Seeing Spots

What is macular degeneration?

Macular degeneration is aging-related changes in the center part of the retina, the macula. The macula is the specialized area of the retina we use to see 20/20 and to see colors. With macular degeneration the center vision is lost, and the patient is only able to see peripherally. The patient does not go blind, but does lose the ability to see fine detail.

How is macular degeneration treated?

There are two types of macular degeneration: wet and dry. Wet macular degeneration happens when blood vessels grow into the macular area and then leak. Dry macular degeneration can turn into wet macular degeneration. When this happens, the retinal specialist will inject a medicine into your eye that hopefully will cause the blood vessels to go away. This may take up to three injections.

What are some signs that dry macular degeneration may be turning into wet macular degeneration?

At this point in time, there is no treatment for mild dry macular degeneration except to monitor your vision, to see if your macular degeneration becomes wet. The best way to monitor this is with an Amsler grid, a square grid pattern with a dot in the center. Hold the grid about 33 centimeters from your nose and look at it with one eye at a time. First, check to see you are able to see all four corners of the entire grid while you are looking at the dot in the center. Then check to see all the lines are straight and all the little squares are square. Repeat with your other eye. Should you notice any waviness of the lines, let your eye doctor know right away.

Can macular degeneration be prevented?

The National Eye Institute (NEI) did an Age Related Eye Disease Study and found nutritional supplements appear to slow the progression from moderate dry macular degeneration to severe macular degeneration. No study has shown any prevention of macular degeneration.

How does diabetes cause blindness?

Diabetes is a disease of the body’s circulatory system. The blood vessels become weakened and then leak. Once the blood vessels are leaky, the retinal tissue is unable to receive oxygen. When the retinal tissue does not receive the oxygen it needs, it sends out a vasoproliferative factor, or VPL factor. The VPL factor promotes growth of new vessels, or neovascularization. These new vessels are very weak and often break, spilling blood inside the eye, known as a vitreous hemorrhage. This blood then interacts with the retina, causing scarring and traction on the retina. The retina then detaches, and this causes loss of vision.

Can diabetes-related blindness be treated? The best thing a patient with diabetes can do is have a yearly dilated eye exam. The first changes that show in the retina from diabetes are dot and blot hemorrhages. Retinal changes from high blood pressure appear as flame-shaped hemorrhages. This is called background diabetic retinopathy. Next, changes indicating the retinal tissue is not receiving oxygen appear. When this happens, the patient needs to see a retinal specialist. The retinal specialist will treat the retina with a laser. This actually destroys some of the retinal tissue. Once the tissue is lasered, it no longer needs oxygen, and will not send out the VPL factor, and then neovascularization will not occur – or, if it has occurred, will hopefully regress.