Understanding Macular Degeneration
“The macula provides our central vision,” explains Tracy A. Klein, OD, a UW Health optometrist who practices at the UW Health Specialty Clinic in Sauk Prairie and Deming Way Eye Clinic in Middleton. “It’s the area that gives us the most detail in our vision, so it has a huge impact on our clarity. If that structure is disturbed, then the images that are sent from the optic nerve to the brain are going to be disturbed, and there’s going to be blur, distortion or a blind spot.”
Macular degeneration causes the loss of central vision both up close and far away, though patients may still be able to look to the side and see through a different part of the retina.
“With macular degeneration, you always keep some of your peripheral vision,” Klein says.
Macular degeneration is a leading cause of blindness for seniors in the United States. There are two types of the disease: wet (exudative) and dry (nonexudative).
“The wet form is the more serious and visually impairing of the two,” she notes. “What happens is there are abnormal blood vessels deeper in the eye that can leak fluid and blood into the macula, and that causes the macula to raise up and cause distortion and loss of vision.”
The dry form of macular degeneration also involves a disruption to the macula, but it’s caused by deposits, called drusen, or atrophy of the retina.
Tips for Protecting Your Vision
So what can you do to protect your macula? Klein shares these tips:
Know your risk and how to lower it. Caucasians are at greater risk for macular degeneration than other races, and women are more likely to develop this condition than men. Other risk factors include advanced age, family history, high blood pressure and cholesterol levels, and smoking.
“Even if you’ve smoked for 20 years, stopping now is going to be a benefit from a macular degeneration standpoint,” Klein says.
Regular exercise, maintaining a healthy weight and wearing sun protection (such as sunglasses and hats with brims) can lower your risk of macular degeneration.
Watch for subtle vision changes. “You might feel like you have a smudge in your vision, but you can certainly have macular degeneration with or without symptoms,” she says. “Sometimes patients don’t pay attention to one eye or the other, and sometimes eyes can compensate for each other. With the wet form, you’re definitely going to see more rapid progression of symptoms, and it will be visually debilitating.”
Preserve the vision you have left. There used to be no treatment for macular degeneration, but today doctors can treat the wet form with eye injections that stop the abnormal blood vessels from growing and bleeding beneath the retina.
“It’s not a cure,” Klein notes. “Sometimes with injections we will see some improvement in being able to read a little further down the eye chart. But the condition is not going to go away; it’s really about preserving the vision that is there.” For the dry form of the disease, there aren’t any injections or surgical treatments.
Maintain a healthy lifestyle. Eat well and strive to keep your weight, blood pressure, cholesterol and blood sugar in the healthy range. “Diet is really important if you have a family history of macular degeneration," Klein says. Limit your consumption of saturated fats and load up on omega-3 fatty acids, which you can find in fish, and antioxidants found in fruits and vegetables. Recommended foods include green leafy vegetables (such as spinach, kale and collard greens), broccoli, corn, tangerines, yellow and orange peppers, and egg yolks.
Take your vitamins. A major clinical trial called the Age-Related Eye Disease Study (AREDS2) found that taking a special formulation of vitamins (including vitamin C, vitamin E, leutine, zeaxanthin, zinc and copper) can slow or keep macular degeneration from progressing, though vitamins have not been proven to prevent the disease from developing in the first place.
Make use of visual aids. “Part of our job as a provider is to help these patients with resources,” Klein says. “We’re not going to help patients with this condition see better, but we have suggestions of magnifying and lighting devices that can help patients maintain some of their independence at home.”
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Date Published: 11/16/2017