Macular Degeneration & Low Vision Care In New York, NY
Macular Degeneration can cause low vision and debilitating vision loss, even blindness if not diagnosed and treated in the early stages. Because the disease often has no obvious symptoms early on, it is critical to have regular comprehensive eye exams, particularly if you are at risk.
Managing Macular Degeneration
There are various types of macular degeneration. However, the most common form is associated with aging, this eye disease is also called age-related macular degeneration (ARMD).
The main symptom of Macular Degeneration is slowly losing vision in the central part of sight. This loss precludes the ability to do many everyday activities, including reading and driving. It also reduces your ability to see intricate details such as small prints and patterns.
The leading cause of vision loss in older Americans, 60 and older, is ARMD. There are two forms of this disease, wet macular degeneration and dry macular degeneration. Both forms affect the central portion of the retina, which is the light-sensitive section located in the back of the eye. This part of the eye processes images and is essentially responsible for sight. The dry form of ARMD is more common than the wet form. In fact, almost 90% of ARMD is the dry form.
Statistics
The leading cause of losing vision in people over 60 years of age is macular degeneration. There are various risk factors, including smoking, obesity, and exposure to UV rays. Caucasians are at a significantly greater risk for contracting ARMD than African Americans. Additionally, macular degeneration affects women in greater numbers than men, and has a genetic component.
Forms of Macular Degeneration
Living and Adjusting to Macular Degeneration
There are 2 basic types of AMD, the wet form and the dry form.
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Dry macular degeneration is considered the less aggressive form of AMD. It typically progresses much more slowly, and the level of eyesight damage is less severe. Dry AMD is detected during routine eye exams, which is why it’s important to have yearly testing. Treating Dry AMD often involves high doses of zinc and antioxidants which have been shown to slow diseases progression.
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Wet macular degeneration is the more severe form of AMD. It occurs when there is abnormal blood vessel growth (angiogenesis), and leakage, which can cause scar tissue to develop. Treatments include laser surgery, injecting light sensitive dyes, or AMD medication injected directly into the eye to inhibit angiogenesis.
- Age is the number one risk factor for AMD.
- High Blood Pressure (hypertension) is a risk factor for AMD.
- Obesity and a diet high in fat is linked to an increase in AMD.
- Research shows a link between long term exposure to blue lightfrom digital devices such as cell phones, computers and macular degeneration.
- People with family history of AMD are at higher risk.
- People who smoke 200% more likely to have AMD.
- Caucasions are more likely to have AMD then African Americans and Hispanics.
Patients with macular degeneration face the challenge of adjusting to a life with limited vision. Daily tasks that used to be taken for granted like using the internet, reading a letter, driving and watching television are now challenging or impossible. Dr. Marianne McDaniel will assess the patients visual level and desires and recommend the best option of visual aides that will assist the patient in achieving their desired tasks. One of the questions our low vision optometrist hears a lot is "Can I drive again?". In many cases a patient with macular degeneration can drive with customized bioptic telescopes.
Symptoms & Risk Factors of Macular Degeneration
Macular Degeneration can cause low vision and debilitating vision loss, even blindness if not diagnosed and treated in the early stages. Because the disease often has no obvious symptoms early on, it is critical to have regular comprehensive eye exams, particularly if you are at risk.
Symptoms of AMD
Macular degeneration is a disease in which the macula slowly breaks down, resulting in a gradual progressive vision loss, at least in its’ early stages. Frequently there are no symptoms and the disease is only diagnosed when a doctor detects signs such as a thinning macula or the presence of drusen in a comprehensive eye examination. Early vision loss can include blurry, cloudy or distorted central vision or dark spots in your central field of view. With advanced stages, vision loss can be severe and sudden with larger blind spots and total loss of central vision.
