kind, is extremely serious, as it can occur very quickly and the care of an eye doctor should be sought quickly when this occurs. Traditionally, the treatment for wet macular degeneration was a scarring type of argon green laser treatment done to the leaking area, which was shown by a fluorecin angiogram where dye was injected into a vein and photographs taken of the back of the eye. However, more recently, a new type of laser called Visudyne or PDT, which stands for photodynamic therapeutic treatment, would use a laser that would only seal the leaking area and not damage normal surrounding tissue. Even more recently, injectables into the back of the eye itself including Lucentis, which is approved by Medicare, as well as Avastin, have been used by our retina specialist, Robert Craig Collier, MD, very successfully and even have been shown to improve vision after a leaking area has occurred. Recently, there have been additional studies to show that Visudyne as well as injectables into the eye can work in concert with each other. One draw back to the injection medicines is that they have to be used several times to halt the process, and in fact even as often as three to four times a year. These injections are given in the Eye Care Center office.
Researchers, in the future, are looking to identify the genetic sequence for macular degeneration, which hopefully could lead toward the eventual cure of macular degeneration. We also look forward to the possibility of transplanting this part of the eye and also using stem cell transplants as well.