Macular Degeneration

What is macular degeneration?

Macular degeneration refers to a group of eye conditions that affect the macula, leading to progressive loss of central vision. This can interfere with the ability to read, drive, recognise faces and complete activities that require detailed vision. 

Age-related macular degeneration (AMD) occurs when the macula, the pigmented central area of the retina, wears down. The disease is the leading cause of severe vision loss in Australia.  While common in older people, AMD is not a normal or inevitable consequence of ageing.

There are two main types of age-related macular degeneration:

Dry AMD is the most common, making up 85 to 90 percent of cases. People with this condition develop yellow deposits in their macula, which distort vision over time. As the disease worsens, the light-sensitive cells of the macula degenerate and slowly stop functioning.

Wet AMD is more severe, making up only 10 to 15 percent of cases. This occurs when blood vessels grow from beneath the damaged macula, resulting in leakage of fluid and blood into the area, distorting vision. These vessels eventually form a scar, resulting in permanent loss of central vision. 

Macular degeneration symptoms

At first, you may not experience any noticeable signs of macular degeneration. In fact, many people are not diagnosed until the condition progresses or begins to affect both eyes. Some common symptoms of macular degeneration include:

  • Declining ability to see objects clearly
  • Distorted vision
  • Dark, blurry areas in the centre of your vision
  • Changes to colour vision
  • Difficulty adapting to different lighting conditions, e.g. from bright sunlight to a dim room

Causes of macular degeneration

The cause of macular degeneration is likely multi-factorial. Factors that are known to increase your risk of developing AMD include:

  • Being over 50 years old
  • Having a family history of AMD
  • Being Caucasian
  • Smoking
  • Eating a diet high in saturated fat
  • Medical conditions, such as obesity, high blood pressure and heart disease
  • UV light exposure

Macular degeneration prevention

Unfortunately, little can be done to prevent macular degeneration. There are, however, a number of things you can do to decrease your risk and slow the progression of the disease.

Making healthy choices such as quitting smoking, regularly exercising, eating a healthy diet and maintaining a healthy blood pressure and cholesterol level can minimise your risk of developing progressive AMD. Wearing a broad-brimmed hat and sunglasses when in the sunlight to protect your macula from UV light is also important.  

Most importantly, undergoing regular comprehensive eye exams will help to diagnose macular degeneration early, providing the information needed to ensure steps can be taken to reduce the chances of progressive disease, and to allow early detection and treatment for wet AMD.  

As macular degeneration may run in families, learn about your family’s eye health history to understand whether you are at increased risk and need more frequent screening. 

Diagnosis of macular degeneration

Diagnosing macular degeneration involves a comprehensive eye exam. Your optometrist or ophthalmologist will give you some eye drops to widen your pupil before checking your eyes for age-related macular degeneration. They will also perform a macular scan to help detect early or subtle changes, and to allow monitoring of your condition. 

Macular degeneration treatment

There is no true cure for macular degeneration. Treatment efforts for this disease are designed to slow down its progression and help maintain useful central vision for as long as possible. There are a number of options available to help treat AMD, and your ophthalmologist will help determine which is the most appropriate for you.

For dry AMD, monitoring for changes in vision that may indicate the development of wet AMD is very important.  Your optometrist or ophthalmologist will demonstrate how an Amsler grid can be used for self-monitoring.  Macular vitamin supplements will be recommended in some cases.  For wet AMD, anti-VGEF drugs are the most common treatment method. These medications are administered directly into the eye to block the growth of abnormal blood vessels in the eye and prevent fluid leaks. This treatment can help improve vision and stop further vision loss. 

Get in touch to see Dr Juanita Pappalardo

Dr Juanita Pappalardo is a Specialist Ophthalmologist with expansive experience treating a range of common eye diseases, including age-related macular degeneration. If you believe that you have AMD, get in touch to plan your visit with Dr Pappalardo.

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