Risk Factors for Macular Degeneration
Age is the most prominent risk factor for AMD, as the disease is most common in individuals over the age of 60 (although it can happen in younger individuals as well). Other risk factors can increase your chances of developing the disease such as:
- Genetics and Family History: Research shows that there are actually almost 20 genes that have been linked to AMD, and they suspect that there are many more genetic factors to be discovered. Family history greatly increases your chances of developing AMD.
- Race: Caucasians are more likely to get AMD than Hispanics or African-Americans.
- Smoking: Cigarette smoking can double your likelihood of developing AMD.
- Lifestyle: Research shows that UV exposure, poor nutrition, high blood pressure, obesity and a sedentary lifestyle can also be contributing factors.
- Gender: Females have a higher incidence of AMD than males.
- Medications: Certain medications may increase the chances of developing AMD.
To reduce your risks of developing AMD it is recommended to make healthy choices such as:
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- Regular eye exams; once a year especially if you are 50 or over.
- Stop smoking.
- Know your family history and inform your eye doctor.
- Proper nutrition and regular exercise: Research indicates that a healthy diet rich in “Eyefoods” with key nutrients for the eyes such as orange peppers, kale and spinach as well as regular exercise may reduce your risks or slow the progression of AMD.
- Maintain healthy cholesterol levels and blood pressure.
- Dietary supplements: Studies by the National Eye Institute called AREDs and ARED2 indicated that a high dosage of supplements of zinc, vitamin C, vitamin E and lutein may slow the progression of advanced dry AMD (it is not recommended for those without AMD or early AMD). Speak to a doctor before taking these supplements because there may be associated risks involved.
- Wear 99% -100% UV-blocking sunglasses.
The first step to eye health is awareness. By knowing your risk, taking preventative measures and visiting your eye doctor on a regular basis, you can greatly reduce your chances of facing this debilitating disease.
Does Macular Degeneration Cause Blindness?
Treatment of Macular Degeneration
Macular degeneration is a disease that effects central vision, and therefore unlike other eye diseases the patient usually has remaining peripheral or side vision. In addition to the stress of being unable to perform daily tasks such as reading and driving, patients with macular degeneration are at significantly increased risks of accidents and falls due to their deteriorating vision.
Macular Degeneration is typically split up into three stages:
- Early macular degeneration-Generally the patient is without vision loss.
- Intermediate macular degeneration-Generally without symptoms but some experience beginning stages of vision loss.
- Late macular degeneration- Wet AMD: Significant vision loss occurs rapidly Dry AMD: Significant vision loss occurs slowly.
Currently there is no cure or treatment for macular degeneration although researchers are experimenting with novel new treatments such as using the patients stem cells, regenerating damaged nuerons, and using DNA for early detection.
While there is no cure for macular degeneration, treatments do exist that can delay the progression of the disease, preserve existing vision and sometimes even improve vision loss.
Currently, there are no approved treatments to prevent or cure dry AMD, although there is evidence that indicates that certain nutritional supplements, including omega 3 fatty acids, lutein and zeaxanthin, can prevent the progression of the disease to the more advanced wet form, which can cause more severe vision loss.
There are a couple of options for treating wet AMD to slow the progression of vision loss which include medicated injections and laser therapy. These therapies are designed to stop the development of new blood vessels, to destroy existing ones and to prevent leakage into the macula - the main dangers with wet AMD.
Unfortunately, while much research continues to be conducted, currently there is no treatment and no way to fully regain vision lost by AMD. Those who have suffered significant vision loss can benefit from the many low vision devices on the market which utilize your existing vision to assist in maintaining your independence. Such devices include standing and hand-held magnifiers and telescopes and other aides that can help to improve your vision.
If you have been diagnosed with AMD, regular vision tests are essential. Close monitoring and adherence to treatment can not only prevent further vision deterioration but can sometimes even improve vision.
Learn More
AMD is an age related eye disease that runs in families, and is a leading cause of blindness in our aging population. There is no cure for this ocular disease, and AMD related vision loss is cannot usually be recovered. There are treatments, and preventative measures that can be taken, if detected early, so routine eye exams are essential.
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