Older gentleman receiving an eye exam from an ophthalmologist.

Macular Degeneration

Macular degeneration is a deterioration of the deepest layers of the retina in the area of the macula.

What Is the Macula?

The thin inner layer of eye is called the retina. It is like the “camera film” of the eye. The central portion of the retina that allows us to see detail vision such as reading and recognizing peoples faces is called the macula. The rest of the retina allows for “side vision” but is not able to distinguish fine detail. A person without good macular function is able to walk around without bumping into things as well as take care of their daily needs such as bathing, cooking, and eating. However, they are unable to read a newspaper, recognized details of a persons face or see highway signs while driving.

What Is Macular Degeneration?

Macular degeneration is a deterioration of the deepest layers of the retina in the area of the macula. The actual cause of macular degeneration is under intense study but it is usually associated with the aging process. The deterioration appears to be related to a build up of oxidants and other metabolic waste products in the pigmented layer of the retina.

Over time this layer begins to degenerate and form what are called drusen. As more drusen form, macular function decreases and vision begins to blur. In some cases the pigmented layer undergoes atrophy. Small gaps (scotomas) in vision develop and eventually enlarge to cause more severe vision loss. Drusen development and/or atrophy of the pigmented layer of the macular is called dry macular degeneration.

In the most severe form of macular degeneration small breaks in the layer between retina and the vascular middle layer of the eye (choroid) can develop. These breaks allow abnormal blood vessels to develop and grow underneath the retina. These vessels (subretinal neovascular membranes) hemorrhage and scar causing fairly rapid and severe loss of macular function and central vision. This is called wet macular degeneration.

Treatment

Treatment for dry macular degeneration consists of vitamin supplements and close surveillance for visual changes. The AREDS vitamin formula is available over the counter and can reduce the risk of dry macular degeneration progressing to the wet form.

The wet form of macular degeneration has many new treatments recently approved by the FDA. These treatments range from lasers to medications injected in or around the eye.

Conclusion

Macular degeneration is a difficult disease but with motivation and patience its effects can be significantly reduced. Early treatment and preventative measures can help slow down the condition and low vision rehabilitation can help people to lead an independent life style.