Symptoms and Complications
Both types of macular degeneration are completely painless. In dry macular degeneration, the center of the field of vision in an eye slowly blurs or grows dim. You can still see colors, but the details aren't clear. This tends to happen over a period of years. Often, people don't notice the early stages, especially if the other eye is working fine.
Unfortunately, macular degeneration rarely affects just one eye. It may take time, but the other eye may eventually start to develop the same problems.
The vision loss in wet macular degeneration is much more rapid. While the central part of the field of vision fades and blurs, it usually vanishes completely, leaving a large blind spot. An early sign of wet macular degeneration is when you notice that lines in the center of the field of view become wavy. This is due to the new blood vessels leaking fluid under the macula, which lifts it from its bed and deforms its shape. Wet macular degeneration usually occurs in one eye at a time.
Making the Diagnosis
An ophthalmologist or eye specialist will likely know you have macular degeneration from your description of the symptoms of whiteout, blackout, or blurring of the center of vision, but an eye exam is needed to confirm the diagnosis.
Any eye test involves examining the retina visually. The ophthalmologist will look into your eyes after putting in some eye drops to dilate the pupils. Tiny yellow flecks called drusen are a possible sign of macular degeneration. Some people have drusen without macular degeneration, but increasing amounts of this material may foretell problems to come.
Macular degeneration can be detected with a test called an Amsler grid. This is a poster showing a grid of vertical and horizontal lines with a dot in the center. A person with macular degeneration may see wavy lines or missing areas of the grid while focusing on the dot in the center. When wet macular degeneration is suspected after an eye exam, a fluorescein angiography is done to see the blood vessels in the eye more clearly. For this test, fluorescein (a non-toxic dye) is injected in to a vein and a special light is used to see the macula.
Treatment and Prevention
While there's little that can be done for dry macular degeneration, the disease progresses very slowly, and will probably never completely black out the central vision. Many people with this condition live full lives without serious disability.
Some studies have suggested a link between poor nutrition and faster degeneration of the macula. According to this evidence, fruit and dark green vegetables like spinach can slow the disease and contribute to better outcomes. For some people, a doctor will recommend a daily supplement that contains zinc, copper, vitamin E, vitamin D, and beta-carotene or vitamin A.
There is no cure for wet macular degeneration, but treatment may help to slow it down. Laser surgery destroys tiny, newly grown blood vessels that may be bleeding into the macula. Photodynamic therapy may also be used. This involves injecting a medication called verteporfin* into a vein. Then, a light is used to activate the medication to close abnormal blood vessels. Medications injected into the eye, such as ranibizumab or pegaptanib, may be used to slow down the growth of blood vessels. Daily supplements may also be recommended.
It's been shown that bright sunlight may speed the progress of macular degeneration. Those with the condition should consider wearing UV-protective sunglasses when they are outdoors during daytime hours.
People who have lost their vision may need magnifiers, strong reading glasses, and other devices to help them manage.
To help reduce your chances of getting macular degeneration:
- Don't smoke,
- Eat a healthy diet rich in leafy greens.
- Maintain a healthy weight.
- Wear sunglasses with UV protection during the day.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Paul B. Griggs, MD, Department of Ophthalmology, Virginia Mason Medical Center, Seattle, WA. Review provided by VeriMed Healthcare Network.