Looking at macular degeneration straight in the eye
Written in association with:
Published: 17/12/2024
Edited by: Jessica Wise
Macular degeneration is a common eye disease where there is sight loss in when looking straight in front of the patient. It mostly occurs in people over the age of 50, which is why it is also commonly referred to as age-related macular generation (AMD). In this article, a celebrated consultant ophthalmologist explains how this disease occurs, its signs, and how it can be treated.
What is the macula?
The macula is the centre of the retina, the photo-sensitive tissue that lies at the back of the eyeball, which focuses the light that comes in through the front of the eye and transmits it as electrical signals along the optic nerve so that the brain can interpret them into images. The macula is in charge of central vision, fine details, and most of the colour processing.
What is macular degeneration?
When the macula is damaged or deteriorated in some way, the patient is unable to see clearly right in front of them, but will be able to still see as normal at the edges of the visual range.
Macular degeneration can develop in one eye or in both at a time, but they may not be equally affected. Macular degeneration can occur in younger people, mostly due to their health condition – such as poor diet, head injuries, diabetes, being a smoker, or having high blood pressure – or due to familial genetics.
There are two types of macular degeneration:
Dry macular degeneration, which is caused when there is a buildup of protein deposits called drusen underneath the macula, drying it out and making it brittle. This is a gradual form of macular degeneration. Wet macular degeneration, which is caused by abnormal blood vessels that leak blood and fluids underneath the retina and macula. This may cause dark spots in the central vision. Wet macular degeneration is more urgent and can lead to complete loss of central vision.
Signs of macular degeneration
Patients who have a degenerating macula may have:
Blurry vision Difficulties seeing in low light Changes or issues in perceiving colours Black or dark spots across their vision Perception of straight lines as curvy or wavy
How is macular degeneration diagnosed and treated?
In its earliest stages, macular degeneration is not symptomatic, meaning that is it mostly diagnosed once it has progressed quite far, or during a routine checkup; an early diagnosis of macular degeneration is preferable as it is easier to treat and manage.
Tests to confidently diagnose macular degeneration include visual acuity tests, dilated eye exams, optical coherence tomography to take photos of the back of the eye, or fluorescein angiography where a coloured fluid is injected into the arm and the eye is monitored for any leakage in the macula.
Once macular degeneration starts, it cannot be stopped and there is no cure. Treatment is focused on slowing and minimising the symptoms.
One method involves the intake of certain vitamins and minerals to slow down particularly dry macular generation:
Zinc Vitamin C Vitamin E Lutein Copper ZeaxanthinThese can be taken as supplements, or be targeted with dietary adjustments.
For wet macular degeneration, injections directly into the eye of anti-vascular endothelial growth factor (anti-VEGF) can block the VEGF protein production that encourages the growth of new blood cells behind the macula.
Photodynamic therapy can also be utilised, alternatively or in combination with anti-VEGF injections, in which a specialist uses a laser and injectable light-sensitive drugs to destroy abnormal blood vessels in the eye.
Another method is laser photocoagulation, where a laser is used to seal off the leaking blood vessels. This is one of the first-ever developed treatments for wet macular degeneration, but is not as common anymore due to the development of other treatments.
If you are suffering from vision problems, you can consult with a specialist on Top Doctors.