What is macular degeneration?
- Macular degeneration is a disorder that strikes patients as they age and can result in significant visual loss or even blindness. It comes in two forms:
- Dry macular degeneration involves the deposition of abnormal materials beneath the retina as well as degradation of the pigment layer which underlies and nourishes the retina. This form of macular degeneration typically causes mild to moderate visual loss, and sometimes severe visual loss can occur from dry macular degeneration.
- Wet macular degeneration is a more severe and rapidly-occurring form of macular degeneration. It occurs, typically, when blood vessels go underneath the retina. These blood vessels can bleed and leak, resulting in degradation of retinal function. The majority of patients who have severe blurry vision or blindness due to macular degeneration have the wet form.
Can it be treated?
- Yes. For patients with wet macular degeneration, we have exciting new therapies which can stabilize vision in almost all patients and even improve in some patients. Two of the more potent drugs available include Avastin and Lucentis. Both of these are antibodies or antibody fragments against vascular endothelial growth factor which is one of the molecules which is essential in blood vessel growth and proliferation in the disease of wet macular degeneration. With these treatments, approximately 90% of patients can have stable vision, and approximately 30-40% may experience significant visual improvement.
- For patients with dry macular degeneration, vitamin therapy may be appropriate. Clinical trials have shown that an appropriate mixture of vitamins A, C, E, Zinc and Copper can result in a 20-30% decreased risk of vision loss for patients with dry macular degeneration. There has been some evidence suggesting omega-3 fish oil supplements and even olive oil may be beneficial. Please consult an ophthalmologist before starting these vitamins.
Who is at risk for macular degeneration?
- The risk of macular degeneration increases with age. Other risk factors for macular degeneration include caucasian ancestry, smoking, and hypertension. There also may be a genetic component of this disorder.
What would I notice if I developed macular degeneration?
- Dry macular degeneration may result in mild blurring, distortion, or waviness in vision. Wet macular degeneration may cause a more severe onset in blurry vision, resulting in severe vision loss and distortion which occurs over the course of several days or weeks. Sometimes, there can be no symptoms at all. This underlies the need for ongoing eye examinations.
What is a retinal tear?
- A retinal tear is a break in the retina, typically caused by traction from the vitreous. This occurs often as patients age or even following trauma. Rips or tears result in the peripheral retina which allows fluid under the retina. This can result in detachment of the retina.
How will I know if a retinal tear or detachment occurred?
- You may notice flashes, floaters, or decreased peripheral or decreased central vision.
Are there treatments available for retinal tears or retinal detachments?
- Yes. Retinal tears, if found in time, can be treated with either freezing, cryotherapy, or laser treatment. These often seal off the retinal breaks and prevent retinal detachment.
- Retinal detachments can be treated either with in-office surgery, laser, or even in the operating room with more complex surgical interventions.
What is diabetic retinopathy?
- Diabetic retinopathy is a disorder of the retina in patients with diabetes mellitus. In diabetic retinopathy, there can be abnormalities in blood flow to the retina. Small retinal hemorrhages can occur, as well.
- With regard to visual loss due to diabetic retinopathy, there are two types of diabetic retinopathy which cause visual loss:
- Macular edema may occur commonly in Type II diabetics. This is where fluid leaks from the blood vessels near the center of vision or the macula. This results in impaired macular function and a decrease in vision.
- Proliferative diabetic retinopathy can also occur. This is where blood vessels grow abnormally, resulting in bleeding or traction on the retina. Retinal detachments can even occur from proliferative diabetic retinopathy.
How often should I be seen by an eye doctor?
- At a minimum, diabetics should be seen once a year. Patients with more severe diabetic retinopathy may need to be seen significantly more frequently.
Are treatments available for diabetic retinopathy?
- Yes. Treatments that may be effective in diabetic retinopathy include laser treatment, intraocular or periocular injection. Tight glucose and blood pressure control may also be of assistance in limiting diabetic retinopathy.