Question: My vision seems to be changing. I am losing the ability to see fine details and I am afraid I have macular degeneration. Can this be treated?
Dr. Hibberd’s Answer:
Macular degeneration (MD) is an age-related disorder that damages the central area of the retina called the macula, which provides fine detail vision and allows us to see crisp sharp imaging. We need this function to read and drive.
Macular degeneration is caused by damage to the areas around blood vessels of the retina that supply the macula. The disorder is seen with increasing incidence as we age, especially after the age of 60, but may be seen beginning as early as 40 years of age.
Macular degeneration is very hard to notice in its early stages without a professional eye examination. It can be quite disabling if permitted to advance unchecked.
Treatment depends on which type of MD you have — "wet" or "dry." Almost all people with MD start with the dry form of it. This type of MD distorts your central field of vision and usually spares peripheral vision. Yellow deposits appear under the macula when the blood vessels there become brittle and thin. You may see well enough to walk, but as the dry MD advances you will experience progressive loss of fine detail and colors will seem more faded.
Treatment of dry MD consists of combinations of vitamins, antioxidants, and zinc that are believed to retard its progression. The most highly recommended supplements contain: vitamin C (500 mg); vitamin E (400 IU); beta-carotene (15 mg) usually labeled as equivalent to 25,000 IU vitamin A; zinc labeled as zinc oxide (80 mg); copper labeled as cupric oxide (2 mg). These levels are difficult to achieve with diet alone and are recommended for those with MD beyond the early stage. No benefit from taking these combinations was seen in people with early-stage, age-related MD.
Wet MD occurs in only 10 percent of MD cases. Brittle blood vessels break and bleed, and new fragile blood vessels grow, creating a condition called neovascularization. The leaking, bleeding vessels cause macular damage and progressive, irreversible vision loss. Lines will appear wavy and distorted, and there may be an enlarging, nonreversible dark spot in your vision.
I encourage you to seek professional advice about remarkable new treatments that exist. They include revolutionary new medications that aim to slow new blood vessel formation and help preserve vision, as well as selected laser surgery to destroy abnormal blood vessel growth and photodynamic therapy that activates an injected drug to destroy leaking blood vessels.
No definitive prevention strategy for MD exists, but these recommendations may help you avoid it:
• Stop smoking. Smokers have an increased incidence of MD.
• Eat lots of fruits and green leafy vegetables, which contain antioxidants. Antioxidants reduce the risk of developing dry MD.
• Eat fish three times a week. Omega-3 fatty acids may reduce the formation of dry MD. Fish is optimal, though other foods such as nuts also contain omega-3. Remember the balance of omega-3 to omega-6 is important, as is the source of your omega-3.
• Maintain your weight to help combat MD and other diseases that affect vasculature (diabetes, hyperlipidemia, hypertension, cardiovascular disease).
• Seek regular professional eye examinations or a slit lamp evaluation of your retina. A slit lamp is binocular microscope that gives the examiner a three-dimensional view of the eye.
Find more information at the National Eye Institute website.
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