A
leading cause of blurry vision and a very serious threat to
the well being of our older white patients in this country
is macular degeneration. This
is a scarring condition that can occur in an area in the back
of the eye known as the retina, specifically the part of the
retina called the macula.
The
macula is a very delicate tissue that absorbs light through
rods and cones; these are light receptors that turn the light
energy into electricity, which passes from the optic nerve
to the striations in the brain that give us the wonderful
sense of vision.
Once
again, we typically see macular degeneration in our older
patients that may have a relative such as a mother, father,
aunt, or uncle that has had this condition prior to them,
and additionally those also at risk can include blue-eyed
individuals, those who have hypertension, those who are exposed
to light without sunglasses, as well as those who have poor
nutrition.
Presently,
there are two forms of macular degeneration, one wet and one
dry. The dry form is the more common of which,
but can eventually turn into the wet form later in life. This
exudative or wet macular degeneration can steal away the patient’s
reading vision very quickly, but typically does not harm the
peripheral vision. Therefore, in its worst form, macular
degeneration never causes complete blindness, but can make reading
extremely difficult.
As
for the dry form of macular degeneration, typically the eye
doctors of the Eye Care Center recommend age-related macular
degeneration vitamins where studies have shown a reduction
in the chance of macular degeneration worsening. These vitamins
typically include vitamin A, E, C, zinc, and copper, as well
as lutein. There are ongoing studies for other antioxidants
in the future that might be helpful in preventing macular degeneration
as well.
We
also, at the Eye Care Center, recommend sunglasses when going
outside and avoiding smoking and controlling hypertension
conditions.
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Even
Dr. Norris and Dr.
Collier have begun using a yellow tinted intraocular lens during cataract
surgery, which, in some studies, suggest that blocking harmful
blue light can be helpful in preventing worsening of macular
degeneration as well.
The
other form of macular degeneration, the wet or exudative kind,
is extremely serious, as it can occur very quickly and the
care of an eye doctor should be sought quickly when this occurs.
Traditionally, the treatment for wet macular degeneration
was a scarring type of argon green laser treatment done to
the leaking area, which was shown by a fluorecin angiogram
where dye was injected into a vein and photographs taken of
the back of the eye. However,
more recently, a new type of laser called Visudyne or PDT,
which stands for photodynamic therapeutic treatment, would
use a laser that would only seal the leaking area and not
damage normal surrounding tissue. Even more recently,
injectables into the back of the eye itself including Lucentis,
which is approved by Medicare, as well as Avastin, have been
used by our retina specialist, Robert
Craig Collier, MD, very
successfully and even have been shown to improve vision after
a leaking area has occurred. Recently, there have been
additional studies to show that Visudyne as well as injectables
into the eye can work in concert with each other. One
draw back to the injection medicines is that they have to
be used several times to halt the process, and in fact even
as often as three to four times a year. These injections
are given in the Eye Care Center office.
Researchers,
in the future, are looking to identify the genetic sequence
for macular degeneration, which hopefully could lead toward
the eventual cure of macular degeneration. We also look
forward to the possibility of transplanting this part of the
eye and also using stem cell transplants as well.
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