Written By: Dr. Stephanie Mulick, O.D.
👁️ Embark on the Eye Odyssey: Navigating the Maze of Macular Degeneration
Ever wondered how your eyes create the magic of vision? It’s a journey from cornea to retina, with the spotlight on a tiny hero called the macula. But beware, as this superhero ages, it faces its own nemesis—macular degeneration.
Even though the macula only makes up about 2.1% of the entire retina, when it becomes damaged it can be very detrimental to our vision. Since the macula is part of the retina that gives us our most detailed central vision. As we age the risk for developing macular degeneration increases. However, age is not the only risk factor for macular degeneration. Family history and cigarette smoke increase the risk as well. The following is a list of several factors for the risk of developing macular degeneration (AMD) from a study of 113,780 persons with 17,236 cases of late AMD.
🔍 Unveiling Macular Degeneration: More Than Meets the Eye
Though the macula takes up just 2.1% of the retina, it holds the key to our detailed central vision. Aging opens the door to macular degeneration, but it’s not the only culprit. Join the risk league with family history, smoking, and even sun exposure. It’s a high-stakes game.
- Advanced Age (AMD is the most common cause of irreversible loss of vision in people over the age of 50).
- Positive family history of Macular degeneration
- Cigarette smoking
- Higher body mass index
- History of cardiovascular disease
- Hypertension
- Higher plasma fibrinogen
- Sun exposure
- Blue light exposure (review my post on blue light)
Macular degeneration can progress with time, starting out very mild with few visual complications and can lead to bleeding in the retina which is termed wet macular degeneration, which can lead to vision loss.
🎭 The Drama Unfolds: Symptoms and Progression
Macular degeneration isn’t your run-of-the-mill eye issue. It’s a Shakespearean tragedy, starting subtly and escalating to wet macular degeneration, where bleeding threatens vision. Cue ocular injectables—a superhero’s last stand.
Common Symtoms of Macular Degeneration
- Wavy or distorted vision
- Blurred central vision
- Decreased visual acuity even with glasses
- Decreased contrast sensitivity (more light will be needed for a newspaper print or restaurant menus
⚖️ Balancing Act: Treatment for Macular Degeneration
From quitting smoking to the Age-related Eye Disease Study’s antioxidant dance, treatments vary. Navigate the maze carefully—smoke signals and Amsler grids lead the way. And beware the siren call of unregulated clinical trials lurking in the shadows.
The treatment of Macular degeneration depends on how far advanced the macular degeneration is. Macular degeneration can progress with time, starting out very mild with few visual complications and can lead to bleeding in the retina which is termed wet macular degeneration, which can lead to vision loss. When bleeding or new blood vessel growth occurs your Retinal specialist may need to use ocular injectable medications to help stop the progression.
- Quit Smoking
- Evaluate progression at home with an Amsler grid (provided below with instructions)
- Supplement with high dose antioxidants and vitamins (as demonstrated in the Age-related Eye Disease Study 2 (AREDS 2). I recommend Preservision AREDS 2 formula with Vitamin c, Vitamin E, zinc, copper, lutein and zeaxanthin
- Ocular injections for progressive wet Macular degeneration determined by a retinal specialist
- Ongoing studies for the treatment AMD include: Stem cell treatment and implants to replace damaged retinal cells (RPE Cells)
Clinical Trials
Beware of Clinical trials as they are usually unregulated and treatment is often performed by non-physicians; even if listed on government websites.
💡 The Prognostic Crystal Ball: 5-Year Outlook
Peek into the future with our Advanced AMD Risk Calculator. Non-smokers, smokers, family history—each has a unique tale to tell. Age and prognosis dance hand in hand. Knowledge is power, my friends.
Chart of the 5-year prognosis of Age-related Macular Degeneration (if diagnosed with first signs of AMD) Based on Advanced AMD Risk Calculator
| Age Range | Non-Smoker without Family History | Non-Smoker with Family History | Smoker without Family History | Smoker with Family History |
| 55-60 | 3-4% | 5% | 6-7% | 7-8% |
| 61-65 | 4-5% | 5-6% | 7-8% | 8-9% |
| 66-70 | 5% | 6-7% | 8-9% | 10-11% |
| 71-75 | 5-6% | 7-8% | 9-10% | 11-12% |
| 76-80 | 6-7% | 8-9% | 11-12% | 13-14% |
🔍 Amsler Grid: Your Detective Tool for Vision
Enter the Amsler grid, your detective sidekick. Wear your reading glasses, bask in good light, and cover one eye at a time. Watch for the plot twists—wavy lines, missing details. Your eye doctor awaits your report.
Printable Amsler Grid Instructions:
1. Wear your reading glasses.
2. Use good light.
3. Cover one eye at a time.
4. Look at the central dot
5. Look for changes to the grid over time
5. If straight lines become wavy, missing or distorted make sure to inform your eye doctor.
Conclusion:
Macular Degeneration is one of the leading causes of blindness, with a higher risk in people over the age of 50 who smoke cigarettes and who have a family history of Macular degeneration. Annual eye exams are necessary for a diagnosis of Macular Degeneration.
Good read