What is macular degeneration?
We all notice differences as we get older. Our joints get creakier and our vision isn’t what it used to be. There is a condition which you may not be aware of, called macular degeneration. If you are over 50 and have been noticing issues with your central vision, you may find this information helpful.
What is it?
On the inside back wall of your eyeball there is a layer of tissue called the macula. This tissue is densely packed with cells that are sensitive to light and it is responsible for your central vision. However, as we age, this tissue can deteriorate and the condition is called macular degeneration. There are two types, dry and wet. Dry macular degeneration is the most common form. Rarely, this can go on to develop into ‘wet’ macular degeneration where new blood vessels grow and leak fluid under the macula.
Initially, only one eye may be affected but eventually, both eyes usually become involved.
Macular degeneration won’t make you blind but it does adversely affect your quality of life by blurring or causing a blind spot in your central vision.
What are the symptoms?
Dry macular degeneration is usually painless and develops very slowly. You may notice some of these symptoms:
- Needing increasingly bright light if you’re reading or doing close work
- Having problems with adapting to low light levels, like going into a dimly lit restaurant
- Printed words may look more and more blurred
- Colors may not look as bright or intense as they did before
- You may find it hard to recognize faces
- Your overall vision may become increasingly hazy
- You may notice blurring or a blind spot in the center of your vision
You may only experience problems with one eye and if you do, it may take a while for you to notice any changes because your ‘good’ eye will compensate for the ‘poor’ one. You may suffer headaches as the good eye struggles to cope. If you have the condition in both eyes, you would definitely notice as it would affect your vision and therefore, how you live.
Hallucinations
Some people who have macular degeneration may ’see’ patterns, geometric shapes, animals or faces as their vision is more affected. This can lead to them not wishing to discuss the issue for fear they are going crazy – or can lead to a misdiagnosis of migraine.
These hallucinations are common to the disorder and are called ‘Charles Bonnet’ syndrome. An optometrist would recognize this so if you suspect you have this condition, it’s worth a visit for a check up.
What causes it?
The exact cause isn’t known but it is recognized as developing as the eye ages. Close to the back of your eye is the retina. Just behind the retina there is a single layer of cells called the retinal pigment epithelium. As the eye ages, these cells begin to lose their pigment and become harder. This means that they cannot fulfill one of their functions, which is to remove outer cell segments which are no longer required by the eye. These particles of segment waste are called drusen. They are yellow, fatty-type deposits which start to build up under the macula and so your vision becomes worse.
Stages of progression
Dry macular degeneration has three stages:
1. Early – There’s no loss of vision in this stage but an ophthalmologist would be able to see small drusen on the macula in one eye, or both eyes.
2. Intermediate – You may be having problems with your central vision blurring and may be needing extra light for reading or close work. Your ophthalmologist would now see many medium sized drusen are now visible in one or both eyes.
3. Advanced – The area of your central vision would now have a definite spot of blurring which may become larger and more dense as time goes on. Large drusen would now be visible on an eye examination as well as light-sensitive cells breaking down in the macula.
When should I see my doctor?
If you are over 50 and notice changes in your central vision and/or you can no longer see colors and fine detail, it’s a good idea to see your Doctor or Opthalmologist. Make the best use of that limited time by preparing beforehand.
- When you make the appointment, ask if there’s anything you need to do in advance.
- Write down any symptoms you’re experiencing, even if you don’t think that they are related to your vision issues.
- Make a list of all medications, including any vitamins or supplements that you’re taking.
- Ask a family member or friend to take you. Your Doctor will use drops to dilate your pupils for the eye examination and you may need someone else to drive or help you home from your appointment.
Try this free test
You may also like to check out your vision using this Amsler grid, which is freely available on the internet from the Mayo Clinic. This is a simple test that involves looking at a grid pattern. It may show changes in your vision that you hadn’t noticed.
How to perform the test:
- Hold the grid 14 inches (about 36 centimeters) in front of you in good light. If you usually wear sight correcting spectacles or reading glasses, then wear them for the test.
- Cover one eye.
- Look directly at the center dot with your uncovered eye.
- While looking at this dot, see if all of the lines of the grid appear straight, uninterrupted and have the same contrast.
- Repeat the above steps with your other eye.
- If any part of the grid is missing or looks wavy, blurred or dark, contact your eye doctor.
Can anyone get it?
There are some known risk factors which increase your chances of developing it:
- Age. In the USA, macular degeneration is the most common reason for severe loss of vision in the 60 and older age group.
- Family history of macular degeneration. If someone in your family had macular degeneration, then you have a higher chance of developing it yourself. Researchers have now identified some of the genes associated with macular degeneration and it is possible that genetic screening tests may be available in the future.
- Race. Macular degeneration is more common in whites than it is in other racial groups, especially after the age of 75.
- Sex. Women are more likely than men to develop macular degeneration. They are also more likely to experience the effects of severe vision loss from the disease, simply because (on average) they live longer.
- Cigarette smoking. Exposure to cigarette smoke doubles your risk of developing macular degeneration. Cigarette smoking is the single most preventable cause of macular degeneration.
- Obesity. If you have early or intermediate macular degeneration, obesity will increase the likelihood of it progressing to the advanced stage.
- Light-colored eyes. People with light-colored eyes seem to be at greater risk than those with darker eyes.
- Exposure to sunlight. Some experts believe that long-term exposure to ultraviolet light may increase your risk of developing macular degeneration. However, there is no proof to back up this claim and so it remains controversial.
- Low levels of nutrients. Antioxidants may protect your cells from oxygen damage (oxidation), which may be partially responsible for the effects of aging and therefore, for the development of diseases such as macular degeneration. Antioxidants include zinc, minerals and vitamins A, C and E.
- Cardiovascular diseases. These include high blood pressure, stroke, heart attack and coronary artery disease with chest pain (angina).
What is the treatment?
Unfortunately, there is no treatment to reverse the effects of dry macular degeneration. However, you won’t lose your sight. This condition progresses slowly and most people are able to continue to live relatively normal lives. However, as previously mentioned, in rare cases, dry macular degeneration can develop into the ‘wet’ type which progresses more rapidly.
What can I do?
Check out the risk factors listed above. Keep your weight down and try to stop smoking. If you can’t stop, try and cut down as much as possible.
Taking anti oxidants will help.
An Age-Related Eye Disease Study sponsored by The National Eye Institute showed that a daily supplement of
- 500 milligrams (mg) of vitamin C
- 400 international units (IU) of vitamin E
- 15 mg of beta carotene (often as vitamin A – up to 25,000 IU)
- 80 mg of zinc (as zinc oxide) and
- 2 mg of copper (as cupric oxide)
reduced the risk of progressing to moderate or severe vision loss by up to 25 percent.
