Sitting in an eye doctor’s office, in front of a rack of brochures, can be a bit unnerving. Given enough time, it is possible to begin imagining symptoms for whatever disease pamphlet has been pulled off the shelf.
But some diseases have a quick test to help with diagnosis. Such is the case with macular degeneration, often known as age-related macular degeneration. It is the leading cause of vision loss in people age 55 and older.
One of the ways to test for this disease is to look at the Amsler grid on the brochure, one eye at a time. If, when you stare at a dot in the center of the grid, the surrounding lines look wavy as opposed to straight, it’s possible that “wet” macular degeneration may be the reason.
Wet macular degeneration – in which abnormal blood vessels begin to grow, leaking blood and other fluid in the back of the eye and causing damage – accounts for about 10 percent of cases. It can rapidly cause central vision loss, sometimes within days. Aside from the wavy lines, symptoms can include blind spots, darkness in the center of things and trouble reading books or signs, as letters may be distorted or missing altogether, said Dr. Michael Johnson, retina specialist at Eastern Maine Medical Center.
There is also dry macular degeneration, which often is less serious than the wet variety. Caused by yellowish deposits that accumulate in the tissue beneath the macula – the part of the retina responsible for sharp, central vision – dry macular degeneration accounts for about 90 percent of cases.
With dry macular degeneration, vision loss is gradual, taking many years if it happens at all. Vision may even remain stable between annual eye exams, and central vision may not be totally lost.
An ophthalmologist can perform several tests to diagnose macular degeneration, but only a retinal specialist can treat it, Johnson said.
The basic test is the Amsler grid, which checks for spots of sight loss.
Acuity tests, using eye charts, measure central vision accuracy at specific distances and in specific lighting situations.
Color testing can be done to check the cone cells – the retinal cells that interpret color.
Finally, there is the fluorescein angiogram test, which allows the inner essential structure of the eye to be seen. Pictures are taken of the retina and the macula in an effort to determine any new blood vessel growth or leakage.
There is no proven way to prevent macular degeneration, so the best thing to do is have regular eye exams, especially if a close relative has the disease. Pay attention to the risk factors, including a history of hypertension, a history of cardiovascular disease, smoking, sun exposure, farsightedness, light skin and eye color, and cataracts.
“Treatments include photodynamic therapy, in which laser light rays directed into the eye are focused on a small spot on the macula, destroying the blood vessels growing beneath the retina and sealing any leaks,” said Johnson. “Vitamin therapy – with large doses of vitamin C, E, beta-carotene and zinc oxide – has been used with measurable success” for limiting progression of dry age-related macular degeneration.
While it is tempting to self-medicate with vitamins in hopes of warding off macular degeneration, resist the urge and let your doctor do the prescribing.
“There is also a drug called Macugen, which is the first-ever pharmacological and FDA-approved therapy for all sub-types of neo-vascular wet age-related macular degeneration, that is one of the latest treatments,” he said. Johnson was involved in the clinical trials for this drug, which led to FDA approval.
And as with most things, early detection is the key.
For more information on macular degeneration, call the Retina Center at 973-4185, and information will be sent to you.
Carol Higgins is director of communications at Eastern Agency on Aging. For information on EAA, call 941-2865 or log on www.eaaa.org.
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